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Neuropsychological Testing

A neuropsychological evaluation answers the question “Why does my child have a learning difference?”

Neuropsychological evaluations are considered the most comprehensive type of evaluation and typically include psychological and psycho-educational testing components.

The major difference is that neuropsychological testing goes a step further than other tests to understand the relationship between behavioral, cognitive and functional deficits and underlying brain functions. A neuropsychological evaluation focuses on learning and behavior in relation to an individual’s brain and involves the use of standardized, norm-referenced tests and behavioral observations. It also incorporates knowledge of brain development, organization and functioning into the evaluation findings.

In other words, it measures cognitive abilities and processes such as attention and executive functions, reasoning, language, memory and learning, and visual-spatial/visual-motor abilities. Neuropsychological tests are typically administered to a single person working with an examiner in a quiet office environment, free from distractions. Neuropsychological tests are a core component of the process of conducting neuropsychological assessment, along with personal, interpersonal and contextual factors.

For instance, a child may struggle to accurately answer questions about what he/she just read. If this is a reading comprehension problem (answers the question IF there is a problem),  it will help to know if the lack of comprehension comes from visual processing difficulties, memory challenges, expressive language deficits or even performance anxiety.

A clearer understanding of “why” problems exist and their underlying cognitive abilities or processing deficits, as well as emotional and behavioral factors, is crucial in determining the most effective, individually-tailored intervention plan. Children with known neurological conditions (ex. seizures, neurofibromatosis, brain tumors) and injuries (ex. concussions), as well as, exposure to toxins (ex. lead poisoning, alcohol and substance exposure prior to birth) and medical conditions and factors which increase risks for brain injury (ex. history of complicated pregnancy, delivery, and prematurity) may be referred for neuropsychological evaluations.

The different types of neuropsych testing include :

Weschler Intelligence Scale for Children (WISC) is an individually administered intelligence test for children between the ages of 6 and 16. The test takes 45–65 minutes to administer. It generates an intelligence quotient or IQ score that represents a child’s general intellectual ability. It also provides five primary index scores: Verbal Comprehension Index, Visual Spatial Index, Fluid Reasoning Index, Working Memory Index, and Processing Speed Index. These indices represent a child’s abilities in discrete cognitive domains. This test covers many other subtests that measure math ability and fluency. The average score is 100 and any score from 90-109 is considered average.

Wide Range Assessment of Memory and Learning (WRAML) is a standardized test that measures an individual’s memory functioning. It evaluates both immediate and delayed memory ability, along with the acquisition of new learning. The WRAML is normed for individuals ages 5–90 years. It is composed of two verbal, two visual, and two attention-concentration subtests yielding indices in each area, which results in General Memory Index.

Peabody picture vocabulary test measures a person’s vocabulary and ability to speak. The person will listen to various words and choose pictures that describe the words.

Woodcock–Johnson Tests (WJ) for Cognitive Abilities  is a set of intelligence tests administered to children from age two right up to adults. The 35-40 detailed  tests include Numerical Reasoning, Pattern Recognition, Spatial Relation, Visual Matching, Decision Speed, Sound pattern and so on. All of these combined allow for a considerably detailed analysis of cognitive abilities.

Children’s Memory Scale (CMS) is another test for memory that can show impairment in visual and spatial memory.

Paced Auditory Serial Addition Test (PASAT) is a measure of cognitive function that assesses auditory information processing speed and flexibility, as well as, calculation ability.

Differential Ability Scales (DAS-II) for ages 2.6–17.11 years. Twenty subtests look at problem-solving skills in a number of areas. There are lots of visual cues, such as pictures. And children can often respond to prompts by pointing to an “answer.”

Stanford-Binet Intelligence Scale-V for ages 2–85+ years. This test assesses abilities in five basic areas. These include fluid reasoning, knowledge, quantitative reasoning, visual-spatial processing and working memory.

Universal Nonverbal Intelligence test is given and answered using a series of eight hand and body gestures, such as pointing. It is targeted for children ages 5 –17.11 years. It’s often used with kids who are nonverbal or who have hearing issues.

Test of pragmatic language measures understanding of inferred language. Its tests a person’s social language skills that are used in daily interactions with others. It includes what we say, how we say it, our non-verbal communication (eye contact, facial expressions, body language, etc.) and how appropriate our interactions are in a given situation. It assesses whether a person understands how the same word can have different meanings in different settings. It also tells us how people react to different symbols. It is a test that may be done for those suspected to have Aspergers syndrome, autism or speech and language deficiencies.

Laterality and Sequencing are tests to determine if a child has difficulty in differentiating between right and left and with visual sequencing.

Continuous Performance Test (CPT) is one of several kinds of neuropsychological tests that measures a person’s sustained and selective attention. Sustained attention is the ability to maintain a consistent focus on some continuous activity or stimuli and is associated with impulsivity. Selective attention is the ability to focus on relevant stimuli and ignore competing stimuli. This skill is associated with distractibility.

Delis Kaplan-Executive Functioning system is a neuropsychological test used to measure a variety of verbal and nonverbal executive functions for both children and adults (ages 8–89 years).

NEPSY stands for “A Developmental NEuroPSYchological Assessment.” It is a series of tests that are used in various combinations to assess development in children ages 3–16 years in six functional domains. NEPSY was designed to assess both basic and complex aspects of cognition critical to children’s ability to learn and be productive, in and outside of, school settings. It is designed to test cognitive functions not typically covered by general ability or achievement batteries such as Visuo- Spatial Processing, Phonological processing, Speed naming, Visuomotor precision.

Comprehensive test of Phonological Processing (CTOPP) assesses phonological awareness, phonological memory and rapid naming. It was developed to aid in the identification of individuals from preschool through college, who may benefit from instructional activities to enhance their phonological skills.

The Rey Complex Figure Test (RCFT) measures recognition memory and assesses the respondent’s ability to use cues to retrieve information. It gives a snapshot of big picture thinking. Appropriate for use with children and adults, this tool gives information about the major aspects of neuropsychological functioning.

Psychiatric Evaluations is a psychiatric evaluation for various disorders, which may be done by  parents if they suspect mental health issues. Schools usually do not facilitate this evaluation. The diagnosis from these evaluations will influence an IEP, 504 Plan or other accommodations. Disorders include: mood disorders (depression, bipolar, etc.), anxiety disorders (OCD, phobias, panic) personality disorders, psychotic disorders (such as schizophrenia), eating disorders (bulimia, anorexia), trauma-related disorders (such as post-traumatic stress disorder) and substance abuse disorders.



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