Frequently Asked Questions

• Traumatic Brain Injury
• Neurological conditions including stroke, epilepsy, brain tumors, multiple sclerosis (MS), Alzheimer’s disease, Parkinson’s disease, etc.
• Medical conditions such as liver disease, Lupus, HIV infection, or cardiac disease
• Learning and Developmental Disorders
• Attention-Deficit Disorders
• Various psychiatric conditions
• Suspected memory problems or dementia

A complete evaluation generally takes between two and six hours to complete, but can take longer depending on the complexity of the issues to be addressed by the evaluation and the patient’s condition (for example, fatigue, confusion, and motor slowing can extend the time required for an evaluation). Occasionally, it is necessary to complete the evaluation over two or more sessions. In general, the clinician attempts to elicit the patient’s best possible performance under optimal conditions.

• Rehabilitation issues
• Ability to return to work
• Ability to function independently
• Tracking of changes in functioning over time
• Educational and vocational planning

1. Test results can be used to plan treatments that use strengths to compensate for weaknesses.  The results help to identify 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 head injury.
2. Scores on specific tests have a relationship to everyday functional skills such as the level of care or supervision required, managing medication regimens, managing money, driving, or readiness to return to work or school.  Testing can therefore guide discharge planning from the rehabilitation setting.
3. Testing can be used to help differentiate among illnesses.  This is important because appropriate treatment depends on accurate diagnosis.  Different illnesses result in different patterns of strengths and weaknesses on testing.  For example, testing can help to differentiate normal age-related changes in thinking and memory from those due to a neurological disorder such as Alzheimer’s disease, or from depression.

A child may be referred for a neuropsychological evaluation when there are concerns about one or more areas of their development. This can include a child’s cognitive, academic, memory, language, social, self-regulatory, emotional, behavioral, motor, visual-spatial, and adaptive functioning.

This type of evaluation can help rule out diagnoses such as Attention Deficit/Hyperactivity Disorder, Autism Spectrum Disorder, Specific Learning Disorder, Language Disorder, as well as various emotional and behavioral disorders. A neuropsychological evaluation can also be helpful if your child has been diagnosed with a medical condition such as Down Syndrome or other genetic disorders, Traumatic Brain Injury, or Epilepsy. The purpose of the evaluation is to identify a child’s patterns of strengths and challenges in order to provide parents, schools, and other providers with strategies to help them succeed across contexts. It can also be used to track a child’s progress and response to targeted interventions. It can provide knowledge of what to expect from the child at the the time the child is tested or in the future. The evaluation can also provide suggestions for improving behavior.

During an evaluation, we may assess:

*Memory:  how a child learns information and retrieves it
*Processing skills:  how a child interprets what they hear, see and touch
*Language:  how the child understands what others’ say and how they put words together to share information, thoughts, and feelings
*Visual perceptual skills:  how a child interprets what they see visually
*Fine and gross motor skills: how a child moves around their world and how they coordinate their hand movements
*Attention:  how a child selects or maintains their attention
*Organizational/Executive Skills:  how a child plans a task, initiates work and problem solves

These are not tests that one can study for, but there are several things that one can do to facilitate the evaluation:

The patient should bring a current list of ALL medications and doses (because medicines may change frequently for some persons, it is important to make sure the list is up to date)
If the patient has difficulty providing information about their history, it is helpful for a family member or friend to accompany them (for at least part of the clinical interview).
It is helpful if the patient can provide records of previous neurodiagnostic testing (e.g., brain scans such as CT or MRI scans) and/or results from previous neuropsychological evaluations if completed at another hospital or institution.
It is the goal of the neuropsychologist to get the best possible picture of the patient’s current functioning. Several things can interfere with this goal such as if the patient is:

• Excessively tired or fatigued or has sudden, unexpected “sleep attacks”;
• Not motivated to put forth their best effort;
• Very emotionally distraught or has a severe psychiatric condition;
• Under the influence of medications or illicit substances which interfere with cognitive functioning;
• Experiencing frequent changes in the ability to move.
• Patients should let the examiner know if they anticipate that any of these issues are likely to interfere with the evaluation.

It is important to get a good night’s rest before evaluation. Patients who live far away might consider spending the evening prior to the evaluation at a local hotel or with friends or family rather than getting up and driving or flying most of the night to get to the appointment. Patients are encouraged not to consume any alcohol 24 hours prior to the evaluation. If taking sleep medicine, patients should check with their doctor whether it might affect test performance the next day.

Patients should not worry about whether they will “pass” the tests. The tests cannot be passed or failed; instead they describe how well a person performs relative to peers.