Neuropsychology is the specialization of brain-behavior relationships, which involves assessment of any or all of the following: cognitive abilities, intelligence (IQ), emotional functioning, personality and academic skills. The neuropsychologist's expertise is in the ability to evaluate individual brain functioning as it relates to these areas. If damage or inadequate brain development occurs, a change in abilities or atypical functioning may result, which the individual may experience as difficulty performing general or specific tasks, decline in functioning or emotional dysregulation. While the individual may externally appear healthy and capable, improper brain functioning often causes devastating effects that if not properly understood can further impair social, occupational and educational functioning.
What is a Neuropsychological Evaluation?
Through individual testing, interview, and medical record review, the neuropsychologist compiles data to elicit a brain-behavior profile. Testing involves evaluation of cognitive abilities such as:
- information processing
- motor speed
- behavioural assessment
These abilities underly basic and complex skills involved in everyday functioning. In addition, intellectual, emotional and psychological functioning are evaluated, as well as academic functioning when appropriate. Results are correlated with brain functioning in light of the individual's history, including medical and psychiatric status. A full report is written, explaining the findings and recommendations, which is followed by a feedback appointment to guide treatment and follow-up.
When is an Evaluation Appropriate?
When brain dysfunction either occurs or is suspected, a neuropsychologist can determine if there is an effect on cognition and behavior. Referral occurs to assist in determining diagnosis, treatment, rehabilitation, care and planning.
Neurological Diseases/Insults: Neuropsychological examinations aid in understanding how a disease process has progressed and affected the individual. It is also used for differential diagnostic purposes and to evaluate effects of treatment and recovery. Furthermore, establishment of a baseline in individuals with a potential deteriorating illness allows for tracking of decompensation, understanding of the changes and appropriate preparation and planning for the individual. Examples of central nervous system diseases or neurological insults are:
- traumatic brain injury
- movement disorders
- toxic poisoning
- drug abuse
Cognitive changes that occur without obvious explanation, such as memory loss, confusion, or disorientation, are other reasons for seeking assessment. It should be noted that extreme stress or depression can also cause such symptoms.
Neurodevelopmental disorders occur when the brain does not develop as it should during growth. As a result, lifelong problems may exist and can be exhibited in disorders such as:
- learning disability
- congenital disorders
- attention deficit hyperactivity disorder
- pervasive developmental disorder
- lead poisoining
Evaluation helps to understand if and where cognitive dysfunction exists. For example, a reading disorder may be due to problems in visuoperception, attention or specific areas of language functioning. In many children who appear to have ADHD are misbehaving for other reasons that are not necessarily obvious and therefore they are misdiagnosed. Proper diagnosis and profiling of the brain-behavior relationship is a necessity before the problem can be properly addressed.