ASSESSMENT & EVALUATIONS FAQ
What is a neuropsychological evaluation and what does it entail?
Psychological, psychoeducational, and neuropsychological evaluations reveal important information about cognition, learning, and behavior in children and adolescents. A licensed psychologist specializing in conducting these comprehensive evaluations typically holds a doctorate in clinical psychology and is specially trained to understand the ways that thinking, learning, and behavior are associated with neurodevelopment, brain structures, and brain systems. Standardized tests are used to measure intelligence, academic skills, attention, executive functioning (e.g., organization, planning, behavioral inhibition), memory, language, visuospatial processing, fine motor skills, emotional functioning and (sometimes) personality. The data obtained from these tests are considered alongside parent/teacher reported functional difficulties, a child’s behavioral presentation, and a detailed clinical history to draw conclusions, consider diagnoses, and generate recommendations. Even more, the comprehensive evaluation identifies an individual's personal learning style including their strengths and weaknesses and helps promote greater awareness, understanding, and compassion.
Licensed psychologists often work with a child’s doctors and/or current therapists to help set goals, monitor progress, and manage expectations. They frequently consult with teachers and/or school officials to help provide necessary educational or academic accommodations.
What is a psychoeducational evaluation?
A psychoeducational evaluation is more limited in scope than the comprehensive neuropsychological evaluation but typically includes intelligence and academic testing in addition to a screening of adaptive functioning. Oftentimes, a diagnosis cannot be reliably provided based on the results of a psychoeducational evaluation alone.
What is a standardized test?
A standardized test is a test that is administered and scored in a consistent manner. They are designed in such a way that all questions, test materials, and testing conditions (e.g. in a quiet room, at a desk) are constant across administrations. One must possess specific professional credentials to purchase and utilize standardized psychological and neuropsychological tests.
What are some of the reasons children are referred for a neuropsychological or psychoeducational evaluation?
Children and adolescents are referred for a neuropsychological or psychoeducational evaluation by a parent, doctor, teacher, school psychologist, or other professional secondary to one or more of the following reasons:
Difficulty with regard to learning and/or academic performance despite adequate attendance and seemingly good effort
Difficulty remaining focused, organized, and exhibiting effective time management when completing homework, tests, or in-class assignments
Difficulty retaining information and requires frequent repetition of instruction or redirection
Difficulty with mood/behavioral problems and socialization
A history of neurological or developmental difficulty with a condition that is known to affect the brain (e.g., epilepsy, perinatal toxic exposure, metabolic disorder, possible Autism Spectrum Disorder or AD/HD diagnosis)
Suspected developmental delay (i.e., language, motor)
Brain injury from head trauma or other type of physical stress
It is necessary or desirable to document a child’s current functioning (e.g., “baseline”) or assess progress or change
You need guidance as to the most effective educational or treatment plan for your child
Your child is seeking entrance into a Gifted Program or applying for Early Kindergarten Entry
What information will a neuropsychological evaluation impart to parents, educators, etc.?
Provide a better understanding of an individual and his/her learning profile by providing a description of their personal strengths and weaknesses.
Help explain the reasons for why an individual is having problems with learning or performing at an expected rate in school, home, or in the community.
Assist with differential diagnosis and diagnostic accuracy which is important in identifying more effective academic and/or treatment plans: For instance, the child that has difficulty paying attention in school due to a specific learning disorder will not benefit from an attention-enhancing medication (e.g., psychostimulant) and will instead require learning interventions and academic supports. Moreover, diagnostic accuracy is important as treatment approaches that may be beneficial with certain conditions, may exacerbate others (e.g., anxiety and AD/HD).
Provide suggestions for what can be done to help an individual achieve their potential.
Help detect the effects or monitor the course of developmental, neurological, and medical problems such as brain injury (e.g., concussion), epilepsy, autism, ADHD, dyslexia: Even when two people have the same diagnosis, they can often present differently and consequently require tailored treatment strategies because diagnosis alone cannot accurately depict who an individual is in the world.
Monitor progress and treatment effects: For example, when a child is put on a medication or a learning intervention has been implemented, testing can help track whether the selected strategies have been beneficial.
Help to provide a context within which adults and the child can understand their struggles. For instance, it helps to identify the problem, describe the factors that cause or sustain the problem, and provide recommendations for how to eliminate or decrease the impact of the problem.
How does a neuropsychological evaluation differ from an assessment that might be performed in school?
Although some of the same tests/instruments may be used, a neuropsychological evaluation incorporates specific measures to identify the neurocognitive skills that underlie many abilities. For example, tests of attention, memory, language are usually not given in other types of assessments so they are not comprehensive. There is also a difference in how test results are utilized. In other words, a neuropsychological evaluation is integrative and goes beyond numbers and cut-off scores alone and focuses on how and why an individual obtains particular scores as well as on the pattern of skills and not only on whether s/he qualifies for special education programs/services. Moreover, school assessments do not diagnose learning or behavior disorders that are resultant of atypical brain development. Without a clear understanding of the underlying difficulty, parents and students are often left unaware of the specific issue in addition to the extent of the individual's needs which ultimately precludes appropriate and effective intervention(s) and supports.
If I decide to go forth with a comprehensive evaluation, what should I expect?
A comprehensive evaluation includes a parent interview regarding the child’s medical, psychological, and academic history, an interview with the child, behavioral observation of the child, and standardized testing. Oftentimes, collateral information is gathered from teachers and treatment providers who work closely with the child. Testing typically involves paper and a pencil, hands-on activities, and a laptop computer/I-Pad. Parents and teachers will be asked to fill out questionnaires about their child’s development and behavior. The time required to complete testing depends on the characteristics and needs of the child being evaluated; some may be able to complete testing in one day (with breaks), whereas testing with other children may take place over the course of two to four days. I complete all aspects of testing myself (i.e., she does not involve professional psychometrists, interns, or trainees). Parents are not permitted to remain in the room during testing.
I strive to inform parents/guardians of conclusions and recommendations in a timely manner within 2 to 3 weeks of your child’s last testing session. If/when appropriate, a feedback session will be held with your child. I aim to compose detailed reports that paint a comprehensive picture of your child and his/her needs. Written reports are typically received approximately 2 weeks after the feedback session.
Is there any drawback to undergoing a neuropsychological or psychoeducational evaluation?
Short answer: Typically no. It is a non-invasive procedure that often is interesting or fun for the individual. Some may experience mild anxiety about being “tested” but a psychologist with the right demeanor and approach will know how to develop a good rapport with you or your child in order to help attenuate such tension and to increase comfort.
One of the most common concerns heard from parents prior to the start of the evaluation process is that they are worried about having their child tested as it may make him/her feel as if something is wrong. The reality is that if someone is struggling, they already feel this way and may be erroneously associating it with being unintelligent or not trying hard enough. Children who struggle often comment that feel they are “stupid,” signifying that their self-esteem is impacted by their challenges. The value of a neuropsychological evaluation also lies in the ability to provide a framework for the young individual in addition to their parents or teachers to help them understand why they are having difficulty and to dispel any misconceived notions of their abilities or achievement potential.
Does insurance cover the cost?
I am an out-of-network provider and, therefore, do not accept insurance. Payment to Erika Baron, Psy.D., PLLC must occur at the time of service. After completion of the evaluation, an itemized “super bill” with diagnostic codes (if applicable), dates of service and types of services provided will be given to you. You can choose to submit this to your insurance company.
It is the responsibility of the patient/parent to contact your insurance company directly for questions about coverage (e.g., covered services, deductible, amount to be reimbursed, and pre-authorization). If you wish to inquire regarding reimbursement, the CPT codes that may be applied for testing are as follows: 90791, 96116, 96121, 96130, 96131, 96132, 96133, 96136, 96137.
Please be aware that reimbursement varies greatly and that, by engaging my services, you are paying "out-of-pocket" and are not assured of any reimbursement from your individual insurance policy.