A large part of my job as a psychologist is performing neuropsychological evaluations. Neuropsychology is a sub-specialty and while they may use assistants to aid in the actual testing, only licensed, Ph.D. level psychologists are able to conduct and interpret the results of neuropsychological assessment. Often in my practice, I initially encounter some confusion about what it is that we actually do, so I wanted to explain it here.
First off, you should know the difference between neurologists and neuropsychologists. Neurologists are medical doctors the focus on the brain. They might have the complete brain imaging or lab work such as an MRI or CT scan in order to look at the structure of the brain and determine if there may be obvious signs of a problem. If they want to get a better picture of how the brain is working, they will send you to a neuropsychologist. As neuropsychologists, instead of looking at the structure of the brain, we look at the functioning. Basically we do a series of assessments to examine areas of functioning such as: language, memory, attention, visuospatial skills, and higher order skills like planning or multitasking.
The process usual consists of about an hour of interview with the patient as well as a friend or family member (if necessary) then anywhere between 2-8 hours of testing depending on the particular presenting issue. Our battery of tests tends to take about 2-3 hours to get through, but some are longer and more comprehensive. Aside from a few short computerized tests, most of them are low-tech and simply involve verbal questions, workbooks, or pen and paper tasks.
When you are finished taking the neuropsychological assessment, we then score them based on the average performance for the patient’s age and education level. This is an important point to understand, even though it is very rare to get 100% on any of these tests, getting 60% might actually be perfectly average for your age or education level. Therefore we can tell the difference between someone who is suffering from normal age related memory loss and someone who is experiencing a memory disorder like dementia.
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It’s interesting to know that a neuropsychological evaluation will base my brother’s performance on his age and educational level. I think that he needs it because he may be suffering from bipolar disorder which is starting to alter his brain structure. In order to see if he’ll need strong medication, we’ll have to see a specialist that gives these evaluations first.