Neuropsychological Assessment: A Comprehensive Guide

Neuropsychological assessment is the process of evaluating an individual using a wide variety of methods, tests, and measures to assess and measure the functioning of the brain. Neuropsychological assessment can be used as part of a clinical evaluation, or during ongoing treatment to monitor progress and identify areas of strength or weakness. If you have been diagnosed with a neurological condition such as attention deficit hyperactivity disorder (ADHD), traumatic brain injury (TBI), or chronic traumatic encephalopathy (CTE), your doctor may recommend neuropsychological testing. These tests are also beneficial for individuals who are at risk for neurological conditions such as Alzheimer’s disease, or those who want to reduce their risk through lifestyle changes. This article will provide you with a general overview of neuropsychological assessment and how it can help your unique situation.

What to Expect During a Neuropsychological Assessment

A neuropsychological assessment is a multi-part procedure that may include a number of different tests and tools. You may be asked to complete self-reporting questionnaires, do computerized or pencil-and-paper tests, or take part in computer-based testing. If you are being assessed for a specific condition, you may be asked to complete tests specific to that condition. If you are being assessed because you have had a traumatic event, you may be asked to take a battery of tests meant to measure potential cognitive and psychological effects of the event. If you are being assessed for learning disabilities or attention deficit disorder (ADD/ADHD), you may be asked to complete learning or attention-themed tests. If you are being assessed for brain damage, you may be asked to complete tests that measure processing speed and word retrieval. If you are being assessed for cognitive decline, you may be asked to complete tests that measure attention, memory, and problem solving.

Why is Neuropsychological Assessment Performed?

Neuropsychological assessments are generally conducted after an individual has experienced a brain injury or neurological event, or has been diagnosed with a neurological condition. Some examples include traumatic brain injury (TBI), degenerative brain diseases, or disorders such as Alzheimer’s disease. Neuropsychological assessments are also helpful for individuals who are exploring treatment options for attention deficit hyperactivity disorder (ADHD) or learning disabilities. The results of the assessment can help determine the following: Though these are all potential uses for a neuropsychological assessment, they are not all mutually exclusive. A single assessment can provide all of this information.

Different Types of Neuropsychological Tests

Neuropsychological tests fall into two categories: self-report assessments and performance-based assessments. Self-report questionnaires - Self-report questionnaires are questionnaires that ask about your current symptoms and functioning. These include the Adult Attention Deficit/Hyperactivity Disorder Self-Report Scale-V1.1(ADHD-V1.1), the Beck Depression Inventory (BDI), and the Beck Anxiety Inventory (BAI). Performance-based tests - Performance-based tests are activities or exercises that measure specific cognitive skills. Examples include computer-based tests, pencil-and-paper tests, and paper-and-pencil tests. Computer-based tests - Computer-based tests are exercises that are delivered on a computer. They are generally more engaging than pencil-and-paper tests, which may allow individuals to perform better. Some examples of computer-based tests include the Cognitive Assessment Screening Test (CASC), the Stroop Test, the Continuous Visual Tracking Test, the Finger Tapping Test, and the Wisconsin Card Sorting Test. Pencil-and-paper tests - Pencil-and-paper tests are generally used when computer-based testing is not possible. They include the Wide Range Achievement Test-3rd Edition (WRAT-3), the Wechsler Adult Intelligence Scale-V (WAIS-V), and the Wechsler Abbreviated Scale of Intelligence (WASI). Paper-and-pencil tests - Paper-and-pencil tests are generally used in the initial assessment when a person is not feeling well enough to complete computer-based testing. They include the Auditory Identificiation Test (AUDIT), the Benton Visual Retention Test (BVRT), the Controlled Oral Word Association Test (COWAT), the Finger Tapping Test, the Grooved Pegboard Test, the Rey-Osterrieth Complex Figure Test, and the Symbol Digit Modalities Test (SDMT).

Limitations of Neuropsychological Testing

Neuropsychological testing can provide valuable information about your current functioning, but it cannot predict future outcomes. For example, if you took a neuropsychological test shortly after being diagnosed with a brain disease, the test may show your cognitive functioning as normal. However, years down the road, as the disease progresses, you may experience cognitive decline as measured by the same test. The results of a neuropsychological test are affected by an individual’s health and wellness, the time of day, the environment, the test instructions, and the person taking the test. For example, if you are not feeling well, you may not perform as well on the test.

How to Prepare for a Neuropsychological Assessment

It is important to prepare for a neuropsychological assessment since the process is time-consuming and sometimes challenging. The following may help you prepare for your assessment: 

• Be organized: Many tests require you to bring information with you, so it’s helpful to have a folder with all relevant information handy. 
• Wear comfortable clothing: If you are taking a paper-and-pencil test, you will probably be sitting for a long time. Make sure to wear clothing that is comfortable and does not restrict movement.
• Prepare for interruptions: If you are taking a pencil-and-paper test, be prepared for interruptions. You may be asked questions about the test, asked to take a break, or have someone else come in to take the test for you. 
• Bring a friend: If possible, bring a friend or loved one with you. The assessment may last several hours, and having a friend there to help you remember instructions, take breaks, and stay focused can be helpful. 
• Be prepared to be tired: Many cognitive tests are challenging and require a lot of focus. Be prepared to feel tired and possibly frustrated if you don’t do well on the test.

Bottom line

Neuropsychological assessments provide valuable information about an individual’s current functioning. They can help determine whether someone has a cognitive deficit and what type of treatment they may need. It is important to prepare for a neuropsychological assessment by being organized, wearing comfortable clothing, and being prepared for interruptions.