A neuropsychological evaluation is often recommended by your child’s school, pediatrician, or therapist to provide further clarity on your child’s diagnoses, strengths, and weaknesses. The goal of this evaluation is to be better able to understand your child’s functioning compared to their same-age or same-grade peers and consider if they may benefit from any interventions such as academic accommodations or additional therapeutic or psychiatric support.
The reason a neuropsychological evaluation is beneficial and considered more highly than a letter from a therapist alone is because these evaluations: 1) consider multiple sources of information, 2) consider IQ, academic achievement, and other variables such as language abilities or executive functioning skills to consider your child’s entire profile and 3) use direct assessments that are standardized, meaning we can draw comparisons between your child and their same-age or same-grade peers across the United States. Direct assessment refers to assessments that are not based on opinions, such as self-report questionnaires and interviews. We often conduct a variety of direct assessments based on your child’s presenting concern but always provide a measure of intellectual abilities (IQ) and academic achievement. In many cases, we are flexible and can add additional measures as the assessment is being completed based on your child’s performance. The reason we do so is because there can be many reasons to explain a child’s presenting concern. For example, if a child is struggling to focus in class, this could be a sign of ADHD but can also be a sign of OCD if they are experiencing intrusive thoughts throughout their school day that make it hard to hear what they are learning.
Another important feature of a neuropsychological evaluation is the goal of capturing your child’s history and their experiences from a variety of sources. The neuropsychological assessment process begins with a parent interview reviewing your child’s history and current symptoms in detail. We specifically review your child’s developmental, medical, academic, and social histories. It is also highly beneficial if you can provide previous assessment documentation, previous IEP documentation, report cards, or medical history to further substantiate your child’s history. It is also very helpful to hear from other adults that work closely with your child, such as therapists, pediatricians, and teachers. These individuals often have a unique perspective on your child’s experiences and can provide clarity. It is often especially helpful to have teachers provide feedback and/or complete questionnaires to provide context on your child’s functioning in the classroom. As we go through the assessment process, parents will also be asked to complete questionnaires and sometimes complete a structured clinical interview that is meant to provide clarity about potential diagnoses. All of this additional information to the direct assessment helps to further substantiate your child’s diagnoses and provides a greater chance that your child will receive the support they need.
The steps of a neuropsychological assessment are:
1. Parent Intake. The assessment process begins with a 1-1.5 hour long parent intake in which we review your child’s history and current concerns.
2. Direct Assessment. Your neuropsychological assessment provider will then meet with your child individually for 2-4 in-person testing administrations to complete the direct assessments. Each session can last between 2-4 hours depending on your child’s comfort level and the efficiency with which you need the assessment to be completed. If you are meeting for longer sessions, we usually recommend taking a break in the middle and to bring water and snacks. The goal of the assessment is to see how your child does in ideal conditions, such as a quiet, individual space so that we can draw comparisons to their performance at school. We therefore want your child feeling as motivated and energized as possible so that they can do their best.
3. Parent Interviews (if necessary). Based on your child’s performance, we may schedule additional parent follow-ups, such as a structured clinical interview to rule out or confirm possible diagnoses.
4. Scoring and writing. Once all of the assessments have been completed, including any parent or teacher questionnaires, your neuropsych assessment provider will score the assessments and write the report. Neuropsychological assessment reports are often 20-30 pages and can often take 2-4 weeks to prepare.
5. Parent Feedback Session. We will meet for 1-1.5 hours to review the report to ensure that you understand your child’s strengths and weaknesses, how the diagnoses were determined, and what the recommendations are for treatment or academic accommodations. The goal of the feedback session is for you to feel comfortable advocating for your child. Following this, you will receive the report and it is yours to keep and distribute as you see fit. We typically recommend that reports are shared with your child’s school and pediatrician so that they can receive the support that they need.
6. Child Feedback Session (optional for teens). Often when working with teenagers, we will hold an additional feedback session with your child either individually or with you present. We will answer any questions they had about the assessment, highlight their strengths, and explain their diagnoses. The goal is to reduce any possible misunderstandings or stigmas about the diagnoses and highlight what your child did well and can continue to grow with.
If you have any questions about whether your child may benefit from a neuropsychological assessment, Dr. Graham conducts them through the Gordon Therapy Group located on the Upper West Side in NYC. Learn more at https://gordontherapygroup.com/