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 NEUROPSYCHOLOGY
AND COGNITIVE ENHANCEMENT
What Is Clinical Neuropsychology?
Clinical neuropsychology is a specialty profession that focuses
on brain functioning. A clinical neuropsychologist is a licensed
psychologist with expertise in how behavior and skills are related
to brain structures and systems. In clinical neuropsychology, brain
function is evaluated by objectively testing memory and thinking
skills. A very detailed assessment of abilities is done, and the
pattern of strengths and weaknesses is used in important health
care areas, such as diagnosis and treatment planning. The clinical
neuropsychologist conducts the evaluation and makes recommendations.
He or she may also provide treatment, such as cognitive rehabilitation,
behavior management, or psychotherapy.
Why Have I Been Referred?
Neuropsychological evaluations are requested specifically to help
your doctors and other professionals understand how the different
areas and systems of the brain are working. Testing is usually recommended
when there are symptoms or complaints involving memory or thinking.
This may be signaled by a change in concentration, organization,
reasoning, memory, language, perception, coordination, or personality.
The change may be due to any of a number of medical, neurological,
psychological, or genetic causes. Testing will be helpful in understanding
your specific situation.
What Is Assessed?
A typical neuropsychological evaluation will involve assessment
of the following:
- General intellect
- Higher level executive skills (e.g., sequencing, reasoning,
problem solving)
- Attention and concentration
- Learning and memory
- Language
- Visual-spatial skills (e.g., perception)
- Motor and sensory skills
- Mood and personality
Some abilities may be measured in more detail than others, depending
on your needs.
How Are Test Scores Used To Understand My Specific Situation?
Your test scores will be compared to scores from people who are
like you in important ways. By using database scores from large
groups of healthy people for comparison, the neuropsychologist can
judge whether or not your scores are normal for your age and educational
background. The pattern of your own test scores will also be reviewed
to estimate whether or not there has been a change in certain abilities.
How you go about solving the various problems and answering questions
during the examination will also be noted. Using these methods,
your strengths and weaknesses can be identified.
What Will the Results Tell Me?
Test results can be used to understand your situation in a number
of ways.
- Testing can identify weaknesses in specific areas. It is very
sensitive to mild memory and thinking problems that might not
be obvious in other ways. When problems are very mild, testing
may be the only way to detect them. For example, testing can help
determine whether memory changes are normal age-related changes
or if they reflect a neurological disorder. Testing might also
be used to identify problems related to medical conditions that
can affect memory and thinking, such as diabetes, metabolic or
infectious diseases, or alcoholism.
- Test results can also be used to help differentiate among illnesses,
which is important because appropriate treatment depends on accurate
diagnosis. Different illnesses result in different patterns of
strengths and weaknesses on testing. Therefore, the results can
be helpful in determining which areas of the brain might be involved
and what illness might be operating. For instance, testing can
help to differentiate among Alzheimer's disease, stroke, and depression.
Your physician will use this information along with the results
of other tests, such as brain imaging and blood tests, to come
to the most informed diagnosis possible.
- Sometimes testing is used to establish a "baseline,"
or document a person's skills before there is any problem. In
this way, later changes can be measured very objectively.
- Test results can be used to plan treatments that use strengths
to compensate for weaknesses. The results help to identify what
target problems to work on and which strategies to use. For example,
the results can help to plan and monitor rehabilitation or to
follow the recovery of skills after a stroke or traumatic brain
injury.
- Studies have shown how scores on specific tests relate to everyday
functional skills, such as managing money, driving, or readiness
to return to work. Your results will help your doctors understand
what problems you may have in everyday life. This will help guide
planning for assistance or treatment.
What Should I Expect?
A neuropsychological evaluation usually consists of an interview
and testing. During the interview, information that is important
for the neuropsychologist to consider will be reviewed. You will
be asked about your symptoms, medical history, medications, and
other important factors. Testing involves taking paper-and- pencil
or computerized tests and answering questions. The time required
depends on the problem being assessed. In general, several hours
are needed to assess the many skills involved in processing information.
Some tests will be easy while others will be more complex. The most
important thing is try your best. Bring glasses or hearing aids
if you use them. Try to rest and relax before your evaluation. You
will probably find testing interesting, and the detailed information
that is gathered will contribute to your care.
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