Brief Description of Services
 

 
The Pediatric Neuropsychological Evaluation

A neuropsychological evaluation is recommended to better understand reasons for difficulties in learning, attending, organizing, interacting appropriately in the social area, and/or demonstrating appropriate emotional reactions to situations or events. Many times a child or adolescent referred to a neuropsychologist is considered a "conundrum kid."

Sometimes we know that a child has sustained a head injury, a birth trauma or some other physical "insult." In these situations the neuropsychologist may know the probable etiology of the difficulties the child or young adult is having, but is still called upon to document a clear and thorough pattern of cognitive and emotional strengths and weaknesses. While the latter may need "remediation," the former may offer us "windows of opportunity" through which we can help these children overcome or compensate for their deficits.

Each evaluation is tailored to answer the specific questions posed.  Sometimes additional concerns arise during the course of the evaluation, and further testing may be recommended to establish a clear, full profile.  Testing considerations for each child are discussed with the parents prior to testing, and are updated, as needed, during the course of the assessment.  There are hundreds of test instruments available; choices must be made intelligently and with sensitivity. 

A "typical" neuropsychological evaluation might include tests of general cognitive functioning (often obtained though the use of IQ batteries), achievement skills in all areas pertinent to the age and grade level of the child/young adult, tests of executive functioning which include one's ability to plan, think flexibility, organize and inhibit impulsive tendencies; tests of attention, tests of learning efficiency in various modalities, auditory and visual memory (both short-term and long-term), receptive and expressive language abilities, visual-spatial skills, holistic vs. piecemeal processing, motor skills, emotional functioning/self-esteem, and social skills.

A neuropsychological evaluation should be a pleasant experience for a youngster. (S)he should be told the purpose of the evaluation in ways that "make sense," (s)he should be encouraged to ask questions, (s)he should be tested in areas of strength, as well as weakness, and praised for all (s)he does well. Breaks should be taken at sensible intervals to make sure focus remains strong. Informal times (breaks to get a snack, fresh air, etc.) should be used as opportunities to get to know the child/young adult outside of the testing arena.

With consent from parents or guardians, a great deal of helpful information can also be obtained through talking to teachers, tutors, and other professionals involved in the child's life.  A thorough review of report cards, from as far back as they are available, also lends insight. If there have been other professional evaluations, these reports are requested and examined, as well. Consistency of findings and impressions are sought; inconsistencies need to be understood.  Confirmation of diagnostic impressions from other sources lends credence to the validity of current findings. Differences of opinion suggest that there is further work to be done in order to arrive at valid conclusions.

Once testing is completed, a very comprehensive written report is prepared. In addition to numbers obtained on the various standardized instruments used, qualitative findings such as the individual's attitude towards testing, confidence level, manners of response, etc. must be documented and considered along with quantitative findings. Numbers alone can NEVER explain how a child or young adult functions.

Results of testing typically lead to a list of specific recommendations. These are first shared with parents. The examinee may opt for feedback, as well, and teenagers are especially likely to seek “answers” to the issues they have been facing.  With signed consent from parents,  school and other professionals involved with the child/adolescent can benefit from the wealth of information, insights, and suggested interventions.

Some evaluations lead to a request for formal accommodations at school. With solid testing and reporting, this process should go smoothly and in accordance with federal and local laws that protect our students, and mandate their right to a free and appropriate education.