Neuropsychological Assessments
The Centers for Disease Control and Prevention (CDC) reports that one in ten adults aged 45 and older deals with worsening memory loss.[1]
And according to the predictions of current research data, 42% of Americans over age 55 will develop dementia during their lifetime. Based on this information, it’s clear that increasing age is a major cause of cognitive decline.[2]
However, cognitive difficulties have also almost doubled in people aged 18 to 39 over the past decade.3 Children, adolescents, and adults can all have impairment in brain function for various reasons. Attention-deficit/hyperactivity disorder (ADHD) and autism, language and learning disorders, Parkinson’s, multiple sclerosis, stroke, trauma – all can contribute to impairments.
A neuropsychological assessment tests for your brain’s current abilities to function in terms of memory, attention, reasoning, language, and executive control. Through these assessments, the best approach to tackling issues can be determined.
Mission Connection Healthcare offers neuropsychological evaluations for adults. This means we help you understand exactly how your cognitive abilities currently are and how you can improve them.
This page can also help by working as a guide for neuropsychological assessments, as it explores:
- What neuropsychological assessments are
- What they’re used for
- The different types of assessments
- Reasons why you might choose to get an assessment
- What happens during an assessment, including how long they typically are, and how to prepare for them
- What the results of these tests can mean
- Where to find professional neurological assessment services
What Is a Neuropsychological Assessment?
A neuropsychological assessment is a structured evaluation of your current brain functioning. It is conducted by a licensed neuropsychologist using standardized tools. These basically are questionnaires that have been validated in U.S. populations.
The core purpose of an assessment is to identify cognitive and behavioral patterns that may be a manifestation of underlying neurological or psychological concerns. But there are many different tests that are validated for various purposes.
Typically, you can get one in a hospital or at an outpatient treatment center recognized by the American Psychological Association.
What Is a Neuropsychological Assessment Test For?
There are many different versions of neuropsychological assessments. However, the majority of them are used to test for one of the following:
- Memory testing where you are required to repeat and later recall lists of words, sentences, or numbers.
- Cognitive reasoning testing that requires you to explain how two or more items are alike. For example, it tests if you are capable of conceptual thinking and how effective you are at forming relationships between ideas.
- Verbal communication testing through naming objects, generating words under constraints like those starting with a specific letter, rapidly retrieving vocabulary, and so on.
- Motor functioning testing to check your fine motor skills, such as your control over precise hand movements. It could, for example, ask you to place pegs into a board with each hand. Gross motor skills can also be tested.
- Sensory-based testing in which your visual and hearing abilities are tested to see how they affect your cognition.
Types of Assessments
The following are some types of neuropsychological assessments:
Neuropsychological Evaluation
Neuropsychological evaluation checks for your brain’s cognitive performance in the following domains:
- Attention and concentration
- Processing speed
- Learning
- Memory
- Language abilities
- Visuospatial skills
- Higher executive functions such as planning, reasoning, and cognitive flexibility
Every domain is assessed using norm-referenced tests. So, your performance will be compared against a large reference population matched for your age, education level, sex, ethnicity, and so on.
The results are validated through performance validity tests (PVTs) to determine whether your scores accurately reflect your true cognitive capacity.
Neuropsychological evaluations are most frequently requested in cases involving traumatic brain injury. You may also need one if you have a chronic neurological condition, such as stroke, epilepsy, multiple sclerosis, Parkinson’s disease, Alzheimer’s disease, and so on. For example, a 2022 review reports that neuropsychological test results integrated with biomarker and neuroimaging data provide early detection of dementia.[3]
Psychoeducational Assessment
This type of assessment checks your cognitive abilities for the purpose of identifying learning disabilities. It is often a requirement to determine your eligibility for special education services.
Psychoeducational assessments can be conducted within the public school system or by private psychologists hired by families.
The tools used for it typically include:
- Wechsler Intelligence Scale for Children (WISC-V)
- The Differential Ability Scales (DAS-II)
- Woodcock-Johnson Tests of Achievement
- Wechsler Individual Achievement Test (WIAT-4)
These measure your reading skills, comprehension, written expression, mathematical reasoning, working memory, how quickly you process information, and so on.
All public schools are required to conduct evaluations to determine whether a child qualifies for special education services under the Individuals with Disabilities Education Act (IDEA). For example, if you are sitting for the SAT, ACT, GRE, or any other professional licensing exam, and you want accommodations on your test, you will need to submit documentation of a qualifying disability, which can be your recent psychoeducational assessment.
Psychological/Personality Assessment
This type of assessment is concerned with how a person thinks about themselves and others and how they regulate emotions. The most widely used instrument for a personality assessment in the U.S. is the Minnesota Multiphasic Personality Inventory (MMPI). It has multiple versions, such as:
- MMPI-2
- MMPI-2 Restructured Form (MMPI-2-RF)
- MMPI-3
These primarily assess you for signs of depression, anxiety, somatic complaints, thought disturbance, antisocial behavior, impaired interpersonal functioning, and so on. For instance, the MMPI-3 was tested in a study of over 800 patients undergoing bariatric surgery and found that those with emotional dysfunction on the scale had higher rates of depression, anxiety, suicide history, and psychotropic medication use.[4]
Developmental Assessment
A special type of neuropsychological assessment is typically used to evaluate a child’s growth and development of cognitive, language, motor, adaptive behavior, and social-emotional functioning abilities.
In the U.S., developmental assessments are conducted from birth through early childhood to about 6–7 years of age. For instance, the Bayley Scales of Infant and Toddler Development is the most popular instrument for the assessment of infants and toddlers. It is used for children from one month to 42 months of age. And similar to the adult testing, it compares the scores to age-matched normative samples.
Bayley-4 testing is sensitive enough to catch signs of autism spectrum disorder, developmental delay, and language impairment in toddlers.[5]
Results from a developmental assessment are usually necessary to get access to early intervention services in the U.S. Children from birth to age three years who show developmental delays or have conditions likely to result in delays are eligible for early intervention under IDEA Part C.
Why Should You Get a Neuropsychological Assessment?
A neuropsychological assessment delivers a structured, evidence-based profile of your or your loved one’s brain function. You might need it for the following reasons:
- Clarity on symptoms: A lot of conditions present with overlapping cognitive and behavioral symptoms, for example, ADHD, learning disorders, anxiety, depression, traumatic brain injury, and neurodegenerative processes. Testing helps in differentiating between them.
- Creating a management plan: The assessment results are used to develop your management plan. Of course, you won’t begin treatment after an assessment alone, but it may become part of the investigations that are conducted to get to the root of your issues. It is also often included in deciding what types of therapy you require.
- Workplace or educational accommodations: If you get a diagnosis, you will be eligible to request accommodations at educational institutions and workplaces. A neuropsychological report meets the criteria for documented eligibility.
What Happens During a Neuropsychological Assessment?
If you choose to get a neuropsychological assessment, you will first need to go to a mental health provider, for example, Mission Connection Healthcare. Your primary care provider can also refer you to a facility.
The first step in the process is an initial consultation with the clinician. This is your clinical interview during which you are asked questions about your education, work, physical and mental health history, and any medications you’re on.
Taking all this information into account, the clinician will talk to you about the right type of assessment for your needs.
The assessment itself can take a few hours. It may take the form of a questionnaire that you need to fill in a comfortable environment, undistracted. But it can also include some problem-solving tasks like puzzles, recalling numbers, making simple drawings, hands-on activities, and so on.
After you’re done, the clinician is going to interpret your test results by comparing how you performed against other people with similar demographics to yours. Your results will also be correlated with specific medical and mental health records you have. After this, the clinician will meet with you to discuss the findings and next steps.
How Long Does a Neuropsychological Assessment Take?
According to the Brain Injury Association of America, you can expect neuropsychological testing to take up to eight hours.
[6] But this can vary largely depending on your need for testing and which test is used.
For example, the clinical interview with a mental health provider before you begin the pen-and-paper testing could take about an hour. Then you complete the actual testing under a psychometrist, which can take between three and six hours.
You will get breaks in between, and you can also request one whenever you want. And in case you become too tired during the process, your testing can be split into multiple days.
How to Prepare for a Neuropsychological Assessment
One of the best things you can do before testing is to get adequate sleep the night before, at least seven to nine hours, because insufficient sleep can reduce your cognitive abilities. In addition:
- Eat a balanced meal before your appointment so that your energy remains stable throughout the session.
- Wherever you get tested, call the facility in advance to ask if you can carry snacks to power through the test.
- Carry a water bottle along.
- Bring all the documents that could help your clinician understand your history. This may include a full list of medications you take with their doses, any past evaluations you’ve had, contact details for the doctor/therapist involved in your care, any referral forms, and so on.
When Should You Get a Neuropsychological Assessment?
You should pursue a neuropsychological assessment in the following cases:
- Experiencing neurological symptoms you haven’t had before.
- Noticing frequent short-term memory loss.
- Being unable to care for your finances.
- No longer being able to register the faces of close friends or family members.
- Having trouble finding words when speaking.
- Feeling confused, as if you are losing your sense of sequence.
- When recovering from a brain injury, concussion, or stroke, and you require an objective measure of cognitive impact.
- If you have a diagnosed neurological condition and need structured monitoring of cognitive change over time.
- You have undergone cancer treatment (since it is known to affect cognition).
Results of Neuropsychological Testing
Shortly after your testing is complete, a score of your performance on the test will be calculated. This is known as a “raw score.”
The raw score is converted into standardized metrics such as percentiles, T-scores, and scaled scores after being compared against a sample of people with similar age, education, and background status.
Your examiner will also describe the results for specific domains of the testing, like intellectual functioning, attention, memory, language, processing speed, executive functioning, and so on.
This is because different neurocognitive conditions affect different functions of the brain. So if a person has low scores in all domains, this can indicate a diffuse brain dysfunction or systemic factors like aging.
The outcomes of neuropsychological testing can include:
- Referring you for an extensive neurological evaluation and brain imaging.
- Getting a sleep study.
- Coordinating with your primary care provider for management of depression, metabolic conditions, or medication effects.
- Initiating a medication that slows down cognitive decline.
- Referring you for a psychiatric evaluation for a mental health diagnosis, and subsequently, therapy.
Neuropsychological Testing at Mission Connection Healthcare
Neuropsychological testing is available through many different treatment centers in the country. Your primary care physicians may use brief cognitive or psychiatric assessments during the intake process. However, a comprehensive neuropsychological evaluation occurs at a dedicated mental health treatment facility.
Mission Connection Healthcare integrates neuropsychological testing into a broader, evidence-based model of care. We ensure that you get a structured understanding of your cognitive functioning, and that this feeds into a targeted treatment plan.
We use your results to determine the exact type of therapy you will benefit from, such as cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), trauma-focused interventions, and so on.
Mission Connection Healthcare provides mental health services across California, Virginia, Washington, and beyond. If you’re interested in an assessment for yourself or a loved one, you can get started today by reaching out.
