Neuropsychological Evaluations: An Integral Part of Your Child’s Success

1. Neuropsychological Evaluations: An Integral Part of Your Child’s Success Lisa G. Hahn, Ph.D., ABPP Board Certified Clinical Neuropsychologist Neuropsychology Associates of New Jersey Morristown, New Jersey

2. What is Neuropsychology? • Clinical specialty in the neuroscience field • Refers to the study of brain-behavior relationships • Influenced by the following disciplines: • Neurology • Psychology • Anatomy

3. What is a Clinical Neuropsychologist? • Training Involves • Doctoral training in psychology • Commonly clinical psychology or neuropsychology programs • Specialized coursework associated with brain-behavior relationships • Two-year Postdoctoral Fellowship • Additional training with specialized populations • Medical • Psychiatric

4. What is a Clinical Neuropsychologist? • Proficiency • Expertise in how behavior and skills are related to brain structures and systems • Clarify relationship between disease state and behavioral consequence

5. What is a Clinical Neuropsychologist? • Role • Diagnose Psychological, Cognitive, Learning, and Emotional Conditions • Provide information to assist differential diagnosis of medical and psychological/psychiatric conditions • Identify cognitive problems associated with neurological or psychological conditions • Monitor progression or response to treatment • Develop treatment and intervention strategies

6. What is a Neuropsychological Evaluation? • Objective testing of skills that correlate with brain function using: • Standardized psychometric instruments used to evaluate multiple aspects of normal cognition • Objective assessment of emotional/psychological functioning • Integration of • objective test data • subjective input from parents • qualitative information from the Neuropsychologist such a clinical observations

7. What does the appointment entail? • It is typically a full day evaluation • The evaluation includes: • Clinical interview of the parents and child • Review of medical, school, and previous testing records, if available • Neuropsychological testing of the child • Completion of questionnaires that assess behavioral, emotional and psychological functioning • Preliminary feedback of diagnostic findings and recommendations • Feedback is provided after the report is received and reviewed

8. Who Refers to a Neuropsychologist? • Parents • General practitioners or pediatricians • Medical specialists (e.g., neurologists, oncologists) • Psychologists, therapists or social workers • School Counselors • Child Study Teams • Attorneys or advocates

9. What are common referral questions posed to a Neuropsychologist? • General ability or rate of growth • Learning and memory • Academic achievement • Language acquisition • Social development • Fine motor development • Emotional development • Chronic or acute medical problems • Family issues • Attention and behavior

10. What is the Purpose of the Referral and Evaluation? • Clarification • To better understand the child’s neurobehavioral profile in the presence of an academic, social or emotional issue or medical condition. • Prevention and Monitoring • To gain a baseline and follow-up evaluation for future • Intervention • To aid in developing a plan to assist individuals with known or suspected cognitive or emotional problems

11. What are the domains assessed? • New Learning & Memory • Speech • Language • Sensorimotor • Visual-spatial and perceptual skills • Intelligence • Attention • Academic achievement • Executive function • Mood • Personality

12. What diagnoses are elucidated from a Neuropsychological Evaluation? • A neuropsychological evaluation can help differentiate or confirm diagnoses such as • Attention Deficit Hyperactivity Disorder • Executive Dysfunction • Learning Disorders • Learning/Memory Disorders • Fine-Motor Disorders • Depression • Anxiety • Bipolar Disorder • Thought Disorders

13. What is a Psycho-Educational Evaluation? • This typically includes tests of • Intellectual Functioning • Academic Achievement • Parent self-report questionnaires • It does not include comprehensive assessment of additional neurocognitive domains • It does not include comprehensive assessment that can result in any diagnosis with the exception of • Learning Disorder • Developmental Disability (i.e., Mental Retardation)

14. Why Not Have My District Complete a Psycho-Educational Evaluation? • By law District does not need to provide this evaluation until your child is doing very poorly in school (i.e., there is a significant problem with their achievement) or their behavioral problems are clearly interfering with their learning • For many children by this stage they have developed low self-esteem, feel inefficacious, are failing academically, and may even be negatively labeled by their teachers or peers • The evaluation is very limited in scope, unlike a neuropsychological evaluation

15. The Common Question: Why So Much Testing? • The brain is a complex organ that encompasses many neural networks and functional abilities • It is important to conduct a broad based assessment • When we leave no stone unturned then we can be more positive the diagnosis is accurate

16. The Final Result: An Integrative Report • Results of standardized testing are integrated into a broader understanding of the individual’s neurobehavioral pattern • Summary of previous evaluations/treatments • Behavioral observations • Test results • Integrative summary of findings placed in the context of medical, developmental and psychosocial history • Diagnostic formulation • Recommendations for intervention and remediation

17. Possible Recommendations • Medical • Consultation with another specialist • Therapeutic Support • Cognitive restructuring • ADHD coach • Psychological counseling or therapy • Educational • Special education services • Classroom accommodations • Advocacy • Out of district placement • Transition planning for after high school

18. Beyond the Final Product of the Report • My goal is always to advocate for the child’s best interests • When a parent is working with an advocate or attorney, I too become part of their team • I am available to participate in Child Study Team meetings to help explain the neuropsychological evaluation findings • I work as a liaison to assist the parents/family in finding appropriate community services or school placement • I provide follow-up testing to assess efficacy of interventions (i.e., medication, academic programs, etc.)

19. How to contact me: Neuropsychology Associates of New Jersey Board Certified Clinical Neuropsychologists 250 Madison Avenue Suite 200 Morristown, New Jersey 07960 973-267-5646 npanj.hahn@yahoo.com www.npanj.com