What is a Pediatric Neuropsychological Evaluation?

Pediatric neuropsychology is a specialty that focuses on learning and behavior in relationship to a child’s brain. A pediatric neuropsychologist is a license psychologist with specialized training in how learning and behavior are associated with the development of brain structures and pathway systems. The pediatric neuropsychologist administers evaluations, interprets test results, and makes recommendations. The neuropsychologist may also provide treatment, such as cognitive rehabilitation, neurocognitive therapy, behavior management, or psychotherapy. The neuropsychologist will consult with parents, physicians, and school personnel to provide appropriate intervention.

How does a pediatric neuropsychological evaluation differ from a school psychological assessment?

School psychology assessments are usually administered to determine whether a child qualifies for special education intervention. They focus on intelligence and achievement, and behavioral outcomes as opposed to origins. A neuropsychological evaluation takes into account that a child is more complex than simple intellect and achievement. It takes a whole brain to function; therefore, all neuropsychological elements need to be examined and considered to accurately determine how and why a child can or cannot access the general school curriculum.

What does a pediatric neuropsychological evaluation include and assess?

• Diagnostic interview with parents
• Review of the child’s academic and medical records General intellect,
• Achievement skills, reading, math and spelling
• Executive function skills-the ability to organize, solve problems planning, in addition and mental flexibility
• Attention and inhibition
• Learning and memory
• Speech and language skills
• Visual- spatial skills
• Motor coordination
• Sensory functioning
• Behavioral and emotional functioning
• Social skills
• Feedback session and comprehensive report

The observing of your child to understand his or her motivation, cooperation, and behavior is a very important part of the evaluation. The evaluation of infants and preschool children is usually shorter in duration because the child is not yet developed many skills.

Assessments are individually customized and are often appropriate for the following concerns:

• ADHD
• Autism Spectrum Disorder
• Brief screens for ADHD or ASD
• Learning Disorders
• Low academic achievement
• Accommodation requests for elementary, middle, high school, college, and graduate school
• Accommodations requests for standardized exams, such as the ISEE, SAT, SAT II, ACT, AP, LSAT, GRE, GMAT, MCAT
• Determination of special education eligibility and IEPs
• Gifted testing
• IQ testing
• Executive dysfunction
• Psychomotor speed and processing
• Language and communication disorders
• Behavioral or social problems
• Brain injuries
• Stroke and Epilepsy
• Concussion and sport-related head injuries affecting learning or behavior
• Medical issues affecting learning or behavior
• Determination of readiness for kindergarten/first grade
• School selection assistance
• Independent Educational Evaluation (IEE)

What will the results tell me about my child?

The pediatric neuropsychological evaluation creates a profile of your child’s strengths and weaknesses. The neuropsychologist will compare your child’s test scores to scores of children of similar ages. The results help those involved in your child’s care in a number of ways.

Testing can explain why your child is having school problems. For example, a child may have difficulty reading because of an attention problem, I language disorder, or a reading disability. Testing results identify what skills to work on, as well as selecting strategies to help the child.

Testing can help detect the effects of developmental, neurological, and medical problems such as epilepsy, autism, Aspergers, attention deficit hyperactivity disorder (ADHD), dyslexia, or a genetic disorder. Testing may be done to obtain a baseline against which to measure the outcome of treatment or the child’s development over time.

Different childhood disorders result in specific patterns of strengths and weaknesses. These profiles of abilities can help identify a child disorder and the brain areas that are involved. For example, testing can help differentiate between an attention deficit and depression or determine whether a language delay is due to a problem in producing speech, understanding or she pressing language, social shyness, autism, or cognitive delay. Your pediatric neuropsychologists may work with your physician to combined results from medical tests, brain imaging, or blood tests to diagnose your child’s problem.

Most importantly, testing provides a better understanding of your child’s behavior and learning in school, at home, and in the community. When we know what a child can or cannot control in their behavior or achievement, we are then in a position to emphatically intervene and avoid seeing the child as being willful or malicious.

When would my child need a neuropsychological evaluation?

• Children may be referred by parents, physicians, school professionals, or other allied healthcare professionals. Referrals often have to do with: If your child is struggling in school or underperforms on standardized tests.
• When developmental challenges make it harder to understand how your child learns.
• When a child has a medical history that can impact learning such as traumatic brain injury, seizure disorder, treatment for cancer, or exposure to toxins.
• Has your child suffered concussions in sports.
• To document changes in your child’s abilities or achievement since prior evaluations.
• If it is unclear why your child is having difficulty meeting the demands that other children seem to master.
• Difficulty learning, attention, impulsivity, behavior, socialization, or emotional control.
• Disease process, inborn developmental problems (fetal) exposure to illicit drugs and alcohol), or birth trauma that negatively affect brain function or development.
• Accidents resulting brain injury, such as motor vehicle or sporting accidents. This may also include infantile neglect or shaken baby syndrome.

A pediatric neuropsychological evaluation assist parents and professionals to better understand the child’s functioning across domains such as executive functioning and attention, learning and memory, language, visual and spatial abilities, sensory and motor abilities, intellect and academic achievement. These measures also shed light on child’s behavioral presentation and personality development. Test results help parents and professionals to select and implement intervention to meet the child’s unique treatment needs.

What should I expect?

A pediatric neuropsychological evaluation usually includes a comprehensive interview with parents about the child’s history, observation of and interaction with the child, and standardized assessment. This may involve paper and pencil and hands-on activities, answering questions, and sometimes using a computer. Parents may be asked to fill out questionnaires about their child’s development and behavior may neuropsychologist employ trained examiners (Psychometrician and/or advanced doctoral students) to assist with administration and scoring of tests, so your child may see more than one person during the evaluation.

Parents are usually not in the room during testing, although they may be present with very young children. The time required depends on the child’s age and presenting problem. Comprehensive testing typically requires more than one session.

Make sure your child gets enough sleep before testing. Make sure to bring your child’s glasses, hearing aid or any other prescribed device they use. If your child has special language, vision or hearing problems, please alert the pediatric neuropsychologist prior to testing.

If your child is prescribed stimulant or other medication, check with the pediatric neuropsychologist and the prescribing physician before hand to coordinate dosage and administration time.

If your child has had school testing, and individual education plan, or has related medical records, lease bring or send copies of these records to the evaluation session.

What you tell your child about this evaluation depends on how much he or she can understand. Be simple and brief, and relate your explanation to a problem that your child knows about, such as “trouble with spelling,” “albums following directions,” or “feeling upset.” Reassure a warrior child that testing involves no “shots.” Inform your child that you wish to find out the things the child does or does not do so well. If we find out things they do not do well, then we will help them improve. You may also tell the child that “nobody gets every question right,” and it is important to “try your best.” Many children find the neuropsychological evaluation interesting.