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Purpose and types of neuropsychological assessments

What is a neuropsychological assessment?

A neuropsychological assessment is a performance-based method to assess cognitive functioning. This method is used to examine the cognitive consequences of brain damage, brain disease, and severe mental illness. The type of test used varies depending on what needs to be assessed.

A clinical psychologist carries out neuropsychological assessments. A medical specialist such as a psychiatrist, your GP or an employer might refer you or you may refer yourself. There are a variety of different functions that can be tested with a neuropsychological assessment. You may need to be assessed for whether you are ready to return to work after a serious physical or mental illness. You might need an assessment after a brain injury or to gage the effects of medication or the impact of illegal substances. You might need to be assessed to evaluate whether a diagnosis such as Adult Attention Deficit Disorder (AADD) is appropriate, as a preliminary to a treatment plan.

Areas that can be assessed

  • Attention
  • Calculation – mental maths
  • Executive function – the ability to think strategically, plan, organise and implement
  • Language – ability to express yourself, grasp of vocabulary etc.
  • Memory – short and long-term as well as the ability to remember when distracted
  • Problem solving
  • Speed – processing and psycho motor speed
  • Visuospatial function – the skills that allow us to visually perceive objects and the spatial relationships among objects

How is the neuropsychological assessment conducted?

Typically, a neuropsychological evaluation will begin with a general interview.  You will be asked questions about your symptoms, history and background. Your answers will help the neuropsychologist develop a good understanding of your symptoms.  If a family member or friend comes with you, they will also be asked some questions about your difficulties and concerns.   Next, your companion will be asked to leave and you will undergo written and oral tests.   Neuropsychological tests examine a variety of abilities and skills such as attention and concentration, general intelligence, memory, language, visuoperceptual and visuospatial skills, executive functions (e.g. planning, mental control, problem solving), and mood. Depending on your injury or illness, the assessment may focus on some abilities more than others.

The length of the testing time will depend on your condition (e.g. fatigue, confusion or slowed motor/cognitive speed can extend the time required to complete the assessment), and complexity of the issues to be addressed by the assessment.  Testing is usually completed in 2 hours but can sometimes take up to 8 hours or longer. This would typically occur on the same day but it may occasionally be necessary to complete the tests over two or more sessions.  In general, your neuropsychologist will attempt to obtain your best possible performance under optimal conditions.

The results of the cognitive assessment are normally presented in a report, together with a summary of your more important medical and personal history as well as current problems you are experiencing. During a feedback session, which typically lasts no more than 60 minutes, your neuropsychologist will discuss the results with you, as well as providing recommendations for you and your family and answering your questions and concerns.

 

What are the results used for?

In general, results can be used to:

  •  Understand your current strengths and weaknesses and help to come up with the best treatment plan for your current difficulties, provide information, resources, or recommendations to you and your family.
  • Assist in a differential diagnosis (e.g. to determine if possible cognitive or behavioural changes are related to a particular neurological disorder, depression or treatment)
  • Provide a baseline against which subsequent evaluations can be compared. If you do more cognitive assessments in the future, your neuropsychologist can see how your abilities change over time (e.g. whether your functioning has worsened or improved as a result of treatment, disease progression etc.)
  • -Monitor the effects of interventions to determine if they are working (e.g. people who engage in psychotherapy can show cognitive improvements over time). Repetitive testing over a prolonged period may, therefore, sometimes be needed to determine a pattern of change.
  • Refer you to other professionals who can help you.
  • Help you to make decisions about returning to work or school.
  • Provide information if you are involved in a court case.
  • Document your disability (e.g., social security claims).

 

Common reasons for having a neuropsychological assessment

The following represent common reasons for assessment:

  • Cerebrovascular disease.
  • Epilepsy.
  • Multiple sclerosis.
  • Parkinson’s disease.
  • Alzheimer’s disease.
  • Huntington’s disease.
  • Hydrocephalus, spina bifida.
  • Other neurodegenerative disorders.
  • Brain tumors.
  • Brain infections.
  • When you have an injury that may have affected your brain (e.g. TBI)
  • Cognitive impairment in the context of alcohol or drug abuse.
  • Depression, schizophrenia or other psychiatric conditions that can involve cognitive impairment.
  • Sleep apnea or other conditions that may cause insufficient oxygen and potential memory or other cognitive deficits.
  • Developmental disorders such as autism spectrum disorders.
  • Genetic disorders that may result in cognitive impairment.
  • Unexplained changes in cognitive or daily functioning.

In each of these conditions, there may be damage or potential damage to the brain and the neuropsychologist can help to determine which areas of the brain are not working properly.

How can I prepare for my neuropsychological evaluation?

  • Try to get a good night’s sleep the night before your appointment.
  • Make sure you eat something before you arrive.
  • If you wear hearing aids or eyeglasses, please bring them with you.
  • If questionnaires were mailed to you, complete them and take them with you to your appointment.
  • Bring medical records that are related to your current illness or injures such as brain scan reports or results from previous neuropsychological testing if completed in another hospital or clinic. It is helpful to also bring a current list of all medication and doses.
  • Bring current academic records, if you are in school.
  • If the patient has difficulty providing information about their history, a family member or friend will be needed for part of the clinical interview.

As your neuropsychologist attempts to elicit your best possible performance under optimal conditions, several situations can interfere with this goal:

  • To be excessively tired, fatigued or sleepy.
  • Not motivated.
  • To be under the influence of medications or substances which may interfere with cognitive functioning.
  • To be emotionally distressed.

Please report to your neuropsychologist if you think that any of these issues are likely to interfere with the evaluation.

Patients should not consider the neuropsychological evaluation to be an exam and be worried as a consequence. The tests cannot be passed or failed, they describe how well you perform relative to your peers, your age and other cultural factors .The tests are meant to test your limits, so please don’t be discouraged if they seem difficult.

Psymplicity Healthcare approach

Our clinical psychologist has over 25 years’ experience carrying out assessments and has worked in community, mental health and hospital settings. Therefore you can rely on Psymplicity Healthcare to provide a thorough, expert and in-depth assessment.

 

 

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