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Psychological & Neuropsychological Testing

Psychological and Neuropsychological Testing is used for a variety of problems for both adults and children.

Psychological testing - This can be used to more clearly diagnosis a patient. The tests are designed to find emotional and personality differences that are not apparent from a regular psychotherapy visit. Some of these tests are in the form of questionaires, others are more open ended questions and still others involve drawings of your emotions.

Neuropsychological Testing can be used for different problems. These range from more accurately diagnosing children and adult learning disabilities, to Attention Deficit Disorder. In addition these tests can also help clarify the extent of a head injury and even evidence of dementia and Alzheimers Disease. These test all the different ways we process information. This includes short and long term memory, spatial relations, math, reading, writing. Some of these tests are timed and you need to respond quickly, while others are untimed. They test for attentional problems, concentration, accuracy, processing speed as well as cognitive dysfunction.

Pediatric Neuropsychology and Testing In this section, parents can find information about what to expect during your child's appointment and evaluation, which includes information on what to bring and how to best prepare your child.

1. What is Pediatric Neuropsychology?

A pediatric neuropsychologist is a licensed psychologist with expertise in how learning, emotions, and behavior are associated with the development of brain structures and systems. Formal testing of abilities such as memory and language skills assesses brain functioning. In addition, emotional difficulties can be assessed. The pediatric neuropsychologist conducts the evaluation, interprets the test results, and makes recommendations to the parents, school (if necessary) and child. After the testing, the neuropsychologist may follow your child over time to adjust recommendations to your child's changing needs. He or she may also provide treatment, such as cognitive rehabilitation, behavior management, or psychotherapy. Often, the neuropsychologist will work closely with a physician to manage the child's problems with medication management if needed, or work closely with schools to help them provide appropriate educational programs for the child.

2. How Does a Neuropsychological Evaluation Differ From a School Psychological Assessment?

School assessments are usually performed to determine whether a child qualifies for special education programs or therapies to enhance school performance. They focus on achievement and skills needed for academic success. Generally, they do not diagnose learning or behavior disorders caused by altered brain function or development.

3. Why Are Children Referred for Neuropsychological Assessment?

Children are referred by a doctor, teacher, school psychologist, or other professional because of one or more problems, such as:

* Difficulty in learning, attention, behavior, socialization, or emotional control;

* A disease or inborn developmental problem that affects the brain in some way; or

* A brain injury from an accident, birth trauma, or other physical stress.

A neuropsychological evaluation assists in better understanding your child's functioning in areas such as memory, attention, perception, coordination, language, and personality. This information will help you and your child's teacher, therapists, and physician provide treatments and interventions for your child that will meet his or her unique needs.

4. What is Assessed?

A typical neuropsychological evaluation of a school-age child may assess these areas:

* General intellect

* Achievement skills, such as reading and math

* Executive skills, such as organization, planning, inhibition, and flexibility

* Attention

* Learning and memory

* Language

* Visual-spatial skills

* Motor coordination

* Behavioral and emotional functioning

* Social skills

Some abilities may be measured in more detail than others, depending on the child's needs. A detailed developmental history and data from the child's teacher may also be obtained. Observing your child to understand his or her motivation, cooperation, and behavior is a very important part of the evaluation.

Emerging skills can be assessed in very young children, though this is more difficult and not always as clear cut. Therefore the evaluation of infants and preschool children is usually shorter in duration.

5. What Will the Results Tell Me About My Child?

By comparing your child's test scores to scores of children of similar ages, the neuropsychologist can create a profile of your child's strengths and weaknesses. The results help those involved in your child's care in a number of ways.

* Testing can explain why your child is having school problems. For example, a child may have difficulty reading because of an attention problem, a language disorder, an auditory processing problem, or a reading disability. Testing also guides the pediatric neuropsychologist's design of interventions to draw upon your child's strengths. The results identify what skills to work on, as well as which strategies to use to help you child.

* Testing can help detect the effects of developmental, neurological, and medical problems, such as epilepsy, autism, attention deficit hyperactivity disorder (ADHD), dyslexia, or a genetic disorder. Testing may be done to obtain a baseline against which to measure the outcome of treatment or the child's development over time.

* Different childhood disorders result in specific patterns of strengths and weaknesses. These profiles of abilities can help identify a child's disorder and the brain areas that are involved. For example, testing can help differentiate between an attention deficit and depression or determine whether a language delay is due to a problem in producing speech, understanding or expressing language, social shyness, autism, or cognitive delay. Your neuropsychologist may work with your physician to combine results from medical tests, brain imaging or blood tests, to diagnose your child's problem.

* Most importantly, testing provides a better understanding of the child's behavior and learning in school, at home, and in the community. The evaluation can guide teachers, therapists, and you to better help your child achieve his or her potential.

6. What Should I Expect?

A neuropsychological evaluation usually includes an interview with parents about the child's history (even obtaining medical or school reports), observation and interaction of the child, and then the testing. Testing involves paper and pencil and hands-on activities, answering questions, and sometimes using a computer. Depending upon the childs age and abilities, the tests can have verbal, writing, reading and listening abilities. Parents may be asked to fill out questionnaires about their child's development and behavior.

Parents are usually not in the room during testing, although they may be present with very young children if needed. The time required depends on the child's age and problem. But usually the testing is done over several visits.

Make sure your child has a good night's sleep before the testing. If your child wears glasses or a hearing aid or any other device, make sure to bring it. If your child has special language needs, please alert the neuropsychologist to these.

If your child is on stimulant medication, such a Ritalin, or other medication, check with the neuropsychologist beforehand about coordinating dosage time with testing. If your child has had previous school testing, an individual education plan, or has related medical records, please bring or send this information and records to the neuropsychologist for review.

What you tell your child about this evaluation depends on how much he or she can understand. Be simple and brief and relate your explanation to a problem that your child knows about such as "trouble with spelling," "problems following directions," or "feeling upset." Reassure a worried child that testing involves no "shots." Tell your child that you are trying to understand his or her problem to make things better. You may also tell the child that "nobody gets every question right," and that the important thing is to "try your best." Your child will probably find the neuropsychological evaluation interesting, and the detailed information that is gathered will contribute to your child's care.

Martin Kluger, Ph.D. © 2010
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