A Guide to Neuropsychological Testing Jeffrey Kreutzer, PhD and Victoria Powell, PhD, Department of Physical Medicine and Rehabilitation Virginia Commonwealth University

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Many people who have a brain injury undergo psychological testing, a specialized evaluation method. In this article, we describe the purpose and procedures involved in testing and answer common questions.

Research reveals that brain injury often affects abilities, behavior, and emotions. Commonly reported symptoms include trouble remembering things, thinking of the right word, seeing clearly, concentrating and doing more than one thing at a time (multi-tasking). Academic abilities are often affected as well. People may have difficulty spelling, doing simple math problems, and understanding what they read. Emotional changes may include frustration, depression, and difficulty controlling anger. After a brain injury, you, your doctor, therapists, and family members may want to know exactly how you have been affected. Testing helps answer important questions like:

• How good are the patient’s memory, attention, and problem-solving skills?
• At what grade level is the patient’s reading, arithmetic, and spelling?
• Does the patient need accommodations and a specialized education plan?

On a more global level, testing can help answer questions like:

• Can a person with the injury:
  • live safely by themselves?
  • successfully go back to work or school?
  • manage their finances or medications safely?
  • drive safely?

Who gives the test?

Neuropsychological tests are given, scored, and interpreted by a licensed clinical psychologist or neuropsychologist. A neuropsychologist is a professional who specializes in understanding how the brain and its abilities are affected by neurological injury or illness. Psychometrists are professionals specially trained in giving and scoring tests under the supervision of a licensed psychologist.

What should I expect on the day of the testing?

Before your appointment, you will usually be asked to provide records about the history of your injury and what rehabilitation treatments you have had. You may also be asked to give your medical, psychological, and educational history. The neuropsychologist also needs to know which living, work, and educational skills are most important for you now. For example, different jobs require different skills. A teacher may need to be very good at math and reading. A construction worker may need good attention and visual skills.

On the day of your appointment, you and a family member or close friend will meet for an interview with the neuropsychologist. Try to get a good night’s sleep, eat breakfast, and take your medications as prescribed. The neuropsychologist will ask questions about your current problems and recovery so far. Testing will then begin.

Usually testing takes between two and six hours, thought some patients take longer. During testing you will be asked to answer questions, do tasks with pencil and paper, remember information, and possibly respond to questions on a computer. You will be given breaks depending on how you feel and how long the evaluation takes. Afterward, your tests will be scored and the scores will be compared to those of other people the same age and level of education.

The Neuropsychological Report

The neuropsychologist writes a detailed report that includes important information form the interview and tests including diagnostic conclusions. Information will be provided on your strengths, weaknesses, and limitations and your emotional well-being. The rport will often include recommendations for improving memory, therapy to improve your mood, or referral to other rehabilitation professionals. The report will usually be sent to you and your doctor. You may request a feedback session with the neuropsychologist to discuss your results and ask questions.

In summary, neuropsychological testing is an important tool. The process can help you and your doctors better understand your injury and recovery and better plan for you to receive the most effective therapy.

Written by Jeffrey Kreutzer, PhD and Victoria Powell, PhD, Department of Physical Medicine and Rehabilitation Virginia Commonwealth University, Richmond, VA. Used with permission. www.pmr.vcu.edu.

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