Two different moms have contacted me about neuropsychological evaluations in the last couple of days…so I started thinking about when it’s appropriate to seek a neuropsychological evaluation and when other assessments or approaches will work.

First you have to know what a neuropsychologist does. This specialization combines the fields of psychology and neurology. Neuropsychologists are generally called upon to do in-depth testing of the cognitive function of people who have neurological impairments of some sort, like brain damage or an organic brain disease. The field of neuropsychology (especially cognitive neuropsychology) is relatively young, especially as it’s applied to people who do not have brain injuries, but have what could be considered mental illnesses instead (autism, ADHD, Tourettes, trauma).

A neuropsychological evaluation differs from an educational psychological evaluation, or the testing typically done by a school psychologist. In some instances the tests are the same, but the neuropsychologist evaluates the results from a background of brain structure and function.

A neuropsychologist differs from a neurologist as well. An neurologist is an MD, where a neuropsychologist generally has a PhD in psychology. Neurologists (or psychiatrists for that matter) rarely do the psychometric testing that psychologists do. For many of our children who do not have readily-apparent traumatic brain injuries, neurologists rarely find anything. They use tools like MRIs or EEGs and can detect structure damage (and seizure activity) within in the brain. But those tools often don’t find, and definitely do not define, the cognitive impairments that many of our special children have.

Many physicians may ask for a neuropsychological evaluation to help determine cognitive functioning levels (things like long term memory, working memory and attention), especially when especially when brain injuries or diseases are known.

But more often, children are referred to neuropsychologist when other fields of psychology can not figure out what’s going on…in other words, either they did not get a clear enough picture from their assessments, or the interventions that have been attempted are not working. This can happen both in a clinical setting (therapies) or in a school setting (special education interventions.). In these instances, the neuropsychologist’s in-depth evaluations often better define the areas of disability as it relates to learning and functioning.

When a doctor refers the child to a neuropsychologist, most generally insurance will pay. But it will not likely pay for a child who is referred by a therapist or school system, or just taken to the neuropsychologist by his/her parents.

LuLu has undergone two neuropsychological evaluations. They do require quite a bit of time. One was 6 hours and the other was nearly 4. In each instance we got more in-depth information than we had received through school psychological evaluations. And each time it was confirmed that her language, sensory, auditory and visual processing impairments were significant.

We obtained good information from both evaluations. We paid for the first one out-of-pocket (very expensive) and the second was paid for by the school system after we disagreed with their school psychological evaluation.

So, does your child need this? It depends. A neuropsychological evaluation is a good idea if you suspect that your child has learning disabilities or challenges that no one has yet adequately identified. It’s also a good thing if you know of the disabilities but don’t know the extent to which it affects your child’s ability to learn.

The problem, when hiring a neuropsychologist to evaluate a child who has been traumatized, or one coming from an orphanage background is that unless the professional has experience with our population of children, he/she may misinterpret test results. While the standardized testing psychologists do is valuable, there are not statistical samples of post-institutionalized or abused/traumatized children. So the people interpreting the tests need to be familiar with the impact that these issues can have upon the child’s brain development, and subsequently upon the testing results.

Wanna learn more:

What does my child need: neuropsychological or psycho-educational assessment?

What is a Neuropsychologist?