What is a neuropsychological evaluation?
A neuropsychological evaluation studies the "work" of the brain. This is a comprehensive assessment of attention ,learning, memory, "think ahead" ability, language and visual-spatial skills, and sensory-motor functions. Several hours are required to complete this evaluation because most of these skills are made up of component parts. The evaluation does not have to be administered in one session or in one day.

Who is a neuropsychologist?
A neuropsychologist is a clinical psychologist who has had special training in neuroanatomy, neuropathology, cognitive psychology, and methods of evaluation. This training not only includes course work but also an internship or residency in working with people with neuropsychological conditions. A diplomate certification in neuropsychology means that the psychologist was examined by a credentialing board. This includes written and oral examinations and work sample reviews to insure that certain standards have been met.

When is a neuropsychological evaluation indicated?
A neuropsychological evaluation is indicated whenever complaints of problems with attention/concentration, learning and memory, language, and visual-spatial skills need an objective assessment. Complaints in these areas often occur in neurological and other physical conditions, in psychiatric disorders, in learning disabilities, and in developmental disorders such as Attention Deficit Disorder.

At what age should a neuropsychological evaluation be performed?
Age-appropriate tests are used for child, adolescent, and adult evaluation. Therefore, an individual of any age can be evaluated.

How does a neuropsychological evaluation differ from a learning disability
assessment done at school?
Learning disability assessments usually focus upon measuring IQ-academic achievement discrepancies. If attention is assessed, it is usually done by having an observer fill out a behavior rating scale. All of this provides information about comparing a student to his/her peers for identifying problems. A neuropsychological evaluation is an interactive assessment that uses standardized procedures to understand the process of how and why an individual behaves, struggles, or fails. The focus is upon understanding the reasons for the problem. The results should be linked to interventions, which may or may not be school based.

What skills are necessary for reading?
Reading can be understood as a mapping of the oral language system into written words. Therefore, all of the specific skills required for language comprehension and expression are necessary for reading. Problems with understanding communications and problems with semantics and syntax (word choice and problems with the structure and organization of language) are associated with reading trouble. Problems with vocabulary development and immediate (short term) memory are linked with reading comprehension problems. Finally, whenever reading an unfamiliar word, phonological analysis is required. The new word must be broken down into its subcomponent sounds in order to be read correctly, regardless of the method that was used to teach a child to read. Therefore, reading is not just one single isolated skill. Many subcomponent abilities are required for fluent reading. As a result, problems in reading occur for many different reasons.

Are all problems with attention the same?
Absolutely not. Attention is not just one ability or skill. Attention is comprised of a group of cognitive processes. The amount of information a person can register or "take in" at one time, the length of time a person can engage in an activity or task, the quickness with which a situation can be understood, and appropriately shifting the focus of attention from one thing to another are a few of the abilities that combine to make "attention". Therefore, there are different kinds of problems with attention, dependent upon which component parts are affected. The management and treatment of these problems differs accordingly.

Is a problem with attention the same thing as an attention deficit disorder?
No. Attention deficit disorder (ADD) is a condition that is defined by a person's behavior. An important aspect of the diagnosis includes having observers rate an individual according to certain behaviors. Rating scales or checklists are often used to make these observations. A problem with attention can be quite different. This might concern a problem in initially registering information, a problem with "forgetfulness," a problem with concentration or distractibility, or a problem in adjusting to the flow of situations, just to mention a few examples. While these kinds of problems can be very impairing, people with these kinds of difficulties may or may not show the behaviors that meet the criteria for attention deficit disorder. Problems with attention are evaluated through a neuropsychological assessment.

In what kinds of forensic or legal situations is a neuropsychological assessment useful?
Neuropsychological evaluation can be helpful in both criminal and civil cases. In criminal proceedings, the evaluation can clarify issues such as fitness for trial, determining sanity at the time of the alleged offense, and even fitness to waive Miranda rights. Evaluation data can also be applied to situations such as fitness for sentencing in capital litigation cases. In civil court proceedings, the assessment can be particularly useful for plaintiffs and defendants in traumatic brain injury cases to identify brain impairment, to estimate severity, and to assist in making a prognosis. In school settings, the evaluation findings can be used to help children obtain services that are not provided by school systems because of disagreements over a student's meeting eligibility criteria for special services.

See also: Common Problems