Neurodynamics

Neuropsychological Testing FAQ’s

What is a neuropsychological assessment?

A neuropsychological assessment is a comprehensive evaluation of an individual’s cognitive, behavioral, and emotional functioning as well as their learning style.  The key areas examined in a neuropsychological assessment are:

1. intellectual reasoning capacity, or IQ
2. academic achievement, particularly in the areas of reading, writing and math
3. language-based abilities;
4. executive functioning (skills such as planning, prioritizing, organizing, problem solving, cognitive flexibility, cognitive inhibition, etc.);
5. attention capacities and associated behaviors
6. memory abilities, including visual and auditory memory in both immediate and delayed modalities; and
7. social and emotional functioning

Who would benefit from neuropsychological assessment?

Neuropsychological assessments provide detailed information about an individual’s functioning in many areas that help  guide intervention strategies at home, in school, and in the community.

Children, for example, may have a combination of problems that have been difficult to sort out, and some children have already been seen by doctors, therapists, and school personnel and yet a clear understanding of their issues has not occurred.

Adults who have experienced neurologic changes resulting from traumatic brain injury or other conditions that affect neurologic functioning, or adults who have complicated histories that may include psychiatric conditions, social problems, or learning challenges can benefit from a neuropsychological evaluation.  The information obtained from the evaluation can provide important  information to doctors,therapists, or family members who are working with the individual.

Why would a student need such a comprehensive assessment?

One of the most common reasons for getting a neuropsychological assessment is that someone – usually a school age child, adolescent or a college/graduate student – is experiencing a pattern of difficulty in one or more areas of their school functioning.  Common patterns of difficulty are listed below.

1. problems paying attention in classes
2. difficulty following through and completing assignments
3. struggling to get reading done because it takes too long
4. reading, but not understanding what was read
5. getting frustrated trying to finish tests on time
6. taking too long to organize and write papers
7. hoping for extended time on college entrance exams
8. struggling to learn a foreign language
9. lack of motivation, particularly regarding school work
10. declining grades in school
11. distracting and impulsive behaviors interfering with school and social success
12. anxiety and/or depression related to school-related performance
13. disparity between honors-level grades in school and low scores on standardized tests
14. effects of certain social, emotional and/or family stressors on academic and social functioning
15. difficulties with math, reading and/or writing
16. wondering about the possibility of having a specific learning disability

How can a neuropsychological assessment be helpful?

A comprehensive neuropsychological assessment can help to evaluate an individual’s current level of overall functioning, and then isolate certain problem areas that are likely to be interfering with their ability to be more successful.

Once these problems are identified, a list of modifications and/or accommodations can be recommended in an effort to tailor specific plans – for the individual and for parents, spouses, family members,  teachers, and other professionals who live/work with them – to help the individual to function more effectively in their academic, work,  or  social environment.

Can a neuropsychological assessment help to diagnose ADHD?

Yes.  With the combination of different assessment tools, such as a clinical interview, specific cognitive and neuropsychological tests, various subjective rater scales/inventories, and observations made by the examiner, diagnosis for Attention Deficit Hyperactivity Disorder can be made.  It is important to recognize that there are a number of factors that can interfere with attention and focus, so getting a clear diagnosis is important in order to determine the most appropriate treatment focus.

Can a neuropsychological assessment help to diagnose learning disabilities or learning problems?

Specific learning disorders, such as dyslexia and other reading disorders, math disorders and writing disorders are more easily diagnosed with these assessments.  Other disorders that interfere with learning, reasoning, and problem-solving, such as  Nonverbal Learning Disorders, auditory processing disorders, Asperger’s disorder, Bipolar Disorder, and Fetal Alcohol Spectrum Disorders can be diagnosed as well.

How long does a neuropsychological assessment take, and when do we get the results?

The evaluation is comprised of three separate appointments.  The first appointment is a comprehensive consultation which includes review of developmental medical social/emotional, and academic history.  If the patient is a child/adolescent at least one parent and the child should plan to attend this meeting.  If the patient is an adult, a parent o other adult who is familiar with that person is invited to attend, as it is very helpful to gain additional information from an individual who knows the patient closely.

The second appointment is the testing appointment.  This appointment is generally scheduled to be completed in one day.  It generally consists of two 3-hour testing sessions (morning and afternoon) with a one-hour break for lunch.  An alternative testing plan can be arranged if there is a clear reason to do so.

After testing, a follow-up meeting is held with the individual and/or his or her parents, to review the findings and to discuss treatment recommendations for optimal success.  The written report is usually completed in four to six weeks after the follow-up appointment.  If it is determined that a separate follow-up appointment would be helpful for the child/adolescent without the parents, this meeting will be scheduled and billed separately.

Will my insurance pay for these assessments?

Some health insurance companies will pay for a portion of a neuropsychological assessment, depending on the diagnosis, but no insurance company currently covers the cost of academic testing or related services.  However, it is a good idea to explore your health benefits first, as some insurers will not pay for this kind of assessment.  In some cases, having a medical doctor make a referral for a neuropsychological assessment can help with the insurance company’s willingness to pay for these services.  Our office has a great deal of experience in working with insurance companies, and we can provide you with information regarding what types of questions are important to ask a representative when calling your insurance company about covered benefits. We will be happy to share that information if you are interested in making an initial consultation appointment but need to check with your insurance company first regarding covered benefits.

If you desire, we will bill your insurance company for the amount of testing included under your insurance plan.  In addition to whatever payment we may receive from your insurance for that part of your child’s evaluation they determine to be medically necessary, we will also bill you separately for its educational component, which we consider integral but they do not cover.  The cost of the school-related portion of our services is usually around $500, and it will be your responsibility to directly pay this portion of the evaluation.

How much does a comprehensive neuropsychological assessment cost?

The cost of a neuropsychological evaluation generally ranges from $1800-$2400, depending on the time required and complexity of the case.  If you have no insurance or your insurance plan does not cover neuropsychological testing, our office has three different options for out-of-pocket payments for services rendered.  We understand that this type of comprehensive evaluation is costly and we will do our best to work with you so that the evaluation you seek can be completed.

What if I or my child is covered by Medicaid?

Medicaid does provide reimbursement for neuropsychological testing; however, only certain diagnoses are covered, and pre-approval from Medicaid must be obtained before an evaluation can be completed.  Medicaid does not cover testing for diagnoses such as learning disorders, ADHD, dyslexia, speech/language disorders, etc. However, if learning/attention/behavioral problems result from neurologic conditions such as Fetal Alcohol Exposure, Developmental Disorders, or traumatic brain injury,  Medicaid may cover testing. With adults, there must generally be a combination of psychiatric, social, and vocational challenges that require more comprehensive testing in order to help with diagnoses, medication decisions, and future treatment planning. Adults with Medicaid coverage are usually referred for testing by a treating psychiatrist, physician, or therapist.

Will my child’s neuropsychological assessment be shared with their school?

Usually, parents are eager for their children’s teacher(s) to know about these assessments, with the hope that teachers can help to accommodate for the child’s learning needs.  However, the report is given to the parents, as they are the owners of their children’s information.  Once the report is approved by the parents, and a written consent is provided, then a copy of the report can be released to the child’s school.

In some cases, parents provide a copy of the report to the school directly, without involving the examiner.  As needed, the examiner can attend meetings at the school or participate in a telephone conference with the child’s parents, teachers and appropriate school administrators in an effort to discuss assessment findings and to coordinate follow-up plans for optimal success in school. Additional fees will be charged for school or phone conferences.

Why Neuropsychological Testing is so costly?
Neuropsychological testing may seem to be rather expensive, however, you may not be aware of the time involved in completion of an evaluation from start to finish. The following is a breakdown of what is involved in a typical neuropsychological evaluation:
15-20 minutes, Telephone intake and referral information
1.5-2 hours, initial consultation
1 hour, Review of consultation information and subsequent letter to referral source
3-6 hours, one-on-one testing
3 hours, scoring and write up of behavioral observations
1.5-2 hours, Evaluation feedback session with parents
1 hour, Feedback session with patient
3-5 hours, Completion of written evaluation and letters
At $150.00 per hour, the cost for such an evaluation would be $2100.00 to $3000.00 dollars. While that may seem very high, compare the cost to what you might pay a mechanic, plumber, or attorney. A Neuropsychologist has up to eight years of post graduate training. His or her expertise and training are important factors in getting the clearest diagnosis and most useful recommendations for the patient.