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Pediatric Clinical Neuropsychological Assessment

Why might my child need a pediatric neuropsychological assessment?

Children may be referred by parents, physicians, school professionals, or other allied health care professionals. Referrals often have to do with:

·        Difficulty in learning, attention, impulsivity, behavior, socialization, or emotional control

·        A pediatric neuropsychological evaluation assists parents and professionals to better understand a 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 a child’s behavioral presentation and personality development. Test results help parents and professionals to select and implement interventions to meet the child’s unique treatment needs.

·        Disease process, developmental problems (fetal exposure to illicit drugs and alcohol), or birth trauma that negatively affects brain function or development

·        Accidents resulting in brain injury, such as motor vehicle or sporting accidents. This may also include infant neglect or physical abuse

What does a pediatric neuropsychological evaluation include and assess?

·        Diagnostic interview with parents

·        Reason for referral

·        Social, emotional, and behavioral functioning

·        Educational history

·        Birth & developmental history

·        Medical & psychological history

·        Review of the child’s academic and medical records

·        Assessment of factors tailored to your child’s individual needs, often including:

·        Intellect

·        Executive Functions (i.e., working memory, inhibition, planning & organization, perception-action coupling, cognitive shift, & encoding)

·        Attention and concentration

·        Learning and memory

·        Language (a brief assessment of receptive and expressive language factors impacting academics and learning)

·        Academic Achievement

·        Visual spatial abilities

·        Sensory motor abilities

·        Feedback Session with parents

·        Comprehensive written report and recommendations

What will the results tell me about my child?

The pediatric neuropsychologist creates a profile of your child's strengths and weaknesses. Each child’s testing and problem solving behavior is closely observed. This qualitative analysis helps the neuropsychologist to fully understand and explain the statistical data obtained through standardized testing. It is often more important to understand how a child missed a testing item than simply relying on the outcome score. A child’s motivation, cooperation, effort, and behavior can positively or negatively affect testing outcomes. The results help those involved in your child's care in a number of ways.

 

·        Testing can explain why your child is having academic or behavioral difficulties in school. For example, a child may have difficulty reading because of an attention problem, a language disorder, a reading disability, or some combination of those problems. Testing results identify what skills to work on and helps the neuropsychologist select strategies and interventions to help the child.

·        Testing can help detect the effects of developmental, neurological, and medical problems, such as epilepsy, Autism, Attention-Deficit/Hyperactivity Disorder (ADHD), learning disorders, 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's disorder and the brain areas that are involved. For example, testing can help differentiate between an attention disorder and depression or determine whether a language delay is due to a problem in producing speech, understanding or expressing language, social shyness, Autism, or cognitive delay. Your pediatric neuropsychologist may work with your physician to combine results from medical tests, brain imaging, or blood tests to diagnose your child's problem.

·        Most importantly, testing provides a better understanding of the child's behavior and learning in school, at home, and in the community. We can be more effective and empathic in helping the child when we know what they can or cannot control in their behavior or achievement.

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. Many neuropsychologists employ trained examiners (psychometricians and/or advanced doctoral students) to assist with the administration and scoring of tests, so your child may see more than one person during the evaluation.

Parents are not in the room during testing, although they may be present with very young children. The time required depends on the child's age, presenting problem, and other factors unique to each child. Comprehensive testing typically requires at least two testing sessions.

Make sure your child gets enough sleep before testing, as well as a healthy and nutritious breakfast. We also often recommend bringing snacks for your child. 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 beforehand to coordinate dosage and administration time.

If your child has had school testing, an individual education plan (IEP), or has related medical records, please send copies or bring these records to the evaluation session.

What should I tell my child?

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," "problems following directions," or "feeling upset." Reassure a worried child that testing involves no "shots." We recommend informing your child that this process helps us understand how their brain works and how they learn best. 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 activities interesting; however, we recommend that parents not refer to these activities as games, as this can be misleading to the child.