What Should I Expect During a Neuropsychological Evaluation?

A neuropsychological evaluation includes an interview with parents about the child’s history, observation of and interview with the child, and testing. Testing involves paper and pencil and hands-on activities, answering questions, and sometimes using a computer. Parents may be asked to fill out questionnaires about their child’s development and behavior. Many neuropsychologists employ trained examiners, or technicians, to assist with the administration and scoring of tests, so your child may see more than one person during the evaluation. Parents are usually not in the room during testing, although they may be present with very young children. The time required depends on the child’s age and problem. Make sure your child has a good night’s sleep before the testing. If your child wears glasses or a hearing aid or any other device, make sure to bring it. If your child has special language needs, please alert the neuropsychologist to these. If your child is on stimulant medication, such as Ritalin, or other medication, check with the neuropsychologist beforehand about coordinating dosage time with testing. If your child has had previous school testing, an individual educational plan, or has related medical records, please bring or send this information and records to the neuropsychologist for review.

What you tell your child about this evaluation depends on how much he or she can understand. Be simple and brief and relate your explanation to a problem that your child knows about such as “trouble with spelling,” “problems following directions,” or “feeling upset.” Reassure a worried child that testing involves no “shots.” Tell your child that you are trying to understand his or her problem to make things better. You may also tell the child that “nobody gets every question right,” and that the important thing is to “try your best.” Your child will probably find the neuropsychological evaluation interesting, and the detailed information that is gathered will contribute to your child’s care.

Neuropsychological evaluation

A neuropsychological evaluation for a school-aged child (6+ years) will typically assess these areas:

• General intellect (IQ)

• Executive functioning skills (working memory, organization, planning, inhibition, and flexibility)

• Attention (auditory, visual, divided, sustained)

• Learning and memory (verbal and visual)

• Language (as needed)

• Visual–spatial skills

• Fine motor coordination

• Processing speed

• Social, emotional, and behavioral functioning

• Adaptive (daily living) skills

• Teacher report of school functioning

• Effort (performance validity testing)

ADHD/Learning Disability (LD) Evaluation

A typical ADHD/LD or psychoeducational evaluation of a school-age child will assess the following areas:

• General intellect (IQ)

• Achievement skills (basic and applied

reading, math, and written expression)

• Attention (continuous performance

testing)

• Visual-motor integration

• Parent, teacher, and self-report of

social, emotional, and behavioral skills

• Learning and memory (as needed)

• Language (as needed)

• Adaptive (daily living) skills (as needed)

• Effort (performance validity testing)

Autism Spectrum Disorder (ASD) Evaluation

A typical ASD evaluation of a child/adult will include the following areas:

• General intellect (IQ)

• Semi-structured assessment of social and emotional abilities using the Autism Diagnostic Observation Schedule, 2nd Edition (ADOS-2)

• Attention and language testing (as needed)

• Social, emotional, behavioral, and adaptive (daily living) skills

Neurodevelopmental evaluation

A typical neurodevelopmental evaluation of an infant or toddler (<3 years) includes assessment of the following areas:

• Receptive language (understanding others)

• Expressive language (communicating verbally)

• Fine motor (e.g., grasping, buttoning, drawing)

• Gross motor (e.g., hopping, skipping, jumping)

• Visual-reception (taking information in from the surrounding environment)

• Adaptive (functional) skills

• Social, emotional, and behavioral skills

Preschool assessment of young children (>3 years) includes assessment of emerging cognitive skills such as:

• General intellect (IQ)

• Emerging attention/executive functions

• Language (receptive/expressive)

• School readiness prior to kindergarten/giftedness

Neuropsychological evaluation versus psychoeducational evaluation

School assessments are usually performed to determine whether a child qualifies for special education programs or therapies (e.g., occupational, speech/language) to enhance school performance. These assessments focus on achievement and skills needed for academic

success. Generally, school psychologists identify behaviors consistent with learning, social, emotional, or behavioral disorders caused by altered brain function or development. However, they do not diagnose these conditions.