What is a neuropsychologist?
Clinical Neuropsychology is a
specialty profession that focuses on brain functioning. A clinical
neuropsychologist is a qualified Clinical Psychologist accredited by
the British Psychological Society,
with expertise in how behaviour and skills are related to brain
structures and systems. A very detailed assessment of
abilities is done, and the pattern of strengths and weaknesses is
used in important health areas, such as diagnosis and treatment
planning. The Clinical Neuropsychologist conducts the evaluation and
makes recommendations. He or she may also provide treatment, such as
neuro-rehabilitation, behaviour management, or cognitive behaviour
What is neuropsychological cognitive testing?
Neuropsychological assessment is an appraisal of the brain's
psychological, that is cognitive and behavioural, functions. An
assessment usually consists of 3 equally important parts.
Firstly, taking a comprehensive history from interviews with the
patient, where appropriate, a close relative, and gathering
information from medical records and school reports. This
first stage allows us to gain a picture of the type and severity of
injury to the brain, what the person was like before the illness and
how they have progressed.
The second stage involves the use of standard psychological tests
to examine how specific functions of the brain are working. The
main areas of cognitive functioning which should be assessed are
attention, memory, visual perception, reasoning and verbal ability.
For each function a number of different tests should be used. There
is no point relying on just one test of attention, for example, when
attention is such a complex system and is known to have different
areas and levels of working within the brain - for example, speed of
thinking, sustaining concentration, keeping to one thing at a time,
being able to work in a busy or noisy environment with other things
going on around you.
An individual's IQ (intelligence quotient) has little relevance
to brain function or neuropsychological assessment. However, the
standard tests of intelligence, which are used to calculate the IQ,
can be very useful if their results are interpreted in terms of
brain function, rather than numerical estimates or lQs. An
appropriate and comprehensive neuropsychological assessment yields
information on how the brain is working, information which cannot be
obtained in any other way.
The third part of assessment is the Psychologist's opinion and
report. The test results are now considered in relation to the
person's history - both before and since the illness. For example,
do the test findings make neurological sense? Does the pattern
of difficulties shown fit with what one would reasonably expect to
find? If not, were there any problems before the illness, such as
dyslexia, learning or behaviour difficulties, or other injury to the
brain, which may have increased the person's vulnerability and
caused disproportionately severe symptoms? The effects of two or
more injuries to the brain, whatever their cause or severity, will
Having decided on the person's present condition, the
Psychologist should then be in a position to make recommendations
for helping further rehabilitation or education, for example. The
so-called "strengths and weaknesses" of the person's assessment
should indicate the main problem areas (e.g. attention and memory),
the nature of the difficulty (e.g. distractibility) and, by logical
application of knowledge on how brain functions are organised, the
best ways in which to approach the problems (e.g. working in a quiet
room; one-to-one practice in learning how to learn).
In children, a neuropsychological assessment must take into
account effects on normal developmental processes and for this
reason repeat assessments at life transition points (such as
preparing for transition to secondary school or further education)
are appropriate in order to plan appropriate education