If You Have Been Referred for Neuropsychological Evaluation

What is Neuropsychological Evaluation?

A Neuropsychologist is a psychologist who specializes in understanding, measuring, and treating conditions involving the brain and behavior.  “Behavior” means “cognitive” (thinking) skills like paying attention, solving problems, learning and remembering; feeling and expressing emotions; and physical (“motor”) skills. Neuropsychological evaluation uses tests and measures to determine how the brain is functioning by measuring behavior.  Common tests you may have heard about that could be used include IQ and memory tests.

Why would I be referred for this?

  • You or your medical doctor or specialist may be concerned about changes in your thinking or memory.
  • You may have had an illness or injury such as stroke or head injury which affects the brain.
  • You may want to document changes after an accident.
  • You may want to measure conditions such as ‘attention deficit’ or ‘learning disability,’ to plan therapy for these, or to plan changes at home, school or work which will help you function at your best.

Even with “high tech” scans available these days, neuropsychological evaluation is the best method to measure how the brain affects WHAT YOU CAN DO. For some conditions, such as Alzheimer’s Disease, the best current practice is to include neuropsychological evaluation to help make the diagnosis.

What are the tests like? The neuropsychologist will ask for background information, and help you become comfortable in the office.  A family member may be with you during an initial interview, but not during testing as this might be distracting. The tests let you try to do things like listen to and remember information, answer questions out loud, read, write, calculate, and solve puzzles. Some tests are timed and measure how quick you are, but many are not timed. Some measure your sense of touch, vision and hearing, and may require the examiner to touch you briefly on the hands or face. None of the tests hurt or cause discomfort. Should you ever become uncomfortable, or cannot concentrate or want a break, let the examiner know right away. Some people have mild “performance anxiety,” but otherwise there are no known risks or side effects.

How can you tell if my functioning has changed if you never tested me before my illness or injury? This is a very frequent question. The neuropsychologist looks for patterns in the test scores to infer how the brain is working. This requires a thorough knowledge of the brain and the tests, and how these relate. Test results are also compared to others similar to you in age and education. In some cases school records, results from tests you may have had before, and information about specialized training, experience or work you have done may help estimate your prior abilities.  Finally, some of the tests themselves help estimate how a person was functioning prior to an illness or injury.

How long does it take? This depends on the reason for the evaluation and the tests used. In many cases a “screening” will be best, which requires 3-4 hours including interview. In other cases, “comprehensive” evaluation is needed, which may require 8 hours. A  comprehensive evaluation is best completed on one day, but can be scheduled on two separate days within a week span.

How do I find out the results? A report is provided to the referring source, depending on the purpose of the evaluation. As with all your health records, you may request a copy of any written report. Also depending on the reason for the evaluation, your neuropsychologist may follow up with you by telephone, in writing or with an in-person feedback visit to summarize the results and recommendations.

How much does it cost? Ask your neuropsychologist about the specific fees. If the evaluation is necessary for a medical reason, most health insurance policies cover neuropsychological testing.  Coverage varies, usually from 50 to 80% of the allowed charge.  For example, Medicare covers 80% of the charge they allow and, if you have a second insurance, that may well cover the rest.  You would be responsible for any amounts not covered by insurance.  Check with your insurance company about coverage and limitations, or ask our office to help verify benefits.  Because of the preparation and equipment involved, any “copayment” is required at the time of the appointment.

What else should I know? You cannot really “study” for the tests, since these mostly measure ability rather than knowledge.  You do not have to do anything special to prepare. Just go about your ordinary activities before the testing day, including taking any prescribed medications.  Try to get a good night’s sleep the night before, and eat a good breakfast.   If you have questions during the testing, just ask.  The only thing we cannot tell you is answers to the test questions!

© 1998-2013, Gordon I. Herz, PhD. All rights reserved.

To request a printed copy of the brochure “If You Have Been Referred for Neuropsychological Evaluation,” email your request to Dr. Gordon Herz.