A neuropsychological evaluation is a comprehensive assessment of cognitive and behavioral functions using a set of standardized tests and procedures. We provide neuropsychological exams for certain conditions, assessing the relationship between the brain and behavior. Our neuropsych evals are conducted virtually, so we limit ourselves to the testing batteries that can validly and reliably be given online. In this post, we go over what you can expect with a neuropsych evaluation, the specific services we provide, and an example of what it could be like.
Don’t hesitate to contact us or schedule a consultation if you want to hear more about our neuropsychological evaluation services or have questions about how they could benefit you or a loved one.
Neuropsychological Evaluation Overview
The following provides an overview of neuropsych evals, including which services we do or do not provide.
Purpose of a Neuropsychological Evaluation
There are three primary purposes for a neuropsychological exam:
- Diagnosis: A neuropsych evaluation can help diagnose cognitive disorders like Alzheimer’s disease, Attention-deficit Hyperactivity Disorder, or traumatic brain injury. Neuropsych evals can be used for the diagnosis of mental health issues, such as the nature of depression, anxiety, and personality issues, which is the core of our work.
- Treatment Planning: To guide treatment planning, including rehabilitation and strategies for managing deficits. Again, we provide neuropsych exam services when the treatment is for mental health symptoms and not purely medical.
- Legal and Educational Settings: Often used in forensic cases or to assess learning disabilities in educational settings. We provide many of these services, as you’ll see below.
Components of the Neuropsychological Evaluation
The following are the general steps in a neuropsych exam.
- Interview and History:
- Medical History: A review of past and current medical conditions, medications, and any history of neurological or psychiatric disorders. We must understand these issues to differentiate psychological from physical causes of challenges.
- Personal History: This may include questions about education, work history, social interactions, and daily functioning so that we can get an idea of what your functioning was before any decline.
- Standardized Tests in Neuropsychological Exams:
- Cognitive Testing: Assessing memory, attention, language, problem-solving, and executive functions.
- Motor Skills: Testing fine motor skills, coordination, and speed. Note that when this type of testing is a core part of the referral question, you may be better off seeing someone in person.
- Emotional and Personality Assessments: Evaluating mood, personality traits, and psychiatric symptoms.
- Behavioral Observations: Observing behavior during testing, such as your focus, effort, and attention.
- Scoring and Interpretation of Neuropsychological Exams:
- Tests are scored using normative data to compare your performance to others in your age group.
- Results are interpreted to identify patterns of strengths and weaknesses in cognitive functioning as they relate to your mental health.
- A detailed report summarizes the findings, diagnosis, and recommendations. We ensure that our neuropsychological evaluation reports are strength-based and provide a wide range of suggestions.
- Feedback Session: A feedback session is conducted after each neuropsych evaluation to explain the results to you and anyone else you’d like there to discuss the results and next steps.
Reasons for Neuropsychological Exams
Neuropsych evaluations are conducted for various reasons, often when there is a concern about a change in cognitive, emotional, or behavioral functioning. Here are some common reasons why a neuropsychological evaluation might be requested and whether we provide the service.
Neuropsychological Exams for Developmental Disorders
- Autism Spectrum Disorder (ASD): To assess cognitive functioning and guide educational and behavioral interventions.
- Attention-Deficit/Hyperactivity Disorder (ADHD): To confirm a diagnosis and develop treatment strategies.
- Learning Disabilities: To identify specific learning disabilities and guide educational planning.
We do a significant number of neuropsychological exams for developmental disorders and related testing for neurodivergence.
Neuropsychological Evaluation for Psychiatric Conditions
- Mood Disorders: To assess cognitive impairment in conditions like depression or to evaluate for bipolar disorder.
- Anxiety Disorders: To understand the impact of anxiety on cognitive function.
These neuropsych evals are a core part of our practice. An example is below.
Academic and Occupational Issues
- Academic Difficulties: When a student struggles in school to identify potential learning disabilities or cognitive impairments and a possible need for academic accommodations.
- Work-Related Issues: To evaluate cognitive functioning in professionals experiencing difficulties at work, possibly due to stress, injury, or a neurological condition. In this case, we may suggest workplace accommodations.
We do a significant number of neuropsychological exams for these conditions.
The Forensic Neuropsychological Evaluation
- Competency Assessments: To determine an individual’s ability to stand trial, make medical decisions, or manage financial affairs.
- Disability Evaluations: To assess cognitive function for disability claims.
- Personal Injury Cases: To evaluate cognitive impairment following an injury for legal purposes.
We do these forensic tests, including neuropsych evals, when a lawyer requests them on behalf of their client.
Monitoring Cognitive Function Over Time
- Progressive Conditions: To monitor cognitive changes in neurological conditions like dementia or multiple sclerosis.
- Effectiveness of Treatment: To assess the effectiveness of treatments, such as medications for ADHD or depression.
These neuropsych evaluations are crucial for developing appropriate treatment plans, guiding interventions, and helping individuals and their families understand the nature and extent of cognitive or emotional challenges.
Neurological Conditions
- Epilepsy: Pre-surgical evaluation for epilepsy surgery or to assess cognitive function in individuals with epilepsy.
- Multiple Sclerosis (MS): To monitor cognitive changes in individuals with MS.
- Parkinson’s Disease: To evaluate cognitive and emotional changes associated with Parkinson’s.
We perform these neuropsych evaluations provided the client feels comfortable using videoconferencing technology.
Neuropsychological Exams for Cognitive Decline
- Memory Loss: To assess potential memory issues, such as those seen in Alzheimer’s disease or other forms of dementia.
- Confusion or Disorientation: When a person experiences frequent confusion or disorientation could indicate cognitive impairment.
- Age-Related Cognitive Changes: Differentiate between normal aging and more serious cognitive decline.
We often refer people with these conditions to a local provider, given that managing the technology needed for neuropsych evaluations in these areas can be challenging.
Neuropsych Evals for Brain Injury
- Traumatic Brain Injury (TBI): After a head injury, neuropsych evals can be used to evaluate the extent of cognitive impairment and guide rehabilitation.
- Stroke: To assess the impact of a stroke on cognitive functions and to plan for recovery.
- Concussion: Neuropsych evals can evaluate the cognitive effects of a concussion, particularly if symptoms persist.
We also refer people to other providers for in-person neuropsych evaluations in these areas
Neuropsych Evals: Example 
neuropsychological exam can be highly informative in the context of mental health, particularly for understanding how a psychiatric condition affects cognitive functioning. Here’s an example of how a neuropsychological exam might be used for someone with a mental health concern:
- Patient: A 35-year-old man, John, has been struggling with major depressive disorder (MDD) for the past two years.
- Symptoms: He experiences persistent sadness, lack of motivation, difficulty concentrating, and feelings of hopelessness. Recently, he has noticed worsening memory problems and trouble focusing at work, which has led to job performance issues.
- Referral: John’s psychiatrist refers him for a neuropsychological evaluation to better understand the cognitive effects of his depression and to differentiate between cognitive symptoms related to depression versus other potential causes like early-onset dementia.
Components of the Neuropsychological Evaluation
- Clinical Interview:
- History: We gather detailed information about John’s psychiatric history, including the onset, duration, and severity of depressive symptoms, as well as any history of psychiatric or neurological disorders in the family.
- Current Functioning: Discuss how his symptoms affect daily life, work, and social interactions.
- Medication: Review of any medications or treatments he is currently undergoing, including their potential cognitive side effects.
- Cognitive Testing:
- Attention and Concentration: Tests like the Continuous Performance Test (CPT) to assess sustained attention and focus.
- Memory: The Wechsler Memory Scale (WMS) or Rey Auditory Verbal Learning Test (RAVLT) to assess short-term and long-term memory.
- Executive Function: Tests like the Wisconsin Card Sorting Test (WCST) or Trail Making Test to evaluate planning, problem-solving, and cognitive flexibility.
- Processing Speed: Digit Symbol, Coding, or other tasks from adult IQ tests measure the speed at which John can process information.
- Verbal and Visual Skills: Tests such as the Boston Naming Test and Rey-Osterrieth Complex Figure to assess language and visual-spatial abilities.
- Emotional and Personality Assessments:
- Mood and Anxiety: The Beck Depression Inventory (BDI) or Hamilton Depression Rating Scale (HDRS) to quantify the severity of John’s depressive symptoms.
- Personality Assessment: The Minnesota Multiphasic Personality Inventory (MMPI) to explore any underlying personality traits or psychiatric conditions.
- Behavioral Observations:
- We observe John’s behavior during testing, noting any signs of fatigue, frustration, or lack of effort, which are common in individuals with depression.
Neuropsych Evaluation Results and Interpretation
- Findings: The evaluation reveals that John has significant impairments in attention, memory, and processing speed, all of which are consistent with cognitive symptoms commonly seen in depression. However, there is no evidence of a progressive neurological condition like dementia.
- Differentiation: We conclude that these cognitive deficits are most likely secondary to his depression rather than indicative of a separate neurological issue.
Neuropsych Evaluation Recommendations
- Treatment Adjustment: We suggest that John’s psychiatrist consider adjusting his medication to manage the cognitive symptoms better or exploring cognitive behavioral therapy (CBT) specifically targeting these areas.
- Cognitive Rehabilitation: Referral to a cognitive rehabilitation program to help John develop strategies for managing memory and attention problems.
- Workplace Accommodations: To help John maintain his job performance, recommendations are made for workplace accommodations, such as flexible deadlines or reduced distractions.
- Follow-Up: A follow-up evaluation is recommended every six months to monitor any changes in cognitive functioning, particularly if John’s treatment plan changes.
Outcome and Next Steps
- The exam provides a clear understanding of how John’s depression is affecting his cognitive abilities, allowing for more targeted treatment. By addressing these cognitive challenges, John is better able to manage his symptoms, improving both his mental health and job performance.
This example highlights how a neuropsychological exam can be crucial in mental health settings. It provides insights that go beyond a standard psychiatric evaluation. It helps tailor treatments and supports based on a comprehensive understanding of the individual’s cognitive and emotional functioning.
Summary and Our Work
We provide neuropsychological exams to help us better understand mental health issues, cognitive difficulties, and some forensic reasons. A neuropsych evaluation is comprehensive and can provide significant information to help you make decisions, get support, and design a unique treatment plan. We cover how to get a psych evaluation, including neuropsych, in detail, in another post.
Don’t hesitate to contact us or schedule a consultation to learn more about our neuropsychological evaluation services or if you have questions about neuropsychological exams in general.
