Neuropsychology studies brain function and its relationship to behavior. It seeks to apply this knowledge through evaluation, treatment, and rehabilitation of those individuals with suspected or documented neurological problems (e.g., TBI, stroke, dementia, and demyelinating disorders, to name a few). Neuropsychological assessment might be best explained as a blend of neurological and psychological measures involving various brain regions. Initially, the major focus of neuropsychology had been mainly diagnostic and primarily concerned with relationships between the localization of brain injury and subsequent cognitive/behavioral alterations. More recently, the primary goal is to determine an individual’s strengths and weaknesses and overall functional adaptation and capabilities.
Reason an individual is referred for a neuropsychological assessment:
· To assist in childhood, adult, and geriatric adult neurobehavioral conditions.
· To establish a baseline of function in determining the course of cerebral dysfunction.
· To help estimate the contribution of personality and mood to the patient’s symptoms.
· To help predict the patient’s short and long term prognosis.
· To assist with planning remedial and vocational interventions.
Purpose of neuropsychological assessment:
· To describe the degree of cognitive impairments and explain the reasons for their existence.
· To measure behavioral impairments that result from brain injury.
· To establish a baseline of function that allows for comparisons over time.
· To provide a plan for cognitive and behavioral rehabilitation treatment.
· To guide the planning and development of remedial education or vocational rehabilitation.
· To calculate the individual’s ability to resume his/her premorbid lifestyle.
· To provide documentation for litigation concerned with the functional impact of brain injury on cognitive and interpersonal behavior.
Components of a neuropsychological assessment:
· History – obtained by the interview with the patient and family and a thorough record review.
· Observations – taken from the interview and testing phases.
· Testing – measures that provide an in-depth picture of the patient’s cognitive and behavioral functions.
· Report – a detailed summary of all information; findings shape specific recommendations that address the patient’s intellectual, behavioral/psychological, psychosocial, education, and vocational needs.
· Exit Conference – the patient, family members, and other involved parties are invited to meet with the neuropsychologist to review the test findings and recommendations.
· Follow-up – medical professions ensure the timely implementation of rehabilitative care and/or re-evaluation based upon the treatment plan outlined in the reports recommendations.
Areas evaluated in a neuropsychological assessment:
· Intelligence
· Language skills
· Attention/concentration (auditory/visual)
· Memory (auditory, visual, tactile)
· Sensory and perceptual functions
· Visuospatial abilities
· Motor skills
· Problem-solving (verbal and non-verbal)
· Abstract reasoning
· Cognitive flexibility
· Sequencing and thought organization abilities
· Information processing speed
· Personality and mood
· Academic achievement
· Executive functions
Factors influencing ecological validity of neuropsychological test data:
· History of injury
· Complaints of patient
· Complaints of family, friends, significant others
· Academic/vocational records
· Medical records
· Neurodiagnostic tests
· Behavioral observations
· Neuropsychological testing
In summary, neuropsychological assessment of individuals with suspected or documented neurological and brain disorders is of the utmost importance in a variety of clinical settings. With access to comprehensive and valid neuropsychological test results, the neuropsychologist assists the patient, family, physicians, allied healthcare professionals, and attorneys in determining an accurate diagnosis and in establishing practical treatment recommendations to maximize an individual’s level of functional adaptation and adjustment.
For additional information or to schedule a consultation, please contact our office at 732-988-3441.
Michael J. Raymond, Ph.D., ABN, FACPN
Board Certified Neuropsychologist #232
Licensed Psychologist #35S100252900