When should I consider a neuropsychological evaluation for my child?
- A neuropsychological evaluation can help your child for any of the following situations:
- Your child is experiencing significant difficulty meeting the demands or expectations in their day-to-day functioning in school or at home, in terms of their thinking skills, behavior, social, and/or emotional functioning
- A school district or psychoeducational evaluation was performed, but your child’s difficulties persist and you still have lingering questions regarding their true strengths and weaknesses and feel that the evaluation did not identify the core of your child’s difficulties
- You would like to verify or confirm a diagnosis that your child received regarding his or her learning abilities or behavioral/social/emotional functioning and you are unsure whether that diagnosis is accurate
- You are concerned whether your child is not developing as expected in areas that involve thinking skills, learning, social development or behavior
- Your child has a known neurological condition such as epilepsy (seizures), hydrocephalus, cerebral palsy, neurofibromatosis, traumatic brain injury, stroke, or an infection of the brain
Other medical problems are present that place him/her at an increased risk of brain injury such as diabetes, chronic heart or respiratory problems, genetic disorders, or treatment for childhood cancer
- You would like to document your child’s cognitive developmental pattern over time so that educational or medical interventions/treatments can be modified to your child’s changing needs
- If you are unsure whether the difficulties your child is exhibiting is due to an underlying biologically-based condition or whether it is due to psychological or motivational issues
How does a school neuropsychological evaluation differ from the testing provided by a clinical or school psychologist?
A school neuropsychologist and a clinical or school psychologist may use some of the same tests. The pediatric neuropsychologist differs from other psychologists in what they do with the test results. The clinical or school psychologist is typically interested in the score that the child obtains. The neuropsychologist is also interested in how the child obtains a specific test score, as well as in the pattern of scores across key underlying neurocognitive domains. Skills are broken down into component parts, so that each child’s unique learning profile is revealed so that appropriate and targeted interventions can be developed.
The school neuropsychologist seeks to understand where the child is having trouble and why. For example, a child may have difficulty following a direction because he/she did not pay attention to the direction, did not understand the direction, or did not remember the direction.
A neuropsychological evaluation also assesses a broader range of skills, evaluating areas not usually tested by the clinical or school psychologist. Finally, school district evaluations typically have one goal in mind: To determine whether the child meets criteria to be classified to receive (or to continue to receive) services from the district. In contrast, the goal of an independent neuropsychological evaluation is to fully understand a child’s abilities and develop a treatment plan to help that child reach their potential.
How can a neuropsychological evaluation help my child?
- The neuropsychological evaluation and report will provide you with:
- A detailed description of your child’s cognitive strengths and weaknesses.
- Suggestions for what you and those working with your child can do to help him or her.
- Recommendations for educational interventions to improve targeted skill areas and to provide direction on how to use your child’s strengths to circumvent problems created by their areas of weakness.
- Learning what is reasonable to expect from your child.
- Anticipating what your child’s needs may be in the future, so that you can plan for their future.
- Steps to take to improve your child’s behavioral/emotional status.
What areas of functioning does a comprehensive neuropsychological evaluation assess?
A neuropsychological assessment typically includes measures that evaluate an individual’s functioning in the following areas:
- General cognitive functioning
- Processing speed
- Working memory (temporarily storing and managing information)
- Abstract reasoning and cognitive flexibility (executive functioning)
- Learning and memory
- Auditory processing
- Visual processing
- Receptive and Expressive Language
- Organization and planning
- Fine-motor skills
- Academic achievement
- Behavioral and emotional status
What should I tell my child to prior to the neuropsychological evaluation?
Children sometimes think that visits to a doctor will involve shots. It is important to reassure your child that no shots or painful procedures will be involved in the visit to the psychologist.
For school aged children, you can tell your child that he/she will be doing many different activities – some activities involve listening and talking, while other activities involve building things and drawing. Although parents are typically not permitted to be present during the actual evaluation session, let your child know that you will be close by while he/she works with the neuropsychologist. Reassure your child that she/he can have breaks if they need them.
For preschool children, you can describe neuropsychological assessment as playing games involving listening, talking, drawing, and remembering things. Let the child know that the neuropsychologist will have toys like blocks and puzzles that he or she will get to use. Your preschool child may wish to bring a security object along to the appointment. Try to choose an object that will not be too distracting for the child (e.g. a security blanket or small stuffed animal as opposed to an action figure or toy with many small parts).
You can help your child get ready for assessment by making sure that he/she gets a good night’s sleep prior to testing. Make sure that you child has eaten so that he/she will not be hungry during testing. Make the assessment day a special day for your child by leaving brothers and/or sisters at home.
What’s involved in the typical evaluation process?
At the first evaluation session, the psychologist will the child and administer various tasks and activities for the child to complete. The evaluator continues the evaluation with the child during the remaining sessions. Each evaluation session is approximately 2-3 hours, which will vary depending on the child’s age, and breaks are provided throughout the session based upon the needs of each child.
Children typically enjoy the evaluation process, as they often find many of the tasks interesting, interactive, and challenging. Positive reinforcement is routinely used to encourage each child to do their best.
Approximately two weeks after the completion of the evaluation, the psychologist will with the parent(s) to discuss the findings and recommendations, and to discuss treatment and educational planning. At that time, referrals are provided as needed to appropriate medical, mental health, educational, or other professionals. Results of the evaluation and recommendations are subsequently provided in a detailed written report, which includes recommendations for remediation and management of the child’s difficulties.
What information will the pediatric neuropsychologist need for my child’s appointment?
You will need to provide copies of the following:
- All previous psychological or neuropsychological assessments that your child has had.
- Copies of report cards (current and last 2 grades).
- Copies of your child’s current Individual Educational Plan (IEP) or Section 504 Accommodation Plan if they have one.
If your child is being seen because of a condition that was previously diagnosed, it will be helpful to bring relevant medical records including reports from any specialists you have seen due to that condition.
Will the evaluation be covered by my health insurance?
Our office does not file health insurance claims; it is solely the responsibility of our clients and their families to research their policy’s eligibility criteria and file their own claims. Our office will provide you with a statement at the conclusion of the evaluation with the necessary codes for you to submit to your insurance carrier.
Neuropsychological assessment may be covered under the medical coverage of your health insurance plan when your child is referred by a physician for a medically-based problem for which this evaluation is clinically indicated and medically necessary. “Medically necessary” is typically defined as a situation where the referring physician requires the information obtained in the evaluation to assist in guiding the physician to provide appropriate care for your child.
Neuropsychological assessment is often covered if testing is being conducted to establish a diagnosis as the basis for medical treatment, to evaluate the functional impact of a medical treatment (baseline testing) or to assist in selecting a treatment. For example, for some children, the use of medication may be the best approach when behavior problems occur, while for other children, the use of a behavior plan or psychotherapy is the best approach.
Most insurance plans will deny coverage for assessment used to establish an educational diagnosis (i.e., learning disabilities). Medical insurance carriers view this as the responsibility of the patient’s school. However, coverage may be provided if the question prompting testing is the relationship of the academic problem to some other medical problem or medical treatment. It is responsibility of the patient and/or their family to clarify this with their insurance carrier.