Do You Do Neuropsych Testing? By Theresa Gunderson, PhD, LP in collaboration with Cindy Spicuzza, PhD, LP

This is a question we clinical psychologists are often asked, and the answer is perhaps more complex than one would expect. This is mostly due to the mystery and complexity of the field of psychology in general, and psychological testing in particular. In addition, the answer is made even more complex because the term is used differently by different types of professionals. Therefore, my initial answer to this question is, “It depends”, followed by a lengthy conversation with the individual in order to identify what the answer depends on and providing referral information depending on the answers to my questions.

What’s In a Name?

Typically, doctorate-level psychologists and neuropsychologists are purists and only refer to testing as neuropsychological (“neuropsych”) testing if we are recommending that the testing be completed by a psychologist who is board-certified or board-eligible in neuropsychology. Other community professionals, such as physicians or educators, may or may not be using the term the same way. When I have fielded this question from different community professionals, after finding out more about the patient’s or student’s history and what questions the professional would like answered through testing I often find that some are using the term accurately and some are using the term as a general term for psychological testing. On top of that, it is usually left to the consumer (the individual themselves or a caretaker) to put the professional’s recommendation into action and use a layperson’s understanding to then explain to a different clinic’s receptionist what is needed.

How is a neuropsychologist different from a clinical psychologist?

Clinical psychology is a branch of psychology which focuses on the assessment and treatment of mental illness, abnormal behavior, and psychiatric conditions. Clinical neuropsychology focuses more on the link between the brain and behavior. Both neuropsychologists and clinical psychologists have training in clinical psychology and both are licensed psychologists, but neuropsychologists have additional training in how the brain develops and how differences in brain structure specifically affect an individual’s learning and behavior.

 What sorts of conditions/questions would each type of psychologist test?

Standard psychological testing completed by a clinical psychologist is typically focused on evaluating general cognitive and personality functioning with the purpose of diagnosing psychiatric conditions. For example, standard psychological testing would be appropriate to find out whether an individual has intellectual or learning delays, whether a person’s attention difficulties are all attributed to his/her anxiety or if he/she also has Attention-Deficit/Hyperactivity Disorder (ADHD) of the Inattentive type, or if the individual meets criteria for Autism Spectrum Disorder.

Neuropsychological testing would be more appropriate if any of the following are present:

1. any of the above conditions may be present but more in-depth information is being sought to learn more about how the child learns best, to help match expectations to a child’s specific strengths and weaknesses, or because previous psychological testing has not yielded desirable outcomes, etc.;
2. a neurological disorder is present or suspected (e.g., dementia, epilepsy, cerebral palsy,);
3. brain injury is present or suspected due to trauma to the head, lack of oxygen to the brain (e.g., near drowning), infection (e.g., Lyme Disease), etc.;
4. medical conditions associated with neurological compromise require monitoring (e.g., pre-and post-testing for individual undergoing brain tumor resection), or medical conditions known to cause changes in cognition are present (e.g., chronic heart problems, diabetes), or medical/genetic conditions known to cause learning differences are present (e.g., cleft lip/palate);
5. decline in cognitive functioning following exposure to lead, street drugs or other toxins;
6. failure to develop appropriately following in utero exposure to toxins (e.g., significant maternal drug or alcohol use)

What Can I (the Consumer) Do to Make Sure I Receive the Right Kind of Testing (Without Having to Figure It out Myself)?

1. Ask the referring professional if they know whether they are referring you for standard psychological testing with a clinical psychologist or neuropsychological testing with a neuropsychologist (be aware that the professional may or may not know for sure themselves).
2. When you call the psychologist’s office to inquire about testing, be ready with the following information:
   1. what exisiting or suspected psychiatric diagnoses, neurological disorders, injuries/illnesses the individual has;
   2. what questions you and/or the referring professional are hoping to have answered as a result of the testing;
3. Sign a Release of Information (ROI) that allows the referring professional and the testing psychologist to share information directly with each other. Once this is signed, further clarification can be done on a professional level by sharing the referring provider’s written document explaining everything can be shared with the testing psychologist, allowing for a phone conversation between the two professionals, etc.

What if I still have questions about what kind of an assessment is needed?

No problem.  You can call PrairieCare and schedule a Free Needs Assessment.  This clinical interview can help to clarify what kind of intervention, whether testing or treatment programs, can be most helpful in your or your loved ones situation.