Neuropsychology Testing:
A Guide for Patients & Their Family

What Is Clinical Neuropsychology?

Clinical neuropsychology is a specialty doctor that focuses on brain systems, brain functioning, brain-behavior relationships, and how various diseases and injuries of the brain influences emotions, perceptions, behaviors. A PhD Neuropsychologist is speciality doctor and scientist who conducts neuropsychological testing, scoring the data, interpretation of the neuropsychological results and neuropsychological testing profiles.  

A Clinical Neuropsychologist is a licensed Clinical Psychologist with additional years of education, training, and expertise and specialization in the brain and brain functional systems.  A Neuropsychologist evaluates the patients patterns of behaviors, cognition, emotion, personality, and other brain functions (e.g. attention, concentration, working memory, learning, storage of memory, motor skills, praxis, proprioception, perception, expressive and receptive language abilities, speech, visuospatial functions, judgement, reasoning, decision making,  and etc )  are related to brain structures and brain systems. 

Clinical Neuropsychology, Brain Functions are Evaluated by Using Scientific Objective Tests and Measurements. 

A very detailed assessment of abilities is conducted; and the assessment also takes into account factors such as depression, anxiety, genetic or familial aspects, medications, and the pattern of strengths and weaknesses in brain functioning. It is important that the Neuropsychologist also explore not only the type and extent of brain neuropsychological systems currently but also historically. A scientific evaluation collects data from multiple data points: For example, clinical interview with patient, and significant other(s), medical records and medical history, clinical observations, occupational and school history.

The neuropsychological evaluation utilizes the testing and its results to identify the root causes of difficulties: and is also used in important healthcare areas such as diagnoses, and treatment planning.   The Clinical Neuropsychologist conducts evaluation and makes recommendations.  The Clinical Neuropsychologist may also provide treatments: Such as,  cognitive rehabilitation, neuro-rehabilitation, behavior management, and psychotherapies. 

Why Have I Been Referred for a Neuropsychological Testing

Neuropsychological evaluations are requested specifically to help your doctors and other professionals understand how the different areas and systems of the brain are working.   Testing is usually recommended when there are symptoms or complaints, for example: behavioral changes, emotional changes, personality changes, memory or thinking changes.   This may be signaled by a change in concentration, organization, reasoning, memory, language, perception, coordination, or personality.  The change may be due to any of a number of medical, neurological, psychological, medication, or genetic causes.  Neuropsychological testing will be helpful in understanding your specific situation.

What Is Assessed during Neuropsychological Testing

• Intellectual abilities
• Higher level executive skills (e.g. sequencing, reasoning, problem-solving, logic analyses, motivational systems, consequences)
• Attention and concentration (simple and complex)
• Neurological hard signs and neurological soft signs
• Learning:  visual learning,  verbal learning,  motor learning
• Memory: Visual memory, verbal memory, motor memory. 
• Working memory, short term memory, long-term memory, implicit memory, explicit memory.
• Language: expressive and receptive verbal language  AND  Non-verbal expressive and receptive language: facial affect, behavioral gestures, prosody
• Visual spatial skills
• Perceptual abilities
• Motor and sensory skills
• Mood and emotions
• Personality

Note:  some abilities may be measured in more detail than others depending upon your performance during the neuropsychological evaluation and your needs.

How Are Neuropsychological Test Scores used to Understand Your Specific Situation

Your neuropsychological test scores will be compared to scores from people who are like you in important ways. By using database scores from large groups of healthy people for comparison the neuropsychologist can judge whether or not your scores are normal for your age and educational background.  *** The patterns of your own neuropsychological test scores (your neuropsychological profile) will also be reviewed to estimate whether or not there have been a changes in  your specific  abilities relative to your other brain abilities. Your own neuropsychological performance is also evaluated for strengths and weaknesses relative to all of your brain (neuropsychological) systems. 

How you go about solving the various problems and answering questions during the neuropsychological evaluation will also be evaluated.   Using scientific methods, your neuropsychological strengths and weaknesses can be identified.  

What will the Neuropsychological Testing Results Reveal

Your neuropsychological profile can be used to understand your situation in a number of ways.

• Neuropsychology can identify weaknesses in specific areas  For example, it is very sensitive to mild memory and thinking problems that might not be obvious in other ways.  When problems are very mild, testing may be the only way to detect them.  For example, testing can help determine whether memory changes are normal age related changes or if they were affected neurological disorder. Testing might also be used to identify problems related to medical conditions that can affect memory and thinking, such as dementia, diabetes, stroke, metabolic, infectious diseases, cancers, alcoholism, brain tumors, brain concussion, medications, and et cetera.

• The neuropsychological test results can also be used to help differentiate among illnesses, which is important because appropriate treatment depends on accurate diagnosis. Different illnesses evaluated early enough result in different neuropsychological patterns of strengths and weaknesses on testing. Therefore, the results can be helpful in determining which areas of the brain might be involved and what illness might be operating.  For example, testing can help differentiate among Alzheimer’s, stroke, and depression.  Your neuropsychologist will use for example, clinical reports, neuropsychological profile, along with the results of other tests such as brain imaging and blood tests to come to the most scientific informed diagnosis possible. 

• Sometimes neuropsychological testing is used to establish a “baseline” or document person’s skills before there is any problem.  In this way later changes can be measured longitudinally and very objectively. A “neuropsychological autopsy” is also evaluated when there is no baseline available.   

• Test results can be used to plan treatments that use strengths to compensate for weaknesses.  The results help to identify what target problems to work on and which strategies to use.  For example, the results can help to plan and monitor neurorehabilitation or to follow the recovery skills after a stroke or a traumatic brain injury. 

• Neuropsychological studies have shown how scores on specific tests relate to every day functional skills; such as, managing money,  driving,  a readiness to return to work, capacity and competency.  Your results will help your doctors understand what problems you may have in everyday life.  This will help guide planning for assistance or treatment.

What Should You Expect during Neuropsychological Testing

A neuropsychological evaluation consists of a very detailed interview and the neuropsychological testing.  During the interview, information that is important for the neuropsychologist to consider will be reviewed.  You will be asked about your symptoms, medical history, medications, and other important factors. Your significant others will also be interviewed so they can report on their observations of you in daily life activities. Neuropsychological testing is scientifically evidence based. 

Neuropsychological Testing involves multifactorial Stimuli:  such as visual, auditory, verbal, motor, perceptual, tactile. It can range from paper and pencil to computerized test and answering questions.  The time required depends on the problem being assessed.  In general several hours to a half day to a full day needed to assess the many and varied brain skills involved and how the brain is processing information.   Some tests may be easy while others will be more complex. 

The most important thing is to try your best.  Bring glasses or hearing aids if you use them.  Try to rest and relax before your evaluation.  If you are taking any prescribed medications or over the counter (OTC) products, please inform in advance  You will probably find testing is interesting and the detailed information that is gathered will contribute to your care.  

Here is a partial list of  Concerns that Warrant Neuropsychological Testing: 

ADD and ADHD
Traumas of any kind including but not limited to PTSD
Behavioral problems
Emotional problems
Cognitive problems
Memory problems
Learning difficulties
Autism Spectrum Signs
Drug Addictions and Drug Withdrawals
Medication interactions on the Brain
Psychiatric drugs
Vaccines
Head injury and Concussions
Alzheimer’s and other Dementias: 
MCI 
Diabetes
Primary Brain Tumors
Secondary Metastatic Brain Tumors
Vascular Disorders
Cerebral Vascular Accident ~ Stroke
Heart attack ~ MI
Chronic Brain Inflammation
Delirium
Depression
Bipolar disorders
Schizophrenia and other psychoses
Sexually transmitted diseases:  HSV, HIV, AIDS, Syphilis
Seizures
Epilepsy

Any questions? Please schedule an appointment through the website Contact page. I invite you to a Consultation for Neuropsychology Testing.

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Thank you.

Warmly,

Dr. Shawna Freshwater
Licensed Clinical Psychologist
Neuropsychologist