Neuropsychological Evaluation: Frequently Asked Questions, Exams of History

Download Neuropsychological Evaluation: Frequently Asked Questions and more Exams History in PDF only on Docsity!         FREQUENTLY  ASKED  QUESTIONS  ABOUT  NEUROPSYCHOLOGICAL  EVALUATION   Kathryn  Wilder  Schaaf,  PhD,  Lillian  Flores  Stevens,  PhD,  Megan  Holcomb,  PhD,  Stephen  Smith,  PhD   Laura  Artman,  PhD,  and  Jeffrey  S.  Kreutzer,  PhD,  ABPP  Virginia  Commonwealth  University   Department  of  Physical  Medicine  and  Rehabilitation   Rehabilitation  Psychology  and  Neuropsychology  Division  Richmond,  VA   After  an  injury  or  illness  that  affects  the  brain,  people  are  commonly  referred  for   neuropsychological  evaluation.   Most  people  know  little  about  the  evaluation  process.   Many  are  not   sure  what  they  will  be  asked  to  do,  how  they  should  prepare,  or  who  will  do  the  evaluation.  The   purpose  of  this  booklet  is  to  provide  answers  to  the  most  common  questions  people  have  about   neuropsychological  evaluation.   Please  keep  in  mind  that  these  are  general  guidelines.   We  encourage   you  to  contact  your  neuropsychology  practice  to  get  additional  information  regarding  policies  and  practices.  1. What  is  a  neuropsychological  evaluation?   Neuropsychological  evaluation  often  includes  at  least  3  components:  (1)  a  review  of  your  medical  and  other  records,  (2)  an  interview  with  you  and,  often,  another  person  who  knows  you  well  (a  family  member,  close  friend,  or  caregiver),  and  (3)  administration  of  tests  that  measure  your   abilities  and  mood.   Using  these  three  sources  of  information,  a  neuropsychologist  will  provide   you  with  a  comprehensive  report  that  summarizes  relevant  medical  history,  your  evaluation   results,  areas  where  your  cognitive  or  emotional  functioning  has  changed,  and  recommendations  for  work,  home,  and  family.  2. Why  do  I  need  a  neuropsychological  evaluation?  The  evaluation  is  helpful  to  answer  questions  about  return  to  normal  life.   You  may  have   questions  like:   o “When  can  I  go  back  to  work?”   o “Can  I  start  driving  again?”    o “Can  I  live  by  myself  or  do  I  need  to  live  with  my  parents?”     o “What  kind  of  accommodations  do  I  need  for  school?”           o “Am  I  depressed  or  am  I  just  tired?”  Although  doctors  are  able  to  look  at  scans  and  images  of  the  brain,  pictures  do  not  always  show   how  the  brain  is  working  and  how  the  brain  has  been  injured.  By  doing  neuropsychological  testing,   doctors  are  able  to  see  how  your  brain  is  working.  These  tests  will  also  help  you  and  your  doctors  understand  how  your  abilities  and  mood  have  changed.   Once  you  have  completed  the  evaluation   process,  your  health  care  provider  will  be  able  to  give  you  recommendations  that  will  help  you  and   your  family  to  develop  a  plan  for  getting  better.   3. What  skills  and  abilities  will  neuropsychological  tests  measure?   Typically,  neuropsychological  tests  will  examine  a  variety  of  skills  and  abilities:   ‐ General  Intelligence   ‐ Language   ‐ Problem  Solving   ‐ Visual  and  Spatial  Perception   ‐ Planning  and  Abstract  Thinking   ‐ Motor  and  Sensory  Skills  ‐ Attention  and  Concentration   ‐ Academic  Skills   ‐ Learning  and  Memory  Depending  on  your  illness  or  injury,  the  evaluation  may  focus  on  some  abilities  more  than  others.  4. Why  is  the  neuropsychologist  asking  about  my  mood?  After  a  brain  injury  or  stroke,  many  people  report  changes  in  their  mood.  Feeling  worried,  sad,   and  discouraged  are  common  after  an  injury.  Feelings,  emotions,  and  mood  also  play  an  important   role  on  our  ability  to  feel  good  about  our  lives  and  to  think.   Feeling  worried,  upset,  or  down  may  affect  a  person’s  attention,  concentration,  or  memory.   Your  neuropsychologist  will  ask  you  a  number  of  questions  about  your  current  mood  to  better  understand  how  your  feelings  and  emotions  may  be   affecting  your  scores  on  measures  of  thinking  and  to  see  if  counseling  might  be  a  helpful  next  step.  5. Who  will  I  meet  with  during  my  appointment?  Neuropsychological  evaluation  is  typically  done  by  a  clinical  neuropsychologist,  a  psychologist   with  specialized  training  in  how  the  brain  works.  A  neuropsychologist  uses  pencil  and  paper  tests  and   questionnaires  to  better  understand  how  the  brain  is  working.   Most  neuropsychologists  meet  with  patients  for  an  interview,  and  specially  trained  technicians   often  do  the  actual  testing.    A  technician  or  “psychometrist”  is  someone  with  advanced  training  on   how  to  administer  the  tests.     13. What  should  I  expect  from  a  neuropsychological  evaluation?   Will  I  find  out  the  results  of  the   evaluation?  The  results  of  the  evaluation  are  normally  presented  in  a  report.  A  copy  of  the  report  explaining   the  test  results  will  be  provided  to  you  if  requested.   The  report  will  typically  include:  a  summary  of   the  tests  you  were  given,  a  summary  of  important  medical  and  personal  history,  current  problems   you  are  experiencing,  test  results,  a  comparison  of  your  results  to  other  people  your  age,  and   recommendations  that  will  help  you  and  your  family  move  forward  in  getting  better.   We  recommend  that  you  take  some  time  to  read  over  the  report,  think  about  questions  you  have,  and  review  the  report  with  your  referring  or  treating  doctor.  If  you  would  like  to  discuss  the  results  and  recommendations  in  your  report,  ask  your   neuropsychologist  about  a  feedback  session.   During  the  feedback  session  you  will  be  given  a  chance   to  ask  questions  and  talk  about  concerns.    14. Who  gets  the  results  of  my  evaluation?   Your  neuropsychological  evaluation  results  are  written  into  a  confidential  report.  Typically,  the   only  people  who  can  read  the  report  are  you  (the  patient)  and  the  provider  who  made  the  referral  (i.e.,  physician,  rehabilitation  specialist,  or  lawyer).   You  may  choose  to  give  the  results  to  other   people,  or  you  can  ask  for  them  to  be  released  to  other  people  by  signing  a  Release  of  Information   form.  We  encourage  patients  to  get  and  keep  a  copy  of  their  report  for  their  personal  records.    15. What  are  the  results  used  for?   The  results  can  be  used  for  a  number  of  things,  and  will  depend  on  your  situation.   In  general,  results  can  be  used:   ‐ To  understand  your  current  strengths  and  weaknesses.   If  you  do  more  testing  in  the   future,  your  neuropsychologist  can  see  how  your  abilities  change  over  time.  ‐ To  help  your  rehabilitation  team  come  up  with  the  best  treatment  plan  for  your  current  difficulties.   ‐ To  help  you  make  decisions  about  returning  to  work  or  school.  ‐ To  help  you  be  more  successful  at  work  or  school.  ‐ To  make  recommendations  for  additional  treatment  that  will  help  you  with  recovery.  ‐ To  refer  you  to  other  professionals  who  can  help  you.  ‐ To  provide  information  if  you  are  involved  in  a  court  case.                ‐ To  provide  you  with  some  ways  to  cope  with  impairments  and  improve  relationships.   ‐ To  provide  information,  resources,  or  recommendations  to  your  family  as  they  help  you   with  recovery.  ‐ To  help  document  your  disability  (e.g.,  social  security  claims).  ‐ To  help  determine  if  counseling  could  help  you.  16. Will  you  tell  me  what  I  can  and  can’t  do  after  the  evaluation?     Many  people  worry  that  their  evaluation  results  will  be  used  to  make  decisions  about  whether   they  can  drive,  go  back  to  work,  manage  their  own  money,  cook,  stay  home  alone,  etc.  These   decisions  may  be  ultimately  made  by  you,  your  physician,  and  your  family.   However,  based  on  your   strengths  and  weaknesses,  a  neuropsychologist  will  make  recommendations  that  seem  to  fit  your  life   at  this  time.   These  recommendations  are  focused  on  your  safety  and  letting  you  be  as  independent   as  possible.   If  you  have  questions  or  concerns  about  recommendations  in  your  report,  meet  with  the   neuropsychologist  who  did  your  evaluation.  Remember  that  neuropsychological  testing  is  a  "snapshot"  of  your  abilities  at  one  point  in  time.   People  who  actively  engage  in  physical  and  emotional  therapies  can  show  many  improvements  over  time.   Your  recommendations  may  include  setting  up  an  appointment  for  reevaluation  after  a  certain  amount  of  time.   If  you  complete  a  reevaluation,  your  neuropsychologist  will  look  at  your  abilities   again  and  will  likely  make  adjustments  to  old  recommendations.     17. Do  I  have  to  come  back  to  get  the  results?   Many  people  like  to  set  up  a  feedback  meeting  after  the  evaluation  is  complete.   Usually  the   session  lasts  about  60  minutes.   During  this  time,  your  neuropsychologist  will  explain  the  evaluation   results,  go  over  recommendations  for  you  and  your  family,  and  answer  questions  you  might  have.   A   feedback  session  is  not  required,  but  could  be  helpful.  If  you  have  questions  about  your  evaluation  or   results,  you  can  also  ask  your  other  doctors  (e.g.,  neurologist,  rehabilitation  doctor  or  therapist).    This  work  was  supported  by  Grants  #H133A070036  and  #H133P040006  from  the  National  Institute  on  Disability  and  Rehabilitation  Research  (NIDRR),  Office  of  Special  Education  and  Rehabilitative  Services  (OSERS),  Department  of  Education,  Washington,  D.C.