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Neuropsychological Evaluation

Neuropsychology studies behavior in order to figure out how the brain is working.

What is neuropsychology?

Neuropsychology is a specialty field within psychology that involves the study of behavior to figure out how the brain is working.

What is a neuropsychological examination?

A neuropsychological evaluation involves measuring a person’s abilities, such as:

  • Reading
  • Speaking and understanding what others say
  • Attention/concentration
  • Memory
  • Reasoning
  • Higher abilities called executive functions, which let us apply our knowledge

Why has a neuropsychological assessment been requested?

  • To help with diagnosis—Test results are sometimes used to help understand the cause of problems with thinking and understanding. For example, test results might be used to determine if someone's cognitive changes are due to normal aging, a neurological illness, or depression or anxiety. Your health care provider can then use the results of your neuropsychological examination along with the results of other tests such as brain scans, EEGs, and blood tests to arrive at a diagnosis that will help to guide your health care.
  • To determine cognitive strengths and weaknesses—In some cases, a health care provider may order tests for a person who has had a known neurological event or injury, such as a stroke or traumatic brain injury, to find which cognitive functions have changed and how much they have changed.
  • To establish a baseline—In some instances, an examination is performed before and after a medical or surgical treatment to determine if cognitive abilities were affected by the intervention. Re-examination at some point after the baseline can also demonstrate how well an individual is recovering from a stroke or traumatic brain injury and whether or not he or she is ready to return to work, resume driving, or take on some other duty.
  • To help plan a treatment or other intervention—Test results can be used to identify which cognitive abilities should be the focus of rehabilitation when a patient has had a brain injury or help therapists determine which strengths might be able to compensate for weaknesses. The evaluation can provide the basis for making adjustments in school or work programs.

How will you know if my cognitive abilities have changed if I have not had an exam in the past?

Some cognitive abilities tend to be very stable despite neurologic illnesses or injuries. Those abilities often provide an estimate of the level of your other cognitive abilities if no injury or illness had occurred. Your results will be compared to those associated with various illnesses or injuries to help to determine if changes have occurred.

What will the examination involve?

A licensed psychologist chooses the tests that will be given, conducts an interview, and writes a report that summarizes the results. The tests are scored by a trained technician called a psychometrist or by a postdoctoral fellow currently in training under the supervising neuropsychologist.

The neuropsychologist will talk with you to understand any concerns you and your family members might have about your cognitive functioning, your medical history, and educational background. He or she will also review your medical record. If a family member comes to the evaluation with you, the neuropsychologist may ask for your permission to interview him or her as well.

You will work with a psychometrist, who will have you complete several tests. The tests typically involve writing, working on a computer, solving puzzles, or answering questions. Most people find some of the tests to be quite easy and others to be difficult. It is important to work as hard as possible on all of the tests in order for the results to be most informative.

Most of the tests used in neuropsychology are standardized, which means they are given the same way to everybody. The tests are also norm-referenced, which means that a patient’s performance on those tests will be compared to the performance of other people who are about the same age and, sometimes, people who have the same educational background. The test results are used to answer many types of questions.

You will also complete questionnaires about mood and psychological symptoms. Parents of children referred for neuropsychological examinations often complete questionnaires about their children's behavior.

The length of time for testing varies considerably based on the nature of the reason for the examination. Typically, evaluations take approximately 3 to 5 hours, depending on which tests need to be administered and how quickly you are able to work comfortably. You are encouraged to take breaks as necessary and, if the testing session extends on to the afternoon, you will be offered a lunch break.

What should I do to prepare for the testing?

  • Get a good night's sleep.
  • Try to eat a good breakfast.
  • Take all of your medications as usual unless you are directly instructed to do otherwise.
  • If you use glasses, contact lenses, or hearing aids, make sure you have them with you.
  • If you have had any neuropsychological, psychological, or academic testing done in the past, bring those records with you.
  • If your child is undergoing the testing, and he or she has completed an intellectual evaluation, psychoeducational evaluation, Multifactored Evaluation (MFE), or Individual Education Program (IEP), please bring along copies of the results of those evaluations.
  • If you want the results of your neuropsychological examination to be sent to a health care provider outside of the Cleveland Clinic, you will need to sign a release form giving the neuropsychologist permission to share your results. Please have their contact results available.

Does insurance cover a neuropsychological evaluation?

Insurance coverage varies greatly, depending on individual insurance plans. Some portion of the evaluation is usually covered. If you want to check with your insurance company before the evaluation, you will need to let them know the following CPT (procedure) codes:

  • 96118: Interview, examination, and interpretation by a neuropsychologist
  • 96119: Test administration

Making an appointment

Typically, patients are referred by a family physician or medical specialist to see one of our neuropsychologists. To make an appointment or referral during business hours (8:00 am to 5:00 pm), please call: 216.444.6115 or 1.800.223-2273, ext. 446115.

References

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Can't find the health information you’re looking for?

This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 12/15/2008…#4893