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A Guide to Neuropsychological Testing

Comments [7]

Jeffrey Kreutzer, PhD and Victoria Powell, PhD, Department of Physical Medicine and Rehabilitation Virginia Commonwealth University

A Guide to Neuropsychological Testing
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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.

Comments [7]

I think it's very interesting that every single comment in this thread states that neuropsychological testing has NOT been helpful to the patient, yet when I search the literature about what do to assess loss of function after a head trauma this is presumed to be the gold standard of diagnostic testing. How can there be such a discrepancy between what professionals tell us and what patients experience? Obviously no test is 100% accurate, but maybe this type of testing is favored by practitioners for their convenience and reimbursement dollars and not it's value to a patient.

Sep 5th, 2014 1:06pm

To the Scientist. Sounds like PTSD.

Jul 23rd, 2014 3:39pm

I suffered gun shot wounds to chest that have taken almost two years to recover from, yet I still struggle with vivid pictures of the fight for my life that took place at the time. I am forced to go through the complete sequence of events several times a day and night, without being able to turn the sequence off. Whatever can this kind of testing prove? it;s clearly a physiological issue and is not going to be resolved by having someone tell me where I fit within some set of gaussian distributions cross-correlated to different skill sets of differing occupations. I am a Ph.D scientist with > 20 years experience in physics and having someone who is not able to offer either medical or scientific reasoning ask me how I feel about this, without the capacity to understand neuroscience is a waste of time.

May 15th, 2014 9:21am

I have been through two, and now need to go again to please the insurance company.

My TBI was over a decade ago, and I did well for a while. Problems (noise sensitivity, transposing numbers...) have re-emerged.

The first Dr. was very good and went over the results with me. The second Dr. got upset when I asked if the high doses of three medications (4,000mg/day gabapentin, 300mg/day tegretol, and 200mg/day lexapro) I was taking could affect the results. She didn't know the common side effects, so in her review said I needed to 'pick himself up by the bootstraps". She was obviously upset when I asked if she knew the side effects. so she stated I have borderline personality disorder; no other Dr. agrees with her.

Pity the patient can't evaluate the administrator of the exam!

Now I am having problems again, and dread being judged by someone who's aim is to to prevent insurance claims. My problems are real, I am motivated to return to work, but find the healthcare system severely lacking for TBI injuries.

Apr 14th, 2014 2:42pm

Same thing happened to me, and I'm not lying. I can't run my own company since the car accident and I'm losing money but can't do anything about it. I don't know how to get better by myself.

May 13th, 2013 7:50am

According to the Dr.'s my grandson passes these tests in the normal range,when administered in a dark room, undisturbed, however he still has a total personality change, extreme headaches when subjected to lights, confusion etc, and appears to be unable to function in relationships etc. Can this be? he received a very high impact kick to the head over a year ago.

Dec 16th, 2012 2:02pm

My husband was hit by a car while riding a bike. He went through this battery of tests and they said he was faking. He is dyslexic AND has right/left dyslexia. Part of the test involves left/right questions. The person giving the test yelled at "don't you know your right from your left?" He never answered that, just kept trying. The results infuriated me.

Nov 13th, 2012 5:19pm


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