Neuropsychological assessment and psychological testing at NBI are designed to facilitate diagnostic understanding, measure symptom severity, inform treatment approaches and recommendations, and help the clinical team and patients gain more knowledge about their learning processes.

 

An evaluation is most helpful when you suspect you or someone you love has a learning disability or other cognitive problems such as difficulty with memory, attention, or executive functioning skill. A comprehensive evaluation may also be helpful for individuals struggling with behavioral, social or emotional difficulties (e.g., anxiety, depression, etc.) that seem to be interfering with social, cognitive, or academic functioning. Such evaluations may offer diagnostic clarity and related treatment recommendations. 

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In general, a comprehensive evaluation is intended to offer increased awareness of why an individual may be struggling to meet developmental, academic, or social milestones. The process often helps to confirm appropriate clinical diagnoses, but more importantly, works to identify which intervention or support services will be most beneficial. As such, upon written consent, our team will communicate as needed with physicians, psychiatrists, therapists, school professionals, and other psychologists to coordinate the management of the individual’s treatment plan, educational programs, and/or other necessary referrals or placements. 

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What Is the Purpose of a Comprehensive Diagnostic Evaluation?

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Evaluations increase our understanding of cognitive, emotional, and behavioral functioning in relation to difficulties that an individual is experiencing, whether at home, school or in the workplace. This information goes beyond what can realistically be obtained via clinical observations, interview material, or medical findings. Through an interactive assessment combining standardized written tasks, hands-on activities, questionnaires, and computer “games,” a greater awareness about present functioning and future risk factors is gained. 

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Once an individual’s unique profile is understood, including areas of relative strengths and weaknesses, we can recommend therapies and treatments tailored for their unique needs. These recommendations are often essential for the development of optimal treatment, educational, or placement plans, or for qualifying for specialty services. 

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Diagnostic evaluations are also instrumental in re-evaluating current or past clinical impressions or identifying the presence of previously unrecognized:

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• Autism spectrum disorders (ASDs)

• Language or nonverbal processing deficits (NVLD)

• Learning disorders (LDs)

• Attentional difficulties (ADHD)

• and a variety of emotional and behavioral problems

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These evaluations can be utilized to track clinical and/or educational progress over time.

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Why Are Individuals Referred for Evaluations?

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Evaluations can be particularly helpful when a person starts displaying signs of emotional or behavioral problems. A medical professional may also recommend one when anxiety or social/emotional difficulties are interfering with an individual’s functioning or when it is important to understand the psychological and/or cognitive ramifications of medical conditions (e.g., epilepsy, cancer, or Alzheimer’s). 

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Individuals often self-refer or are referred for assessment by a parent, doctor, teacher, or other

professionals because of one or more of the following reasons:

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• Difficulty in learning, attention, behavior, socialization, or emotional control.

• Teachers or work supervisors report persistent difficulties.

• Poor work performance despite adequate attendance and seemingly good attention and effort.

• Problems with retention of information.

• Inadequate achievement in school or at work despite sufficient effort.

• Family history of neurological or developmental difficulties known to affect the brain and/or brain systems.

• Suspected developmental delay (e.g., language, motor, etc.), which may or may not be accompanied by other areas of impairment.

• Traumatic brain injury or significant illness that impedes cognitive development.

• Specific medical disease or congenital developmental problem that affects brain functioning.

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At What Age Should an Evaluation Be Considered?

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It is best to conduct evaluations as soon as possible, especially for children. Nearly all professionals agree that early intervention plays a

significant and vital role in the treatment of developmental needs and long-term progress. Further, diagnostic evaluations and the resulting

reports serve as important tools for documenting the development and pattern of cognitive strengths and weaknesses over time.

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Evaluations are appropriate for individuals over two years of age, although children under two may be seen as well, depending on the

specific circumstances and referral questions.

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What Does an Evaluation Typically Consist Of?

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NBI’s team of psychologists and neuropsychologists personally conduct each component of the evaluation process. Most evaluations include

the following:

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Initial Intake: At the first appointment, the psychologist meets with the patient and his/her family to gain an understanding of the reason for referral and obtain a detailed developmental, medical, psychological, educational, and depending on age, occupational history.

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Evaluation: If a comprehensive evaluation is determined to be in the individual’s best interests, testing will usually begin immediately after the initial interview. During testing, standardized measures are administered systematically in an appropriate environment. The same tests are not given to every patient but are created based on what we already know. Tests generally include a series of interactive activities that assess language and perceptual processing abilities, attention and memory, school-based learning, cognitive skills, emotional functioning, and behavior. Emerging skills can also be assessed in very young children. Parents and/or family members are usually not in the room during testing, although they may be asked to be present with very young children or on a case-by-case basis. Testing time varies based on the individual's evaluation may take up to eight hours and may spread across several sessions, depending on the needs of the patient. The evaluation of infants or preschool children is usually shorter in duration. Informal feedback may be provided to family members at the 

end of each session, as appropriate and relevant to the process. 

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During the course of the evaluation, the following areas may be assessed:

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• General Intelligence

• Academic Achievement

• Attention / Concentration

• Executive skills, such as organization, planning, inhibition, and flexibility

• Learning and Memory

• Language and Communication Skills

• Visual-spatial Skills

• Motor coordination

• Social Interaction Skills

• Adaptive Functional Skills

• Social-emotional Functioning

• Behavior

• Personality factors

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Some abilities may be measured in more detail than others, depending on individual needs.

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Feedback Session:  Approximately three weeks after the initial testing session, a feedback session will be scheduled. This timeline allows the psychologist to obtain and score teacher report measures and integrate and interpret all of the results gathered in the interview, testing session(s), and self-report measures and/or parent and teacher checklists. During the feedback session, each test that was completed and the subsequent results will be discussed. Based on the individual’s performance, individualized recommendations will be offered that draw upon the individual’s strengths and needs.

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Report: A comprehensive written report documenting the test results, corresponding diagnostic findings, and subsequent recommendations will be provided upon completion of the testing.

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Families are also offered consultation services both before and after the evaluation process, as needed. Reports are disclosed to other persons, professionals, or agencies upon appropriate written authorization unless specifically forbidden by legal or ethical concerns. 

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What Is a Standardized Test?

A standardized test is a measure that is administered and scored in a consistent manner and then compared with the appropriate age and/or group norms. They are designed in such a way that all questions, materials, and testing conditions are consistent across administrations. One must possess specific professional credentials to purchase, utilize, and interpret standardized tests.  

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Is There Anything Else I Should Know Before I Come Into the Office for Our Testing Appointment?

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Since comprehensive evaluations often take an entire day, it is important to make sure there has been adequate sleep the night before an evaluation and that the person does not arrive to the session without eating. If special language needs are evident, it is important to be sure the psychologist is aware of these. Similarly, if the individual wears glasses, a hearing aid, or any other device, please make sure to bring them. If any medications are prescribed, do not refrain from administering them on the day of testing. If a child has had previous school testing, please bring copies of any relevant documents to the appointment for the case record. See our intake packet for additional information. 

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How Is This Evaluation Any Different From a Testing Performed in the School?

​School-based assessments (also known as psychoeducational assessments) are typically performed with one goal in mind: to determine if a child qualifies for special education programs or therapies to enhance school performance. These evaluations focus almost exclusively on intellectual and academic achievement skills needed for academic success, whereas comprehensive psychological and neuropsychological evaluations provide detailed information regarding a child’s strengths and weaknesses across a variety of cognitive domains. By objectively testing various skills, neuropsychologists can assess an individual’s overall cognitive, developmental, and psychological functioning leading to a diagnostic formulation. Generally, school assessments do not diagnose learning or behavior disorders caused by altered brain function or developmental problems. Moreover, although this type of evaluation suffices for some children, it is difficult for a professional to responsibly diagnose any difficulty other than a clear specific learning disability with the limited amount of clinical data typically gathered in a school evaluation.