A Guide to Psychological/Neuropsychological Testing

Evaluations, or testing, can be a helpful component in obtaining information about an individual's learning style, behavior, or mental health diagnosis. An evaluation may be recommended by a therapist, medical provider, or school staff working with the individual who is looking for a greater understanding of the individual's presenting concerns. Licensed psychologists (i.e. Ph.D, Psy.D, Ed.D) or interns under the supervision of licensed psychologists are the only professionals trained to administer and interpret psychological and/or neuropsychological evaluations.

The procedures are administered as part of a comprehensive evaluation, or battery, and should address the referral question(s). Standard psychological/diagnostic evaluations include clinical interviews, record reviews, face-to-face testing sessions, self/parent/teacher/informant reports, a write-up of test results, and consultations with the therapist and other providers. The evaluations should provide individualized recommendations to foster improvements in the area(s) of concern. These recommendations may help individuals and families make informed decisions about treatment, allow therapists working with the individual to adjust the therapeutic approach or treatment plan, and assist educators in making adjustments in order to maximize the individual's learning potential in an academic setting.

Though the basic format of an evaluation is similar across types, there are a few different categories of evaluations to be aware of in speaking with providers:

1. Psychological Assessments/Psychological Evaluations
2. Neuropsychological Assessments/Neuropsychological Evaluations
3. Academic and Educational Testing
4. Forensic Assessments/Risk Assessments

 

1. Psychological/Diagnostic Evaluations:

A psychological evaluation may consist of a variety of procedures ranging from standardized tests of cognitive functioning to projective tests of social-emotional functioning. Psychological assessments are typically requested around questions of differential diagnosis (i.e. helping a clinician better distinguish or understand an individual’s psychiatric diagnosis), testing for more broad learning disabilities or IQ, or as a component of a forensic or risk assessment. Standard testing includes:

• Cognitive Testing: To determine a person’s strengths and weaknesses and assessment of attention, verbal comprehension, visual-spatial ability, computation, abstract thought, impulsivity, problem solving, social comprehension, and judgment.
• Emotional: To assess for depression, anxiety, obsessive/compulsive disorders, sleep disorders, etc., as well as personality functioning, developmental and emotional age, and family dynamics.
• Behavioral: To evaluate substance abuse, trauma and abuse, risk of self-harm, aggression, and treatment compliance/readiness; screen for behaviors that are high risk, illegal, or violate the rights of others or major social values; rule out thought disorders and screen for brain-based impairment.
• Executive Functioning: To evaluate self-regulation, problem solving, planning, organization, inhibition, self-awareness, communication, and working memory.

 

2. Neuropsychological assessments, or neuropsychological evaluations:

Neuropsychological evaluations are used when there is evidence to suggest neurological problems like: ADHD, dyslexia, autism spectrum, nonverbal learning disorder, alcohol or drug related damage, brain injury or concussion, or other neurologic conditions. Neuropsychology is the unique integration of genetic, developmental, and environmental history combined with extensive testing data to better understand brain functioning.

Building upon the standard evaluation, neuropsychological evaluations assess:

• Attention and Concentration
  • Verbal and Visual Memory
  • Auditory and Visual Processing
  • Visual-Spatial Functioning
  • Language and Reading skills
  • Phonology and Audiology
  • Sensory Integration
  • Gross and Fine Motor Development
  • Executive Functioning

 

3. Academic and Educational Testing:

Academic testing (also sometimes called Educational or Achievement Testing) is used to diagnose learning disabilities. It can also help better understand the academic level at which someone is performing. This is typically done within a child’s school system when you formally request a CORE evaluation if the child is struggling academically. A School Psychologist, which can either be doctoral or Master’s level) can complete this testing through the school. This type of testing is not covered by insurance if you choose to see an outside provider.

 

4. Forensic or Risk Assessments:

Forensic assessments are generally ordered by a court or hospital while Risk Assessments are generally around topics such as violent behavior (e.g violent behavior, fire setting, etc.). These may involve some of the same measures as other forms of assessment, in addition to more specific forensic measures, and a clinical interview more focused on subject of that referral. Mental health professionals (i.e. Master’s level clinicians) can be trained to complete risk assessments.

 

Many health insurance plans cover a percentage of the fee for psychological testing; however, academic or educational testing is not covered by insurance and will be an out-of-pocket expense if you are not going within your child’s school system. Prior authorization for testing may be needed and it is always important to understand your insurance coverage and whether or not you have a deductible that applies. If you have questions about insurance coverage, contact your health insurance company to better understand your mental health benefits.

Please see the following resources for more information:

From the American Psychological Association: Understanding Psychological Testing and Assessment

From Psych Central: What is Psychological Assessment?