Neuropsychological and ADHD Evaluations 

Neuropsychological evaluations can provide a window into the processes that may be leading to academic, work, or interpersonal problems, learning difficulties, memory complaints, and/or difficulties effectively managing daily tasks.

Neuropsychological assessments evaluate and assess diverse areas of cognitive functioning, including:

• speed of information processing
• attention
• learning and memory
• language functioning
• visuospatial functioning
• motor functioning
• executive functioning (e.g., reasoning, planning, organization, cognitive flexibility, impulsivity)
• auditory processing

A neuropsychological evaluation is typically requested for or by individuals who have suspected ADHD or dementia, and for individuals who have sustained brain injuries.

They may also be indicated for individuals with complex combinations of cognitive, emotional, and/or functional challenges, for whom more information is required to determine the impact of various factors.

Neuropsychological evaluations provide an impressive amount of information and can be used to:

1. identify the presence or absence of brain dysfunction (for instance, in the case of dementia or a traumatic brain injury), as well as the presumed source of cognitive difficulties;
2. describe the effects of a disease that impacts the brain, or of a brain-based injury, such as a concussion;
3. guide treatment planning, including placement in a rehabilitation facility, psychiatric medication management, and school- or work-based accommodations;
4. assess or monitor the effects of treatment over time (e.g. speech and language therapy or cognitive rehabilitation).

The first step in a neuropsychological and/ or ADHD evaluation is a comprehensive interview, documenting developmental, medical, family, social, academic, occupational, and emotional history.

For younger children, the intake interview is often conducted with only the parents. Adolescents may be included in portions of the interview, and this tends to increase their interest in and motivation for testing. Adults can choose to interview alone or with significant others who have insight into their difficulties (e.g., a spouse).

With the consent of the client, I also obtain collateral information from individuals such as family members, doctors, therapists, teachers, friends, and/or colleagues.

The neuropsychological testing itself is conducted over series of appointments. Most commonly, there are three sessions of 2–3 hours each. If individuals have difficulty sustaining focus for 2–3 hours, 1-hour testing blocks are sometimes appropriate.

I always conduct these evaluations in person. (Virtual testing is not an option).

Common tests used in neuropsychology include the WISC-V, WAIS-IV, IVA-2-CPT, TOVA-9, D-KEFS, NEPSY-II, WRAML-3, WMS-IV, CVLT-III, Beery VMI, Boston Naming Test, Clock Drawing task, WCST, Grooved Pegboard Test, QNST-3R, and Rey CFT, among others.

Examples of tasks include activities such as learning and recalling visual and auditory information, sustaining focus to target stimuli during distracting or boring conditions, puzzles, problem solving, copying drawings, constructing block designs, and naming pictures.

An individual’s performance is compared to others at their same age in order to derive standardized scores that reflect their functioning in different domains.

Results are analyzed and integrated into a report that explains the meaning of test scores and elucidates the underpinnings of a client’s challenges. Recommendations are included in the areas of treatment, academics and/or work, and tasks of daily living.

A feedback session is generally scheduled about a month after the completion of testing. Children may be included in feedback sessions, or a separate session can be scheduled for parents and children. Adult clients may attend the feedback session alone or with significant others, including parents, caregivers, spouses, etc. During this feedback session there is ample opportunity for you to ask questions so you have a solid sense of recommended next steps.

The report can then be forwarded to pertinent parties, such as therapists, psychiatrists, clinical psychologists, neurologists, teachers, or bosses.

Neuropsychological assessments are almost always combined with social/emotional evaluations, to rule in or rule out psychological diagnoses (such as depression), and determine their relative impact on functioning, if present.

The main difference between neuropsychological evaluations and psychoeducational evaluations is that neuropsychological evaluations provide a much broader view of an individual’s functioning, including greater understanding of the sources of academic challenges. For children or adolescents, neuropsychological evaluations are often combined with psychoeducational evaluations.

No referrals are required for neuropsychological and ADHD evaluations, though individuals are often assessed as a result of recommendations from doctors, therapists, psychiatrists, teachers, or concerned family members. Individuals may also seek these evaluations themselves due to perceived worsening in their cognitive abilities.

I am not in network with insurance. However, I am able to provide a superbill for submission for out of network benefits. If you have out of network benefits, insurance companies may reimburse for part or most of the cost of the evaluation, though you should always check their rates and policies.