Pediatric and Adult Neuropsychological Evaluations
Neuropsychological evaluations are requested as part of a comprehensive medical evaluation to assess whether different areas and systems of the brain are functioning properly, or whether deficits present are part of neurological disorders. Testing is usually recommended when the symptoms or complaints involve memory or thinking. This may be signaled by a change in concentration, organization, reasoning, memory, language, perception, coordination, or personality. Neuropsychological evaluations are helpful in differential diagnoses of disorders and is frequently part of the evaluation of problems such as: Memory loss Dementia – Alzheimer’s disease, vascular and other types Traumatic Brain Injury, ADHD, Cognitive Disorders, Stroke, Dementia associated with Parkinson's disease, and other medical conditions.
Children with developmental delays or autism spectrum disorders often require specific assessment procedures to make accurate diagnoses and identify the best treatment approaches. APG of Texoma has specially trained professionals with extensive experience in assessing such disorders as: Autism Spectrum Disorder, Intellectual Disability, Language Disorders, Neurodevelopmental Disorders, and Learning Disorders.
Other Services Provided
- Developmental Assessments for non-verbal children
- Determination of Mental Retardation (DMR/IDD) Evaluations
- Placement Evaluations for juvenile offenders
- Contracted with Region 3 (State of Texas) for Child Protective Services Psychological Evaluations
- Pre-Surgical evaluations for gastric sleeve/bypass, Spinal Simulator, and Deep Brain Simulator
What Neuropsychological Evaluations Are?
A neuropsychological evaluation is used to discover your child’s strengths and weaknesses as a learner. It can determine if the way your child’s brain functions effects his/her ability to learn. Neuropsychological evaluations are far more comprehensive than the evaluations typically given by school psychologists. School evaluations, officially known as psycho-educational evaluations, are free. They can help determine whether your child has a learning disability and is eligible for special education services.
What is Neuropsychology?
Neuropsychology is concerned with relationships between the brain and behavior. Neuropsychologists conduct evaluations to characterize behavioral and cognitive changes resulting from central nervous system disease or injury, like Parkinson’s disease or another movement disorder. Some neuropsychologists also focus on remediation of or adaptation to these behavioral and mental changes and other symptoms.
What is an adult neuropsychological evaluation?
Neuropsychological evaluation is an assessment of how one’s brain
functions, which indirectly yields information about the structural and
functional integrity of your brain. The neuropsychological evaluation
involves an interview and the administration of tests. The tests are typically
pencil and paper type tests. Some tasks might be self-reports meaning that
they are completed by the patient with assistance from a technician, but the
majority of the tests require administration by a neuropsychologist or
trained, skilled psychometrist.
Neuropsychological tests (unlike bedside cognitive and behavioral
neurologic screens) are standardized, meaning that they are given in the
same manner to all patients and scored in a similar manner time after time.
An individual’s scores on tests are interpreted by comparing their score to
that of healthy individuals of a similar demographic background (i.e., of
similar age, education, gender, and/or ethnic background) and to expected
levels of functioning. In this way, a neuropsychologist can determine
whether one’s performance on any given task represents a strength or
weakness. Although individual scores are important, the neuropsychologist
looks at all of the data from the evaluation to determine a pattern of
cognitive strengths and weaknesses and, in turn, to understand more about
how the brain is functioning.
Neuropsychological tests evaluate functioning in a number of areas
including: intelligence, executive functions (such as planning, abstraction,
conceptualization), attention, memory, language, perception, sensorimotor
functions, motivation, mood state and emotion, quality of life, and
personality styles. The areas addressed in an individual’s evaluation are
determined by the referral question (what the referring doctor and patient
wants to know), patient’s complaints and symptoms, and observations
made during interview and test administration.
How long does a neuropsychological evaluation take?
A complete evaluation generally takes between two and five hours to
complete, but can take up to eight hours, depending on the complexity of
the issues to be addressed by the evaluation and the patient’s condition
(for example, fatigue, confusion, and motor slowing can extend the time
required for an evaluation). Occasionally, it is necessary to complete the
evaluation over two or more sessions. In general, the clinician attempts to
elicit the patient’s best possible performance under optimal conditions.
Why has a neuropsychological evaluation been recommended?
Neuropsychological evaluation documents patterns of strengths and
weakness among cognitive and behavioral functions. For patients with
Parkinson’s disease or another movement disorder, an evaluation and
interpretation of this pattern of strengths and weaknesses can:
- Assist in a differential diagnosis (e.g., to determine whether possible
mental and behavioral changes are related to the movement disorder,
depression, another brain disease or treatment);
- Assist with evaluation before and after functional neurosurgical
procedures (e.g., deep brain stimulation) to help determine if a given
treatment is appropriate for a particular person and whether treatment has had any positive or negative effects on mental functions and behavior;
- Provide a baseline against which subsequent evaluations can be
compared. Thereby your doctors can decide whether your functioning
has declined because of the disease process or document whether
your functioning has worsened or improved as a result of treatment
(e.g. medications or DBS);
- Reveal areas of daily functioning (e.g., financial management) with
which the patient may need assistance indicate rehabilitation
potential. For example, will the individual benefit from certain
cognitive or behavioral treatments, occupational therapy, or
Is there any way to prepare for a neuropsychological evaluation?
These are not tests that one can study for, but there are several things that
one can do to facilitate the evaluation:
- The patient should bring a current list of ALL medications and doses
(because medicines may change frequently for some persons, it is
important to make sure the list is up to date)
- If the patient has difficulty providing information about their history, it is helpful for a family member or friend to accompany them (for at
least part of the clinical interview).
- It is helpful if the patient can provide records of previous neurodiagnostic testing (e.g., brain scans such as CT or MRI scans) and/or results from previous neuropsychological evaluations if completed at another hospital or institution.
It is the goal of the neuropsychologist to get the best possible picture of the
patient’s current functioning. Several things can interfere with this goal such as if the patient is:
- Excessively tired or fatigued or has sudden, unexpected “sleep attacks”;
- Not motivated to put forth their best effort;
- Very emotionally distraught or has a severe psychiatric condition;
- Under the influence of medications or illicit substances which interfere with cognitive functioning;
- Experiencing frequent changes in the ability to move.
Patients should let the examiner know if they anticipate that any of these issues are likely to interfere with the evaluation.
It is important to get a good night’s rest before evaluation. Patients who live
far away might consider spending the evening prior to the evaluation at a
local hotel or with friends or family rather than getting up and driving or
flying most of the night to get to the appointment. Patients are encouraged
not to consume any alcohol 24 hours prior to the evaluation. If taking sleep
medicine, patients should check with their doctor whether it might affect
test performance the next day.
Patients should not worry about whether they will “pass” the tests. The
tests cannot be passed or failed; instead they describe how well a person
performs relative to peers.