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Indications for testing

Posted by Margaret Donohue on June 14, 2015 at 9:35 AM

I did a presentation for a local networking group on neuropsychological testing.  Here's a recap:

Neuropsychological testing looks for problems and deficits in functioning localizable to the cortex.  Much of the purpose of neuropsychological testing has been replaced by neuroimaging.  MRI's or CT Scans.  But there are still several purposes for neuropsychological testing.


1.  Likely etiology for neurological impairment.


If you think your symptoms are due to a head injury and not a brain tumor, it might be nice to get that confirmed.  If you have musical hallucinations, get neuroimagry.  Different types of brain tumors show up at different ages.  Sometimes following a head injury with concussion, people have more symptoms.  Worsening headaches five years post injury is NOT from the head injury.  Worsening other symptoms 3 years post injury is NOT from an injury.  Head injuries improve with time. Orthopedic injuries can worsen over time.  There's some worsening for the first 3 years as the brain adapts to the injury, and headaches of migraine like intensity will continue for up to and including 5 years from injury lessening in intensity and severity as time passes.  So if you are past tose time markers and symptoms are worsening, you can get either neuroimaging or neuropsychological testing.  Many people don't like neuroimaging, especially people with claustrophobia, because it's a small tube and it's noisy. So to differentiate neurological symptoms neuropsychological testing can be done.  Brain injuries generally show a fairly wide specific area of impairment in two places, one smaller than the other.  Brain tumors generally show a small specific area of impairment.  Neuropsychological testing is used most often to show strengths and impairments folowing a known brain injury or illness.


2.  Functional strengths and impairments of a known neurological condition.


Anyone with a recent brain injury would benefit from neuropsychological testing to get a baseline for functioning.  If you were in an accident and are pursuing litigation, it's best to ask your attorney for a referral as many personal injury attorneys have specific neuropsychologists they work with for this purpose.


If you have a known neurological condition, neuropsychological testing can document what strengths and weaknesses are present. Neuropsychological testing can also help with strategies for accommodations.  It can be used to evaluate capacity for certain types of tasks such as managing funds, living independently, taking medication, etc.


3.  As part of a battery of tests, neuropsychological testing can be used to help with differential diagnosis.


This can be true for dementia versus depression, types of dementia, clarifying types of attentional problems. Or other issues.  In right handed people right hemisphere neurological impairment can show up as anxiety.  In right handed people left hemisphere neurological impairment can show up as depression.  (The same is true 80% of the time for left handed and ambidextrous people, but 20% of the time it's the opposite.)  


4.  It can be used to document the formal need for accommodations under ADA.


ADA testing follows a legal standard established by the California State Bar Association for accommodations for learning disabilities, ADHD, or neurological conditions.  These evaluations are lengthy and have substantial documentation of how someone performs with and without desired accommodations.  That allows for a functional evaluation of the need for accommodations.


There are a lot of conditions where neuropsychological testing will not be productive and general psychological testing or even just a clinical interview will be sufficient.  I can consult on cases over the phone.  The consultation is free.  If you'd like to be tested, feel free to contct me at 818-389-8384.

Categories: General Psychology, Brain Injury, Diagnosis

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