Psychological and Neuropsychological Assessment

Claystone Clinical Associates (CCA) prides itself on offering a variety of clinical services. Psychological and neuropsychological assessments are two services provided at CCA by licensed psychologists who have had specialized training in the area of testing and assessment.  Psychological and neuropsychological  testing can be very similar to medical tests (without the needles!). “If a patient at their medical doctor’s office has physical symptoms, a primary care provider may order some blood tests to understand what's causing those symptoms. The results of the tests will help the physician to effectively treat the issue. Psychological evaluations serve a similar function. Psychologists use tests and other assessment tools to measure and observe a client's behavior to arrive at a diagnosis and guide treatment. Psychologists administer tests and assessments for a wide variety of reasons. Children who are experiencing difficulty in school, for example, may undergo aptitude testing or tests for learning disabilities. Tests for skills such as attention span, planning, organizing and memory can help a neuropsychologist diagnose conditions such as brain injuries or dementia. If a person is having problems at work or school, or in personal relationships, tests can help a psychologist understand whether he or she might have issues with anger management or interpersonal skills, or certain personality traits that contribute to the problem. Other tests evaluate whether clients are experiencing emotional disorders such as anxiety or depression” (taken from the APA website). Testing can therefore offer a way to help specify the issue(s) and thus more effectively treat what is going on for that individual. Psychological testing can also help inform a psychiatrist or medical doctor with regards to choosing a medication that would be best for that individual. 

The types of tests and assessments used for a psychological or neuropsychological evaluation vary depending on the questions or concerns being addressed. Some things that are fairly consistent during evaluations include a clinical interview and a review of one’s history and records. The interview is typically the first step in any evaluation and includes answering questions regarding the diagnosis under consideration, how long the issues have been around and the impact they are having on the individual’s life.  It is a good idea to be prepared for this appointment by thinking about these questions ahead of time. In addition, if there are previous psychological records or evaluation results, it would be a good idea to bring them to this appointment. In addition to a clinical interview there may be a number of things included in an evaluation. Following the initial interview the psychologist will decide what tests should be administered based on the presenting questions/concerns. The testing may include self-report questionnaires, paper and pencil tests, computerized assessments and answering questions asked by the examiner.   

“Psychological and neuropsychological tests (unlike bedside cognitive and behavioral neurological screens) are standardized, meaning that they are given in the same manner to all patients and scored the same way each time. An individual's scores on tests are interpreted by comparing their score to that of healthy individuals of a similar demographic background (i.e., of similar age, education, gender, and/or ethnic background) and to expected levels of functioning. In this way, a neuropsychologist can determine whether one's performance, on any given task, represents a strength or weakness. Although individual scores are important, the neuropsychologist looks at all of the data from the evaluation to determine a pattern of cognitive strengths and weaknesses and, in turn, to understand more about how the brain is functioning” (taken from UNC School of Medicine website).

How long does a neuropsychological evaluation take?

A complete evaluation generally takes between 3 and 8 hours to complete, but can take up to 10 hours, depending on the complexity of the issues to be addressed by the evaluation and the patient's condition (for example, fatigue, excessive inattention and focus struggles and motor slowing can extend the time required for an evaluation). Sometimes, it is necessary to complete the evaluation over 2 or more sessions. In general, the psychologist attempts to elicit the patient's best possible performance under optimal conditions. It is important to remember that a psychological evaluation includes an interview, completion of a number of assessment instruments, scoring the instruments and summarizing the results into a written report. This is a process that can take some time thus it is important to think ahead when possible, and realize the process of an assessment may take several weeks or months to complete. At the end of the assessment process, the individual will have a completed evaluation with clinical recommendations that can inform treatment and improve outcomes.  

For more information visit

www.med.unc.edu/neurology/divisions/movement-disorders/npsycheval
www.apa.org/helpcenter/assessment.aspx