1. What is a neuropsychological evaluation (aka “neuropsych”)?
A neuropsychological evaluation is a comprehensive assessment of an individual’s thinking and learning style. It involves interviews, 1-1 testing, questionnaires, and review of relevant records. The key areas examined in a neuropsychological evaluation are:
- intellectual reasoning capacity, or IQ;
- academic achievement, particularly in the areas of reading, writing and math;
- executive functioning (skills such as planning, prioritizing, organizing, problem solving, cognitive flexibility, cognitive inhibition, etc.);
- attention capacities and associated behaviors;
- memory abilities, including visual and auditory memory in both immediate and delayed modalities; and
- social and emotional functioning.
2. Why would someone need such a comprehensive assessment?
One of the most common reasons for getting a neuropsychological evaluation is that someone – usually a school age child, adolescent or a college/graduate student – is experiencing a pattern of difficulty in one or more areas of their school functioning. Common patterns of difficulty are listed below:
- problems paying attention in classes
- difficulty following through and completing assignments
- struggling to get reading done because it takes too long
- reading, but not understanding what was read
- getting frustrated trying to finish tests on time
- taking too long to organize and write papers
- hoping for extended time on college entrance exams
- struggling to learn a foreign language
- lack motivation, particularly regarding school work
- declining grades in school
- distracting and impulsive behaviors interfering with school and social success
- anxiety and/or depression related to school-related performance
- disparity between honors-level grades in school and low scores on standardized tests
- effects of certain social, emotional and/or family stressors on academic and social functioning
- difficulties with math, reading and/or writing
- wondering about the possibility of having a specific learning disability
A comprehensive assessment can also be helpful to those who are interested in learning more about their child’s or their own unique learning style, even if they are not currently struggling in a significant way. Such understanding can allow for better use of one’s strengths to work through or around one’s weaknesses.
3. How can a neuropsychological evaluation be helpful?
A comprehensive “neuropsych” can help to evaluate an individual’s current level of overall functioning, and then isolate certain problem areas that are likely to be interfering with their ability to be more successful.
Once these problems are identified, a list of interventions, modifications and/or accommodations can be recommended in an effort to tailor specific plans – for the individual and for parents and teachers who live/work with them – to help the individual to function more effectively in their academic and social environment.
4. Why pay for a private evaluation when the public schools are required to provide an evaluation for free?
Public schools are only charged with determining if a student is making effective progress and if not, what types of services are necessary to help them catch up with their peers. Sometimes this kind of evaluation is enough, but often parents have unanswered questions. And rarely does a school integrate the findings from each area tested to provide a comprehensive picture of a young person’s learning profile. Dr. Greenstein’s evaluations are more in-depth than most school assessments, allowing for a clearer understanding of WHY someone is struggling, not just documentation that they are. This deeper understanding can lead to more targeted, and therefore more successful, interventions.
5. Can neuropsychological testing help to diagnose ADHD and other disorders?
An Attention Deficit Hyperactivity Disorder is usually detectable with the combination of different assessment tools, such as a clinical interview, specific cognitive and neuropsychological tests, various subjective rater scales/inventories, and observations made by the examiner. Since this diagnosis may be overly assigned, such a thorough approach to ADHD evaluation and diagnosis is recommended. When necessary, consultation with an individual’s physician and/or psychiatrist helps to coordinate diagnostic observations and treatment recommendations.
Specific learning disorders, such as dyslexia and other reading disorders, math disorders (e.g. dyscalculia) and writing disorders (e.g. dysgraphia or difficulties with written organization due to executive functioning weakness) can clearly be diagnosed with these assessments. Testing is always necessary for diagnosing dyslexia and other specific learning disorders.
6. How long does a comprehensive evaluation take, and when do we get the results?
In general, a comprehensive neuropsychological evaluation takes about six to eight hours of direct, one-on-one testing time with the examiner. Depending on the age of the client, these testing sessions are scheduled over 1-3 sessions to maximize energy and attention levels. There is also a 1.5 – 2 hour interview with parents/guardians and with additional input from others who know the student well.
After an assessment is completed, it usually takes about 2-4 weeks to receive a full, written report. At that time, a follow-up meeting is held with the individual and/or their parents, to review the findings and to discuss treatment recommendations for optimal success. With your consent, Dr. Greenstein will also speak with other service providers such as a therapist, tutor, or school staff member to provide a summary of findings and recommendations.
7. How long does it take to schedule an assessment?
Evaluations are scheduled on a first-come, first-served basis. Sometimes there is a one month wait, but in general, every effort will be made to accommodate the request for services as soon as possible.
8. Will my health insurance pay for one of these evaluations?
Some health insurance companies will pay for a portion, if not all, of a neuropsychological assessment, if they deem it medically necessary. However, since I do not bill insurance companies directly, I expect payment from the client/parents and then will provide you with a detailed invoice to aid you in seeking reimbursement from your insurance company. Please know that I cannot guarantee that your insurance company will reimburse you for fees paid to me.
It is a good idea to explore your health benefits first, as many insurers will not pay for this kind of assessment. In some cases, having a medical doctor make a referral for a neuropsychological assessment can help with the insurance company’s willingness to pay for these services. Please note that medical insurance does not ever cover academic skills assessment, which is almost always a necessary part of a comprehensive evaluation.
9. Will my child’s neuropsychological evaluation be shared with their school?
Usually, parents are eager for their children’s teacher(s) to know about these assessments, with the hope that teachers can help to accommodate for the child’s learning needs. However, the report is given to the parents, as they are the owners of their children’s information. In some cases, parents provide a copy of the report to the school directly, without involving the examiner. Once the report is approved by the parents and a written consent is provided, then a copy of the report can be released to the child’s school.
As needed, and as part of an additional agreement with the parent or adult client, Dr. Greenstein can attend meetings at the school with the child’s parents, teachers and appropriate school administrators in an effort to discuss assessment findings and to coordinate follow-up plans for optimal success in school.
10. My son or daughter is applying for admission to an independent school, and needs an IQ test as part of the admissions process for that school.
Many independent schools require that their applicants include an IQ assessment as part of their application to their school. Typically, this test is called the WISC V. It takes about two hours to administer in a one-to-one format with the examiner. A full report of this assessment is usually available within two weeks of the time of the assessment. In some cases, this report can be completed more quickly, but an added fee is included for a “rush order.”