Frequently Asked Questions
What is a neuropsychologist?
A neuropsychologist is a specialist in brain-behavior relationships, with advanced training in brain pathology, neuroscience, and models of behavior that allow us to examine, diagnose, and treat a variety of clinical conditions. Whether evaluating children, adults, or providing geriatric assessments, the neuropsychologist uses standardized tests, along with behavioral observations, to determine current functional or ability levels when compared to others of the same age and general background.
What is a neuropsychological assessment?
Taking into account normal brain development and normal brain aging, as well as functional anatomy, a neuropsychological assessment can define weaknesses (as in the case of academic performance, concussion, or head injury) as well as patterns of deterioration (as in the case of chronic disease, dementia, etc.).
When should I consider a neuropsychological evaluation?
A comprehensive neuropsychological examination is clinically indicated and medically necessary when a variety of indicators are noted by either a medical professional and or family members. Such categories can include:
Head Injury or Concussion;
New or unexplained learning difficulties;
Strokes or mini strokes;
Fluctuation or changes in mental status;
Changes in language or speech;
Chronic medical illness which compromises cognition;
Heart failure, heart disease, or heart attack;
Unexplained changes in mood, behavior or personality;
Dementia or suspected dementia;
What is involved in the examination?
The exam is completed one-on-one with a clinical neuropsychologist. Various tests assessing vision, memory, language, judgment and reasoning, motor functions, and planning are selected based upon the individual as well as the specific reason for the examination. The individual will be sitting at a desk performing a variety of tests with one of our neuropsychologists, many of which are paper and pencil measures or computer assisted.
Depending upon the reason for the exam and other factors, one half or one full day of testing may be required. At the outset, you'll be interviewed by the neuropsychologist, who will also be happy to meet with a member of your family or significant other to provide some further information regarding the nature of the exam and the test process.
What do the tests show?
While many individuals try to focus on the results of radiological studies such as a CAT scan or MRI, these studies only display a "picture" of the brain, and don't tell us what the brain is capable of doing. Other studies, which can include lab work or other clinical assessments in a hospital or physician's office, cannot always identify the reasons for changes in mood or behavior, or answer important questions about current functional abilities.
For example, answering the question, "Can my mother live alone? Can she drive?" cannot be answered by the results of an MRI. Similarly, academic performance, the diagnosis of a learning disability or other behavioral disorder cannot be ascertained by bloodwork or radiological studies, or identify if someone will be successful in school.
The neuropsychological exam, however, provides a compendium of strengths and weaknesses of the individual and can assist in the diagnosis of complex neurological and psychological conditions. The exam also helps us to determine if a mood disorder, such as depression, is negatively influencing memory or cognition and contributing to deficits in functional ability or overall decline.
How is the neuropsychological examination different from testing that I may have had when I was in school, or my child has had during his academic career?
Those who provide basic assessments within the school setting, are generally interested in simply looking at grade-appropriate performance or abilities. That is, they try to determine if a child is "at or below" a specific grade level or age equivalent. As such, information regarding brain function is absent, or at best, somewhat limited by the scope of these school-based exams.
In contrast, our neuropsychologists look at test patterns using multiple specialized tests which are not available to the school community. Thus, a comprehensive neuropsychological evaluation may uncover the specific difficulty someone is experiencing in school or at work. Various tests will help us understand not only the strengths and weaknesses of an individual, but how that individual performs on tests of attention, following directions, language interpretation, and various modes of interacting with the environment (e.g., visual, perceptual, etc.).
How do I schedule a neuropsychological evaluation?
Simply contact our office directly at 215-750-5525 to schedule an appointment. When you provide our intake team with information regarding your referral question or needs, and provide necessary demographic and insurance information, we will be able to guide you with the process.
When a physician's office contacts us to refer a patient, additional information will be requested, and can include prior medical records, medication lists, etc. If any of this information is available at the time of the initial appointment, please feel free to bring it with you when meeting with the doctor.
Will the neuropsychological examination be covered by my insurance plan?
There are a variety of insurance organization plans, and many plans cover the comprehensive evaluation when there is a need to assist in a differential diagnosis, or to document the degree of injury or deficit secondary to a traumatic injury, dementia, etc..
Although insurance plans vary from state to state and from employer to employer, we make every effort to investigate and secure an authorization for services, when applicable. However, as with all medical care or exams, you are ultimately responsible for the services provided by our group.
For non-clinically related referrals (e.g. independent medical examinations, forensic examinations, court-ordered evaluations, or other specialized tests) we will provide you with information regarding the fee for the services requested. Generally, some examinations are not covered by insurance plans, as they are viewed as "elective" in nature.
What do I bring to an evaluation?
If you have results of prior evaluations or any other relevant medical records, please feel free to bring them with you, in addition to any glasses or hearing aides you may use. If you take any medications, please continue to take them, as prescribed.
Due to the length of the test, we will work with you to assure that you are functioning at your best during the time of the evaluation. However, we ask that you get sufficient sleep and rest prior to the exam. During a full day evaluation, we do provide a lunch break and encourage you to bring snacks, drinks, or lunch to our office.
How do I study for the exam?
There is no way to study for a neuropsychological evaluation. Throughout the exam, you will be asked a variety of questions and presented with tasks of varying levels of difficulty. Making sure you have had sufficient rest before the exam is your best preparation.
Will I get the results of the examination?
Unless specifically prohibited by the nature of the evaluation (e.g., a court ordered evaluation, IME, or other legal circumstance) you will have an opportunity to sit down with the doctor to review the results and recommendations, as appropriate.
What do I do with the results of the exam?
Evaluation results help outline the development of treatment or rehabilitation plans (as in the case of head injury, dementia, etc.). In the case of pediatric evaluations (e.g., learning disorder, ADHD), the information can be integrated into an adaptive learning plan for the student and/or provide valuable information to the attending physician regarding the potential use of medication or alternative treatments.
In cases where progressive disorder is identified, such as dementia, or coexisting psychological problem is identified, a consultation with one of our doctors can lead to recommendations for treatment and help address family decision-making for future patient care.
Can memory and attention problems be fixed?
We know that not all cognitive problems are treatable. Some may be the result of a transient illness or trauma, and some the result of an "aging brain" or a more progressive, debilitating neurological condition.
Your doctor will make recommendations about various cognitive remediation strategies and programs, as appropriate to your situation.
Whether concussion or severe head injury, we can offer recommendations for community treatment, work or school accommodations and computer based interventions to assist in your recovery.
Please feel free to ask your evaluating doctor.