What is neuropsychological testing?
Neuropsychological testing is a medical assessment tool that helps us understand the relationship between brain functions and behavior. It’s used for a range of purposes to clarify, understand, diagnose, and monitor neurological, medical, and psychiatric conditions. These conditions include Alzheimer’s disease, ADHD, and concussions.
Neuropsychological testing is carried out by specialized mental health professionals with specific training in its administration and interpretation. In most cases, this will be a neuropsychologist; while a clinical psychologist assesses and treats mental health conditions, a neuropsychologist specializes in the assessment and treatment of brain-based psychological disorders. In many states, other mental health professionals such as social workers and counselors are also able to administer and interpret such tests as long as they have received the appropriate advanced training.
The tools used are usually performance-based measures of mental functioning, meaning that they require people to actively participate in the tasks.
Read on for more information about what neuropsychological testing is like, and what it can help with.
What neuropsychological testing can help with
Neuropsychological testing is used to assess a person’s cognitive functioning, a term used to refer to our many mental abilities, including:
- Spatial functions
- Processing speed
- Decision making
Neuropsychological testing gives us a measure of a person’s cognitive functioning, which can help to detect and diagnose clinical issues, including:
- Neurological disorders like Alzheimer’s disease
- Changes to mental abilities due to brain injury, such as may occur following concussion
- Neurodevelopmental disorders in children, such as ADHD
- Effects of severe mental illness, such as schizophrenia
What happens in a typical neuropsychological test?
Neuropsychological testing usually occurs following a referral from a medical professional. It’s typically - but not always - completed in one sitting.
A trained examiner, usually a mental health professional, interviews and then guides the examinee through a variety of individual tests designed to assess specific mental abilities, such as those described above. Tests can vary in length; some can take several hours. Some of these tasks might feel like puzzles, quizzes, or pencil-and-paper activities.
How does neuropsychological testing help?
The clinician compares the results from the tests to a normative sample. This means that the results are compared to the performance of a comparable sample of people - those of a similar age, sex, race, education, or other demographic factors. This enables the clinician to decide whether the examinee is performing as would be expected, compared to similar peers. It’s important to note that there’s no pass or fail mark - just a profile of strengths and weaknesses.
If the test scores are lower than expected, the clinician can use that information to determine which mental abilities are affected, and how to best assist the examinee to compensate for any cognitive difficulties affecting their daily life.
For example, an individual who experiences a stroke may be referred for neuropsychological testing. The clinician might discover that the individual’s scores on memory tests are lower than would be expected, which may reflect difficulty with memory affecting daily life. The clinician would be able to help with memory tools, to improve the examinee’s quality of life.
Some neuropsychological tests can be re-administered in a later session, to assess changes over time. This can be helpful for many reasons, such as tracking the progression of Alzheimer’s disease, or the recovery of functioning following a brain injury.
What to look for in a clinician for neuropsychological testing
There are several factors to keep in mind when selecting a mental health professional, including:
It’s essential to seek assessment from a licensed clinician with specialized training in neuropsychological assessment. In most cases, this will be a neuropsychologist. In many states, other mental health professionals such as social workers and counselors can also provide assessments if they have received the appropriate advanced training.
Look for a neuropsychologist who has been board certified by the American Board of Clinical Neuropsychology (ABCN) and is a member of the American Academy of Clinical Neuropsychology (AACN), to ensure they have the appropriate level of expertise. You can find this information in the clinician’s biography on their website or online profile.
Neuropsychological testing often occurs in a one-off appointment, and therefore the relationship differs from the typical client-therapist relationship in ongoing psychotherapy. However, some individuals continue to work with their neuropsychologist, receiving treatment based on the results of the neuropsychological testing. In this case, it’s important to make sure you feel comfortable with the practitioner.
The trusting relationship between you and your therapist, known as the “therapeutic alliance,” has an important impact on the efficacy of therapy. The best way to judge how you might feel about a practitioner is to ask for a preliminary phone call. This also allows you to ask about their experience and what the testing will be like.
- G.G.Fisher, M. Chacon, & D.S.Chaffee, 2019, “Theories of Cognitive Aging and Work”, Work Across The Lifespan
- P.D. Harvey, 2012, “Clinical applications of neuropsychological assessment”, Dialogues Clin Neurosci, 14(1). Accessed online December 2019 at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3341654/
- UNC Department of Neurology website, “Neuropsychological evaluation FAQ”. Accessed online December 2109 at https://www.med.unc.edu/neurology/divisions/movement-disorders/npsycheval/