• What is Neuropsychological Testing?

    on Jul 25th, 2016

Karen Schiltz, PhD, is an Associate Clinical Professor at UCLA who has 26 years of experience on neuropsychological testing for children, adolescents, and young adults. She sheds some light on its role in diagnosis and treatment. Thank you, Dr. Schiltz, for sharing your expertise.

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Pediatric and Young Adult Neuropsychological Assessment: The Big Picture

 

“We were in our hotel room sleeping. I remember waking up vomiting. The next thing I remember is my mom helping me down the stairs. I’m 16 years old. I found out I had carbon monoxide poisoning at the hospital. I was out for eight hours. The doctors told me I was unconscious. I’m having trouble with memory and focusing at school now. Those weren’t problems before.”

“My son has trouble reading simple words. He guesses and substitutes words when he reads. Daniel calls himself ‘stupid.’ He will be in the third grade next fall. Something is wrong. I need help.”

 “I guess my granddaughter always had problems with focus. She had a snowboarding accident two years ago and was unconscious. That was her third accident. Christina is now 14 years old. She had problems with attention before the first accident. Everything seems to have gotten worse. We need to help her in school. Christina is getting very frustrated. She seems depressed.”

“I can’t focus in class. It’s worse in history and English. The teachers go on and on. My dad tells me I need to work harder. I just can’t. I think my brain is not wired right. I feel different. No one works as hard as me.”

 

Neuropsychological assessment is one of the procedures that your child’s pediatrician, psychiatrist, neurologist, or even teacher may order. A comprehensive evaluation is critical in order to understand the “big picture” of your child’s needs. This assessment surveys all areas, which could be potentially affecting your child’s learning, thinking, and emotional areas. It provides a “blueprint” by assessing the following areas:

 

The neuropsychological assessment is very comprehensive because it includes not only the testing data but also input from parents, other caregivers as needed, teachers, and medical/educational records. The neuropsychologist, in assessing all aspects of a child/young adult’s functioning, is able to integrate the information obtained and describe how the child approaches learning and the effects of an accident or an acquired illness such as a tumor and stroke or even sports-related injuries, i.e., concussions from football, soccer, boxing.

 A comprehensive assessment will help you understand what your child really needs in order to succeed in school and in the workplace. All conclusions are based on a systematic and organized manner of assessment using a scientific approach. Physicians such as psychiatrists, neurologists, and pediatricians use the assessment as a “roadmap” to target intervention needs. Similarly, remediation therapists such as psychologists, speech-language therapists, occupational therapists, and educational remediation therapists use the neuropsychological “roadmap” to identify specific goals and objectives when planning intervention goals and objectives.

 

Who is trained to administer a pediatric/young adult neuropsychological assessment?

A clinical neuropsychologist is a professional psychologist who is trained in assessment and intervention as it relates to normal and abnormal functioning of the brain. Training involves the following:


What are the limitations of a pediatric/young adult neuropsychological assessment?

An assessment typically takes time and cooperation not only from the child/young adult but also from their caregivers and teachers. Specifically, caregivers and teachers are asked to complete rating scales designed to assess a student’s overall behavior, social-emotional, social communication, academic, and regulation, i.e., attentional and concentrational skills, across home and school contexts. Typically, assessments on an outpatient basis will take six to eight hours of face-to-face testing time. In addition, selective neuropsychological screenings are routinely performed such as when a child/young adult is poisoned by carbon monoxide or even hurt in a scuba-diving related accident. These assessments are brief and are driven by immediate medical care needs. Still, other neuropsychologists work in a hospital setting such as with patients with intractable epilepsy and psychological-driven illnesses. In addition, not all insurance companies will pay for a neuropsychological assessment if a physician does not authorize the evaluation as a medical necessity.

The lifelong consequences of learning and social disabilities, as well as an acquired injury such as a head injury, can be quite alarming. Society depends, for the most part, on an individual’s ability to read and write, manage their attention and emotions, and get to school/work on time. The neuropsychological assessment is a critical part of the diagnostic and intervention process.

Thank you, Dr. Jesalva, for inviting me to post on your educational blog. Your blog is a valuable source of information to parents, caregivers, and health care professionals who are invested in maximizing a child’s potential in life.

 


Karen L. Schiltz, Ph.D., is a clinical psychologist in private practice, specializing in the clinical and forensic neuropsychological assessment of children, adolescents, and young adults.  She is an Associate Clinical Professor (Voluntary) at the David Geffen School of Medicine within the Department of Psychiatry and Biobehavioral Sciences, an appointment she has held since 2004. Prior to that, Dr. Schiltz held an appointment as an Assistant Clinical Professor within the same department (1993-2004).

Dr. Schiltz supports a comprehensive team approach in the assessment and remediation of children, adolescents, and young adults who struggle with cognitive, learning, behavioral, social, and emotional difficulties. In addition to her private practice in Calabasas, California (www.karenschiltz.com) over the past 26 years and academic supervisory duties, Dr. Schiltz has written, co-written, and/or presented over 81 papers, manuscripts, and publications. She wrote Beyond The Label:  A Guide to Unlocking a Child’s Educational Potential (Oxford University Press, September, 2012) with Amy Schonfeld, Ph.D. and Tara Niendam, Ph.D. She lives with her husband and 13-year-old daughter in Westlake Village, California.

Karen L. Schiltz, Ph.D.

Psychologist (CA PSY 9508)

Private Neuropsychology Practice of Karen Schiltz Ph.D. and Associates

Associate Clinical Professor (Voluntary)

Medical Psychology Assessment Center

Semel Institute for Neuroscience and Human Behavior

Department of Psychiatry and Biobehavioral Sciences

David Geffen School of Medicine at UCLA

 

REFERENCES:

Echemendia, R.J., Iverson, G.L., McCrea, M., Broshek, D.K., Gioia, G.A., Sautter, S.W., Macciocchi, S.N., & Barr, W.B. (2012). Role of Neuropsychologists in the Evaluation and Management of Sport-Related Concussion: An inter-organization position statement. Archives of Clinical Neuropsychology, 27, 119-122.

Halstead, M.E., & Walter, K.D. (2010). American Academy of Pediatrics. Clinical report-sport-related concussion in children and adolescents. Pediatrics, 126 (3), 597-615.

Lindstrom, J.H. (2007). Determining appropriate accommodations for postsecondary students with reading and written expression disorders. Learning Disabilities Research & Practice, 22, 229-236.

National Academy of Neuropsychology. (2001). Definition of a Neuropsychologist. Retrieved June 1, 2012, from https://www.nanonline.org/PostitionPageLinks/Pages/DefinitionofaNeuropsychologist.aspx

Policy Statement, Houston Conference on Specialty Education and Training in Clinical Neuropsychology.  (1998). Retrieved June 1, 2012, from http://www.div40.org/pub/Houston_conference.pdf

Schiltz, K.L., Schonfeld, A.M., & Niendam, T.A. (2012). Beyond the label: A guide to unlocking a child’s educational potential. New York: Oxford University Press.

Schiltz, K. (2012, June 1). Beyond the Label: A guide to unlocking a child’s educational potential. Retrieved from http://www.psychologytoday.com/blog/beyond-the-label/2011.

Schiltz, K.L., Humphrey, L.A., & Pappas, K.B. (2000). Neuropsychological applications to remediation planning in children. The Educational Therapist, 21, 12-18.

Silver, C.H., Ruff, R.M., Iverson, G.L., Barth, J.T., Broshek, D.K., Bush, S.S., Koffler, S.P., & Reynolds, C.R. (NAN Policy & Planning Committee). (2008). Learning disabilities: The need for neuropsychological evaluation. Archives of Clinical Neuropsychology, 23, 217-219.

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