Neuropsychology is a subspecialty of psychology that focuses on the study and application of brain-behavior relationships. That is, neuropsychologists are not only interested in the behaviors that can be observed or specific diagnoses given to an individual, but also how brain functioning and processes contribute to areas of weaknesses in order to provide specific recommendations. Neuropsychological evaluations are often conducted in the context of an individual with a complex/chronic medical condition in order to document the impact of brain abnormalities, damage, or dysfunction.
A pediatric neuropsychologist is a licensed psychologist who has additional training in brain development, brain structures and systems, and neurological conditions that impact brain functioning. Specialized training in neuropsychology is obtained through graduate course work and a two-year post-doctoral fellowship in neuropsychology.
Differences between Neuropsychological Evaluations and Psychoeducational or Psychological Evaluations
One of the primary goals of a neuropsychological evaluation is to understand an individual’s strengths and weaknesses through a comprehensive testing battery. These batteries include tests that are selected based on the referral question, areas of weakness expressed by the family or medical provider, and medical history. Test results help to inform diagnosis and treatment recommendations. Typically, neuropsychological evaluations are recommended for children and adolescents with a history of complex and/or chronic medical condition (e.g., seizure disorder, cancer, brain tumor, congenital heart defect, concussion, genetic disorder) or those who have required treatment that has impacted thinking, learning, and behaviors. In contrast, a psychoeducational evaluation is often completed to determine whether a child would benefit from educational accommodations or supports. A psychological evaluation may or may not include cognitive testing but may be more focused on identifying whether or not a child is demonstrating symptoms of anxiety, depression, an attention disorder, or related issues that can impact learning or well-being.
Referrals for a Neuropsychological Evaluation
Individuals may be referred for a full neuropsychological evaluation for a variety of reasons. For example:
- My child was treated for leukemia/brain tumor. A neuropsychological evaluation was requested to assess current levels of cognitive functioning and to monitor long-term outcomes of treatment. A neuropsychological evaluation may be completed up to 10 years post-treatment to monitor late effects.
- My child was born with a congenital heart defect (CHD) such as Tetralogy of Fallot. A neuropsychological evaluation was recommended due to concerns with attention and/or to establish her current level of functioning.
- My child had a brain injury due to a stroke. I am concerned about his learning and behaviors.
Components of a Neuropsychological Evaluation
While the specific aspects of the evaluation will vary depending on the presenting concern and the age of the child, neuropsychological evaluations typically assesses the person’s intellectual abilities, attention, executive functioning, memory, language, visual spatial skills, motor skills, social-emotional functioning, and adaptive behaviors.
What to Expect at a Neuropsychological Evaluation
A neuropsychological evaluation consists of multiple steps to a comprehensive evaluation:
- Parent and child intake/interview at the beginning of the evaluation day or on a previously scheduled day. This is completed to obtain information about the child’s developmental, medical, educational, social, and psychological history.
- Neuropsychological testing may be completed on the same day as the intake/interview or on a separately scheduled day. Assessment consists of one-on-one testing with the neuropsychologist to measure domains of cognitive, social-emotional, and academic functioning.
- Feedback session is scheduled after the one-on-one testing session, approximately 1-2 weeks after the evaluation to discuss the results and recommendations.
- Written report describing the results of the evaluation, any diagnoses, and recommendations are provided to the family.