Counselling, Mental Health

What’s the Deal With Neuropsychology?

Clinical Neuropsychology is a subfield of psychology that aims to understand the complex and multifaceted relationship between brain function and behaviour. Neuropsychologists are diagnostic specialists who assess the ways in which our client’s brain structures and systems impact their everyday functioning.

When should I refer a client to a neuropsychologist?

As mental health providers, we know that a client’s emotional, behavioural, and cognitive symptoms can have many underlying causes. You may consider making a referral for a neuropsychological assessment if your client presents with any of the following:

  • Intellectual giftedness or disability
  • Learning/academic problems
  • Issues with attention, focus, distractibility, and concentration
  • Changes in energy and speed levels
  • Memory complaints, which can include forgetfulness and short-term memory loss
  • Expressive and receptive language difficulties
  • Visuospatial difficulties
  • Poor judgement, decision-making, insight, or problem-solving
  • Impulsivity and disinhibition
  • Sensorimotor problems, which includes motor speed, planning, dexterity, and sequencing of movements
  • Personality changes
  • Social/communication problems
  • Mood disturbance
As mental health providers, we know that a client’s emotional, behavioural, and cognitive symptoms can have many underlying causes

How can neuropsychology help my clients?

A neuropsychological evaluation is a comprehensive assessment of a client’s cognitive skills and abilities. Assessments can provide valuable information on your client’s intellectual, academic, attention, problem-solving, processing speed, memory, language, visuospatial, executive, social, and emotional functioning.

Standard assessments start with a thorough clinical interview where a neuropsychologist will gather relevant clinical information which includes onset, course, and severity of symptoms. Then a neuropsychologist or trained psychometrician administers a series of standardized tests that can include oral questions, paper and pencil or computer-administered tasks, manipulation of various test materials, storytelling, questionnaires, and other procedures. A neuropsychologist then interprets the data within the context of the client’s history and creates a written report.

While reports may differ slightly, most will include a summary of relevant history, medical/developmental/academic/social/mental health history, behavioural observations, test findings, diagnoses, and recommendations. Your client will receive a feedback session to review findings, affirm diagnoses, and discuss recommendations.

As the referring provider, a neuropsychological evaluation provides a functional profile that can be used for:

1. Diagnostic clarification

The primary goal of a neuropsychological evaluation is diagnostic. It can help differentiate between disorders with overlapping symptoms, assess for subclinical vs. clinical severity, and determine possible etiological considerations.

2. Determining cognitive strengths and weaknesses

Every brain develops differently based on genetic, developmental, environmental, and cultural factors. The results of a neuropsychological evaluation will describe your client’s individual profile of cognitive functioning.

3. Establishing a cognitive baseline or monitoring interval progress 

In the case of an acquired or developmental event or injury, results can help determine what cognitive functions have been impacted and to what extent. Routine re-evaluations can also help track rate of recovery or deterioration, inform prognosis, and determine the effectiveness of implemented interventions.

4. Treatment planning 

An accurate diagnosis is often considered a cornerstone to effective treatment. A profile of your client’s cognitive abilities can help guide the focus of treatment and identify the ways in which a client’s strengths may have clinical utility to compensate for deficits.

How can we help clients prepare for a neuropsychological evaluation?

Depending on the referral question, test administrations can take between two to eight hours. While your client will be encouraged to take frequent breaks, the average length of an evaluation is typically between three to six hours.

  • You should encourage your client to get adequate sleep the night before their evaluation, eat a high-energy breakfast in the morning, and take all medications as prescribed. But keep in mind that the neuropsychologist may suggest something different during the clinical interview process.
  • Your client should also arrive with all necessary assistive devices (glasses, contacts, hearing aids, etc.) and be free of all mood-altering drugs. Providing previous medical records will also be helpful. This includes previous testing reports, academic records (e.g., IEP and 504 plans), and neuroimaging (e.g., CT or MRI scans).
  • Due to the length of some evaluations, it may be necessary to also bring snacks or plan for a meal break. And lastly, your client will be mentally drained after their evaluation. As such, they should plan not to return to work or school or do any other mentally taxing tasks.

After feedback is provided, a neuropsychologist may continue to collaborate with other treatment team members to coordinate care. They may also be available for further consultation to answer any questions about the results and recommendations or participate in multidisciplinary meetings to advocate for school or workplace accommodation.

While there are many benefits to referring for a neuropsychological evaluation, results can help to deepen your understanding of your client’s cognitive and emotional functioning, which helps to determine next steps for effective treatment.


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Author

Krystel Salandanan

Psy – Trainer, Crisis & Trauma Resource Institute

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