Neuropsychological Evaluation

A neuropsychological evaluation is an asset for personal injury attorneys in litigation when a TBI is alleged. This is especially true for cases involving concussion and mild brain injury where the effects of trauma are subtle. Neuropsychologists can express their results in quantitative terms (ex: IQ points) to help the jury understand the extent of the plaintiff’s impairment. Neuropsychological testing can also identify identify malingering, pre-existing conditions and uncover deficiencies in individuals who appear otherwise competent.

Healthier Minds has neuropsychologists who provide evaluations and expert testimony for plaintiff and defense counsel. Our team use the results of neuropsychological evaluations in life care plans, vocational evaluations and loss of earning capacity.

Neuropsychological Testing and Assessment

A neuropsychological evaluation is a test to measure how well a person’s brain is working. The abilities tested include reading, language usage, attention, learning, processing speed, reasoning, remembering, problem-solving, mood and personality and more.

What is neuropsychology?

Neuropsychology is a specialty field that joins the medical fields of neurology, psychology and psychiatry. Neuropsychology involves determining how well the brain is working when it is disrupted by a brain injury or psychological disorder. A neuropsychological assessment is a comprehensive test of a wide range of mental functions including behavior.

What mental functions are assessed in a neuropsychological exam?

If you are undergoing a neuropsychological assessment, the mental functions tested include:

  • General intellect.
  • Reading/reading comprehension.
  • Language usage and understanding of what others say.
  • Attention/concentration.
  • Processing speed.
  • Learning and memory.
  • Reasoning.
  • Executive functions, which are higher-level skills you use to organize and plan, manage your time, problem solve, multi-task, make judgments and maintain self-control.
  • Visuospatial skills.
  • Motor speed and dexterity.
  • Mood and personality.

Why has a neuropsychological assessment been requested?

A neuropsychological assessment can be requested for a number of reasons including:

  • To help with diagnosis: Test results are sometimes used to help understand the cause of problems with your thinking and understanding. For example, test results might be used to determine if your cognitive (mental) changes are due to normal aging, a neurological illness, depression, anxiety or other causes. Your healthcare provider can then use the results of your neuropsychological examination and the results of other tests, such as brain scans, EEGs, and blood tests, to arrive at a diagnosis that will help guide your healthcare.
  • To determine cognitive strengths and weaknesses: In some cases, a healthcare provider may order tests if you’ve had a known neurological event or injury, such as a stroke or traumatic brain injury, to find which cognitive functions have changed and how much they have changed.
  • To establish a baseline: In some instances, an exam is performed before and after a medical or surgical treatment to determine if cognitive abilities were affected by the intervention. Re-examination at some point after the baseline can also demonstrate how well you’re recovering from a stroke or traumatic brain injury and whether or not you’re ready to return to work, resume driving or take on other duties.
  • To help plan a treatment or other intervention: Test results can be used to identify which cognitive abilities should be the focus of rehabilitation if you’ve had a brain injury. Results also help therapists determine which strengths might be able to compensate for weaknesses. The evaluation can provide the basis for making decisions and/or adjustments to school or work schedules and determine the skills to work on that are most important to you. 

How will I know if my cognitive abilities have changed if I have not had an exam in the past?

Some cognitive abilities tend to be very stable despite neurologic illnesses or injuries. Those abilities often provide an estimate of the level of your other cognitive abilities if no injury or illness had occurred. Your results will be compared to the pattern of results associated with various illnesses or injuries to help determine if changes have occurred.

What common complaints might signal the need for a neuropsychological test?

See your healthcare professional for a referral for a neuropsychological assessment if you or a loved one show any of the following signs:

  • Changes in short-term memory, asks the same question repeatedly.
  • Frequently loses items, gets lost easily.
  • Confusion.
  • Poor attention and concentration. Doesn’t appear to listen. Gets confused in conversation.
  • Language difficulty. Has difficulty speaking or finding words or cannot understand what others say.
  • Can’t recognize things.
  • Visuospatial difficulties including difficulty drawing or using a map.
  • Poor judgment/decision-making.
  • An unexplained change in personality, increase in anxiety or depression, development of delusions or hallucinations.
  • New difficulty with understanding or managing bills or finances.
  • Can’t recognize familiar persons.

What should I do to prepare for the neuropsychological examination?

  • Get a good night’s sleep.
  • Try to eat a good breakfast.
  • Take all of your medications as usual unless you are directly instructed to do otherwise.
  • If you use glasses, contact lenses, or hearing aids, make sure you have them with you.
  • If you have had any neuropsychological, psychological or academic testing done in the past, bring those records with you.

What does a neuropsychological exam involve?

The neuropsychologist will talk with you to understand any concerns you and your family members might have about your cognitive (mental) functioning. He or she will also review your medical and psychological history and educational background.

Your neuropsychologist will choose the tests that you are given. The tests are given and scored by a trained technician called a psychometrist who works under the supervision of the neuropsychologist. The tests typically involve writing or drawing, solving puzzles or answering questions, and responding to things presented on a computer. Most people find some of the tests to be quite easy and others to be difficult. It is important to work as hard as possible on all of the tests in order for the results to be most informative.

You will also complete questionnaires about mood and psychological symptoms.

Finally, the neuropsychologist writes a report that summarizes the results and includes recommendations for improving cognition (e.g., attention, memory) and possibly referrals to other professionals.

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