A neuropsychologist is a licensed, clinical psychologist who has extensive, specialized training in neuroanatomy, neuropathology, and evaluation in order to in order to assess how brain systems affect learning, behavior, and development. A neuropsychologist has an advanced degree in psychology, known as a Ph.D. (Doctorate of Philosophy) or Psy.D. (Doctorate of Psychology). A neuropsychologist usually works with therapists, psychiatrists, neurologists, neurosurgeons, physiatrists and other medical specialists as a team to coordinate a patient’s care.
Without a doubt. Adults who have never been diagnosed properly for their ADHD symptoms have lived for years wondering why they frequently seem to “miss the mark,” to play “catch up” almost daily, or to have a nagging sense that they are not living up to their potential. Many people think that ADHD is a “child’s disorder,” so it’s not until a child is diagnosed with ADHD that the parent realizes personal symptoms of ADHD as well. They find that they have used compensation strategies their entire life which partly masked their symptoms. Others suffered silently by continually encouraging themselves to “try harder.” Research reveals that ADHD is genetically inherited in about 80% of cases, so when one family member is diagnosed, you may want to look for symptoms of ADHD in other family members.
The questions below outline some of the components of the three core symptoms of ADHD: inattention, hyperactivity and impulsivity. Even people who do not have ADHD can occasionally demonstrate inattention, hyperactivity or impulsivity, but people with ADHD will demonstrate more of these behaviors, consistently, over time.
Do you find that you frequently “wander off” mentally, especially during meetings, lectures, or conversations?
Are you frequently distracted by irrelevant sights or sounds?
Do you find yourself missing details or making careless mistakes?
Do you have difficulty following instructions?
Do you find yourself losing or forgetting things often?
Are you always moving your hands or feet while in your chair?
Do you tap your pencil or your feet?
Do you regularly play with your hair or clothing?
Do you consciously resist fidgeting or squirming?
Is it difficult to sit through a movie or lecture?
Do you often take action before you consider the possible consequences?
In conversation, do you interrupt others? Do you blurt out inappropriate comments?
Do you experience difficulty waiting in line or for your turn?
Although losing consciousness is a common symptom of a concussion, it’s very possible to suffer a concussion without losing consciousness. A concussion occurs when there is a physical blow to the body or head causing an injury to your brain.
The brain floats within the skull surrounded by fluid, which cushions it and prevents it from bumping into our hard skulls with every movement of the head. But the fluid may not be able to absorb the force of a sudden blow or a quick stop. In these situations the brain may slide forcefully against the inner wall of the skull. More serious injuries to the brain include bruising and swelling of the brain (contusion), a broken skull bone (skull fracture), and blood that collects in or around the brain (hematoma).
Every concussion should be taken seriously. Although not usually life-threatening, concussions can have serious effects. Most people with mild injuries recover fully, but the healing process takes time.
We accept Aetna, Medicare, Blue Cross Blue Shield, Cigna, United Healthcare (including Optum and UMR), and Humana. You may also file for out-of-network reimbursement, if you have such coverage as part of your insurance plan. We have seen reimbursement for out-of-network range from 0% to 70% depending on the insurance carrier. Sometimes insurance carriers require a referral, please have the referring physician send over a referral to our office. We do not accept insurance for FAA appointments as they are not billable and considered a fit for duty exams.
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. We’d love to help you explain this evaluation to your child in a simple way so please feel free to print out a handout specifically designed to help you explain the evaluation to your child.
If you have a broken arm or a bad cold, you go to the doctor for help and to feel better, right? Well, sometimes kids and adults have problems that can’t be seen as easily as a broken bone or a runny nose. When people have troubles with their feelings, the way they act, or the way they learn in school, sometimes they see a psychologist. These are people who have gone to school for special training in the way people think and feel and know how to help people feel better. A neuropsychologist is a special kind of psychologist—it’s easy to say if you break down the syllables: new-row-sigh-call-o-gist. A neuropsychologist has special training in order to tell how your brain affects your learning, behavior, emotions, and thinking.
A a neuropsychologist knows a lot about kid stuff, like how kids think, how they grow up, and how they see the world. She helps kids and parents figure out what is causing the problems at school or at home so they can feel better and be the best they can be.
Download PDF “Why Am I Going to See a Neuropsychologist?”
There are many reasons to see a neuropsychologist, but the biggest reason is so that you can start feeling better and doing things better. Maybe you’re having trouble getting along with your classmates, your brothers or sisters, or your mom or dad. Or maybe you’re having problems learning or paying attention in class, or your homework and your grades aren’t as good as your mom or dad thinks they could be. Maybe you have trouble remembering things so you forget a lot. Other reasons to go see a neuropsychologist could be that you’re very shy and have trouble making friends or that you feel sad, afraid, or anxious a lot. These are all examples of the types of problems that cause someone to go see a neuropsychologist
During an appointment, you won’t be examined on a table like you are at a typical doctor visit. You’ll sit in a chair and talk, complete tasks that may seem like a game or brain teaser, and sometimes draw pictures. There are no needles or shots. If you’re having problems with schoolwork, a neuropsychologist may ask you to answer some questions or solve different types of puzzles. You will have the chance to talk about how you feel and what things bother you or make you happy. You may perform tasks on a computer or with pencil and paper. Sometimes you will do work similar to the work you do in school. Some tasks will be easy for you and some may be more challenging.
At your appointment, your mom, dad, grandparent or guardian might come in with you, or the neuropsychologist may have a private adult talk first. Afterward, the person who brought you will wait for you to finish. Depending on why you are coming to see the neuropsychologist, you may spend time with her for only one visit, or you may come see her several times across 2-4 days. You can choose to tell people that you are going to see a neuropsychologist, or you can decide not to share this information. Who you tell, or if you tell, is your decision.
Clinical Neuropsychology is the study of brain-behavior relationships for the purpose of identifying and explaining abilities and disabilities that might affect a person’s behavior, learning, work performance, and/or daily functioning.
A neuropsychological evaluation is a comprehensive evaluation that studies how the brain “works” or functions. What makes an assessment “neuropsychological” is not the tests used, but the training of the doctor who performs the evaluation. These evaluations identify inefficiencies in brain functioning which contribute to attention, memory, language, motor, thinking, and learning difficulties. Neuropsychological evaluation involves assessing and understanding one’s overall functioning using noninvasive, comprehensive, clinical methods.
The evaluation helps to identify a person’s neurocognitive strengths and weaknesses and explain how these impact the individual in:
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 involving memory and thinking. 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, or genetic causes, or a result of head injury. Testing will be helpful in understanding your current situation.
- General intellect
- Higher level executive skills (e.g., sequencing, reasoning, problem solving)
- Attention and concentration
- Learning and memory
- Visual-spatial skills (e.g., perception)
- Motor and sensory skills
- Mood and personality
- Some abilities may be measured in more detail than others, depending on your needs and/or the referral question
Your test scores will be compared to scores from people who are like you in important ways. By using a database of 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 pattern of your own test scores will also be reviewed to estimate whether or not there have been changes in certain abilities. How you go about solving the various problems and answering questions during the examination will also be noted. Using these methods, your strengths and weaknesses can be identified.
Test results can be used to understand your situation in a number of ways:
- Testing can identify weaknesses in specific areas. 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 reflect a neurological disorder. Testing might also be used to identify problems related to medical conditions that can affect memory and thinking, such as diabetes, metabolic or infectious diseases, or alcoholism.
- Test results can also be used to help differentiate among illnesses, which is important because appropriate treatment depends on accurate diagnosis. Different illnesses result in different 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 instance, testing can help to differentiate between Alzheimer’s disease, stroke, and depression. Your physician will use this information along with the results of other tests, to come to the most informed diagnosis possible.
- Sometimes testing is used to establish a “baseline,” or document a person’s skills before there is any problem. In this way, later changes can be measured very objectively.
- Test results can be used to plan treatments that utilize 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 rehabilitation or to follow the recovery of skills after a stroke or traumatic brain injury.
- Studies have shown how scores on specific tests relate to everyday functional skills, such as managing money, driving, or readiness to return to work. Your results will help your doctors understand what problems youmay have in everyday life. This will help planning for assistance or treatment.
The neurological evaluation generally involves examination of the basic motor and sensory functions (strength, reflexes, sensitivity to touch, and coordination) and of basic thinking skills including functional communication (speech and language), orientation to person, place, time and circumstances, simple memory functions, and an ability to follow basic commands.
The most sensitive indicators of head injury, learning disabilities, etc., are often deficits in subtle and complex cognitive and behavioral functions, and it is these functions that are assessed in a neuropsychological evaluation. Particularly sensitive to the evaluation is the measurement of cognitive domains and social-emotional functions. These involve the following areas: Intellectual ability, language functions, attentional and concentration skills, motor skills, sensory perceptual skills, auditory perception skills, verbal memory skills, visual perceptual skills, visual memory skills, executive functions, achievement abilities, as well as social-emotional levels. Unlike the neurological evaluation, the neuropsychological assessment taps these areas of cognitive functioning levels in depth using standardized objective systematic tests. The performance of the patient is then analyzed using both normative and individual comparison standards for measuring the relative strengths and weaknesses of cognitive and social-emotional systems
The psychological assessment focuses on social-emotional issues whereas the neuropsychological assessment tests both cognitive and social-emotional areas. Neuropsychological assessments are routinely ordered on adults who have thinking problems, attentional and memory disturbances, and other suspected or documented learning problems. Therefore, it is very important to determine whether there is a deficit or compromise of cognitive and social-emotional levels in order to assist with appropriate treatment planning.
Each assessment is tailored to the individual since the reasons for assessment will vary. A specific “core” of tests will be administered with additional tests being performed depending on the referral question and/or compromises seen during the assessment. The tests will identify the areas of strengths and weaknesses and will allow for more specific treatment planning. Generally, adults will complete the assessment in 3 to 5 hours.
A neuropsychological evaluation usually consists of an interview and testing. During the interview, you will be asked about your symptoms, educational, work and medical histories, medications, and other important factors. Testing involves taking pencil-and-paper or computerized tests and answering questions. The time required depends on the problem being assessed. In general, several hours are needed to assess the many skills involved in processing information. Some tests will be easy while others will be more complex. The most important thing is to try your best. You will probably find testing interesting, and the detailed information that is gathered will contribute to your care.
Please bring your completed intake forms, also bring any copies of previous assessments, educational records, and neurological/psychiatric records for background information purposes. These materials will not change the neuropsychological test data, but will provide a background context for the referral question(s). Please bring your glasses or a hearing aid if applicable. Remember to eat breakfast prior to the time of the assessment and wear comfortable clothes. An hour for lunch is taken and breaks are provided as needed.
A clinical interview is scheduled with you before the assessment begins to discuss the presenting situation and relevant background information. At that time, all medical/educational records are collected for review, including the information packet you and/or a significant other were asked to complete.
After the assessment is completed, records are reviewed, test data is scored and interpreted, and a written report is compiled. A feedback session will be scheduled to discuss the test results, usually within 10-15 working days of assessment.
Age-appropriate tests are used for so that an individuals ages 4 years and older can be evaluated.
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 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.
- 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.
- The neuropsychologist may collaborate with your child’s physician to combine results from medical tests, such as brain imaging or blood tests, to help diagnose your child.
- Most importantly, testing provides a better understanding of your 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.
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. For more information, see the American Psychological Association’s (APA) Division 40 (Clinical Neuropsychology) at www.div40.org.
A neuropsychological evaluation usually includes an interview with parents about the child’s history, observation of an interview with the child, and testing. Testing involves paper and pencil and hands-on activities, answering questions, and sometimes using a computer. 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. The time required depends on the child’s age and the referral question.
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 any 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.
Dr. Johnson is certified to perform FAA-related cognitive and substance abuse evaluations required for pilots and air traffic controllers. Please refer to your specific letter from the FAA to determine your individual requirements. The following are some of the common types of evaluation requirements for general information:
- Substance Abuse/Dependence
- ADD/ADHD/History of Stimulant Medication
- Anxiety/Depresssion/SSRI Use
- HIV+ Cognitive Evaluation
- Neuropsychological Evaluation