What is a neuropsychological assessment ?
It is the evaluation of cognitive abilities in a person at a time T. What are cognitive abilities ? These are attentional capacities, memory, executive functions (inhibition, flexibility, working memory, planning, etc.), the famous IQ test.
Juste like the ADHD assessment, The neuropsychological assessment is done by a neuropsychologist. The neuropsychologist is a psychologist specializing in neuropsychology, that is to say science at the crossroads between neuroscience and psychology. He is a graduated of a faculty of psychology and has at least master degree.
How is a neuropsychological assessment carried out ?
The assessment can be done at the hospital, in a structure or in private practice.
Generally at the hospital there is a waiting period, in the structure not everyone is necessarily accepted, for lack of space. Most of the time, therefore, there is only the balance sheet made in town.
The family makes contact, on the recommendation of a doctor, another health professional or the school, with the neuropsychologist. The latter offers a first appointment called the anamnesis interview. The main purpose of this first meeting is to be able to review the course and development of the person concerned. It is a question of approaching schooling and learning, behavior, management of emotions and social interactions. Go back to the various assessments or follow-ups carried out so far as well as the daily life and any complaints if there are any.
Then the neuropsychologist determines what type of assessment should be proposed according to the needs and the strengths and weaknesses to be highlighted in order to be able to subsequently propose adjustments or at least recommendations.
The IQ test
Purpose and structure
The IQ test is a common starting point when assessing a person's cognitive functioning, especially when no other evaluations have been conducted previously. This standardized assessment is tailored based on age groups:
- WPPSI : for children under 6 years old.
- WISC : for children aged 6 to 16.
- WAIS : for individuals over 17.
The test provides a global snapshot of cognitive functioning, serving as a comparison tool against age-related norms. While IQ results should not be overvalued, they remain significant when administered rigorously and interpreted correctly. The test holds particular value in identifying two key profiles :
- High Potential (HP) : indicates advanced intellectual functioning.
- Global Developmental Delay : highlights below-average functioning.
However, IQ interpretation requires a certain level of homogeneity in results. Discrepancies across domains can make global IQ scores less meaningful, necessitating deeper analysis through additional testing.
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The Five Competency Areas Assessed
The IQ test evaluates cognitive functioning across five core domains, with optional subtests included in cases where mandatory scores are inconclusive:
- Verbal Skills : assess vocabulary, verbal abstraction, and knowledge of social and adaptive codes.
- Visuo-Spatial Skills : evaluate abilities with and without manipulation of objects.
- Logic : includes tasks with and without quantitative elements.
- Working Memory : measures the ability to process information in the short term, combining attention, short-term memory, and self-confidence.
- Processing Speed : analyzes efficiency in tasks, with or without graphic production.
The neuropsychologist interprets results through :
- Standard Scores : comparing performance to age-group norms (scores of 8-12 or 9-11 reflect average).
- Indices : domain-specific scores (90-110 indicate average development).
The results guide further action, such as recommending specialized assessments or interventions:
- Language Skills : referral to a speech therapist for detailed language evaluation.
- Emotional and Behavioral Correlations : referral to a psychologist for issues like anxiety or confidence deficits.
- HP Profiles : referral to specialists for managing high-potential characteristics.
Other assessments
Other evaluations come under the name of neuropsychological assessment.
For each cognitive function, there are batteries of tests or subtests that allow specific assessment of the cognitive skills in question.
For example, if the entourage has questions about memory, it will be possible to carry out an assessment focusing on memory skills by taking into account the different modalities (short-term memory, long-term memory, auditory memory, visual memory, with indexing, without indexing, the quality of encoding, storage, recovery, etc.). The same will apply to the other cognitive skills mentioned at the beginning of the article.
This is why it is important to take the time to understand the patient's request, to listen to his complaint, to properly investigate the patient's journey. You don't always need to do a full review. It is quite possible to do the tests step by step, if the need arises.
Once the assessment has been carried out, the neuropsychologist corrects and interprets the results. He writes a report that he gives to the patient during the return appointment. With the patient's agreement, he may also be required to communicate it to other professionals or to the school.
The neuropsychologist takes advantage of this appointment to explain the results and give recommendations.
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What kind of questions does a neuropsychologist ask during a neuropsychological assessment ?
1. Background and Medical History
To understand the individual's history and context.
- Personal History. Can you describe any difficulties you've experienced in daily life, work, or school ?
- Medical Background. Have you had any illnesses, injuries, or neurological conditions (e.g., head trauma, seizures) ?
- Family History. Is there a history of learning difficulties, mental health issues, or neurological conditions in your family ?
- Medication. Are you currently taking any medications? Have they impacted your thinking or mood ?
2. Current Functioning and Concerns
To pinpoint specific issues.
- Cognitive Challenges. Do you find it difficult to focus, remember things, or solve problems ?
- Emotional Concerns. How do you feel emotionally? Have you been experiencing anxiety, depression, or mood swings ?
- Behavioral Issues. Have you noticed changes in your behavior, such as impulsivity, social withdrawal, or aggression ?
- Functional Impact. How are these challenges affecting your work, school, relationships, or daily activities ?
3. Cognitive Domains
Targeted questions or tasks to explore specific areas of cognitive functioning:
- Memory. Can you recall what you ate for breakfast yesterday? How about events from a year ago ?
- Language. Can you name common objects or describe their use ?
- Attention and Concentration. Can you stay focused during activities? Do you get easily distracted ?
- Executive Functioning. How do you approach planning or organizing tasks? Do you find it hard to prioritize or follow through ?
- Visuo-Spatial Skills. Can you follow a map or visualize objects in your mind ?
4. Emotional and Psychological State
To assess emotional well-being and its impact on cognition.
- Mood: Have you been feeling unusually sad, irritable, or euphoric?
- Stress: Are there particular situations that stress you out or make your symptoms worse?
- Social Interactions: How do you interact with others? Do you feel supported in your relationships?
5. Functional Activities
To assess the practical implications of any difficulties.
- Daily Life. Can you manage personal care, cooking, or household tasks independently ?
- Work/School. Are you able to meet deadlines, concentrate, or remember instructions at work or school?
- Leisure Activities. Are you able to engage in hobbies or activities you used to enjoy?
6. Observations During Testing
In addition to verbal questions, neuropsychologists often use observations.
- Do they appear attentive and engaged during the session ?
- Are there noticeable difficulties with tasks requiring memory, problem-solving, or verbal skills ?
