WHAT IS NEUROPSYCHOLOGY AND WHAT IS A NEUROPSYCHOLOGICAL EVALUATION?
Neuropsychology is a specialty within psychology that focuses on the relationship between the brain and behavior. Neuropsychologists are trained to evaluate this relationship by conducting evaluations that indirectly give information about brain functions. Some of the functions measured include alertness, focus of attention and concentration, memory, language, intellectual capacity (IQ), sensorimotor abilities, perceptual skills, visuoconstructional abilities, and executive functioning (i.e. abstraction, organization, reasoning, planning, judgment, ability to switch back and forth between tasks). Also measured are mood and personality as these, too, sometimes change with brain dysfunction. The areas to be examined are determined by the referral question and what the doctor and patient want to know.
The purpose of a neuropsychological evaluation is to help with differential diagnosis, assess specific brain functions, evaluate changes after neurosurgical procedures, develop a baseline assessment against which subsequent evaluations can be compared, appraise quality of life, and make recommendations for treatment.
Typically, neuropsychologist gather information through a clinical interview and then give a series of pencil and paper tasks, answering questions, and completing planning tasks. These tests differ from screening instruments in that they are much more comprehensive, standardized, and designed to assist with diagnosis. From this, a neuropsychologist can determine patterns of strengths and weaknesses in brain functioning and make recommendations accordingly for treatment.
A neuropsychological evaluation generally takes several hours to complete, although some evaluations require more or less time, depending upon how complex the issues are. Sometimes, evaluations are conducted over a couple of sessions to avoid fatigue, as the goal is to measure one’s best efforts. Following evaluation, patients and their loved ones are given feedback about the results of the assessment, and recommendations are made.
Dr. Miller is trained not only in neuropsychological evaluation but also in neurocognitive rehabilitation, cognitive-behavioral therapy, and other treatments. She values working with families and significant others to involve them in treatment, when appropriate. She enjoys collaborating with referring physicians and other clinicians, schools, and work places to ensure follow-through on recommendations.
WHAT SHOULD BE DONE TO PREPARE FOR A NEUROPSYCHOLOGICAL EVALUATION?
The best preparation is to get a good night’s sleep and avoid consuming alcohol and recreational drugs the day before the evaluation unless otherwise suggested by your physician.
Prescribed medications should be taken as usual.
Bring glasses or hearing aids with you, if you need them.
Bring a list of current medications with you.
Bring copies of any neurological test summaries with you (MRI, CT Scan, EEG, neurological exam).
If applicable, bring a copy of any previous neuropsychological evaluation reports, sleep studies, and, if appropriate, work or school performance evaluations.
WHAT SHOULD I EXPECT IF MY CHILD IS BEING EVALUATED?
All evaluations begin with a clinical interview in which both child and parents/legal guardians are present. The purpose of this interview is to gather pertinent developmental and medical history about your child. Sometimes, parents will be asked to fill out a questionnaire about their child. Following the interview, your child will meet with Dr. Miller to do a series of pencil and paper tasks, answer questions, and possibly fill out a separate questionnaire. Evaluations for children may be scheduled over a couple of sessions to make sure I have your child’s best energy. Please reassure your child that I will not do any medical tests such as shots, x-rays, or other invasive procedures. Also, let them know that they are not expected to get all items correct, nor will they receive a grade for their performance. Rather, they are simply to do their best job.