A Parent’s Guide to Neuropsychological Evaluations
Selecting a neuropsychologist
Identifying an expereinced pediatric neuropsychologist is important, as a parent will want a professional with whom they can work with over the course of the child's development into adulthood. A neuropsychologist who can track the child's development will have a firm grasp on the child's cognitive strengths and weaknesses over time. That knolwledge will be the most informative to parents, physicians, therapists and educators, and sometimes the legal system. It is also quite important that the neuropsycholgist have expereince in working with specific disabilities and medical conditions, such that he or she can effectively work with the child, interpret data appropraitely and offer insights into the neurocognitive impact of the condition.
In your initial contact with a neuropsychologist you are considering consulting, ask questions that can infrom your choice:
- What is your training and professional qualifications? Most states do not separately license neuropsycholgists, so you can for a licensed psychologist who completed a full-time post-doctoral fellowship of at least two years in pediatric neuropsychology. Many neuropsycholgists also obtain board certification, but it is not a necessary qualification.
- What age patients do you serve in your practice? A practice focused on infants/toddlers, children and teens to young adults will offer more relevant expertise regarding development and transitions to adulthood.
- Do you have a special interest or particular experience working with (name your child's known or suspected condition)?
- Have you had any prior experience with my school district or current private school (or one the child may attend in future)?
- Do your reports include recommendations? A strong report offers recommendations, based on data obtained, for home, school, therapists, physicians to carry out.
- Are your recommendations customized to the child’s individual profile?
- Does your evaluation cover social skills, executive functioning, psycholgical and emotional issues, and transition to independence?
- Do you attend team meetings or consult with other professionals about the results?
At the intake meeting
- The neuropsychologist will first meet with the parent(s) or caretaker(s) and ask for detailed information about the child through written questionnaires and documents (e.g. past testing, medical and school records, samples of current work, or 504/IEPs) and likely request obtaining any additional infromation that might be helpful. At this meeting, be as specific as you can in articulating your concerns, and bring as much previous infromation as you can gather.
- Be ready to explain your goals for this evaluation; what worries you about your childs development, what brings you to an evaluation at this time and what are you oiping to get from it? For example, you may want the evaluation to help you and educators identify and understand your child’s learning style or social struggles, or to assist with school placement decisions.
- The neuropsycholigst should conclude this meeting with some initial impressions and hypotheses about the child's functioning, and propose a testing plan to address those. You insurance company might require pre-authorization of these proposed services, which will typically be requested by the neuropsychologist.
At the feedback meeting
- The neuropsychologist will meet with parents, caregivers and any other interested parties approved by the parents to review and explain the findings and provide a diagnosis as well as some initial recommendations. As you listen, ask whether the infromation is consistent with your understanding of your child. If not, discuss these areas of difference with the neuropsychologist, trying to understand what the evaluation shows and how the neuropsychologist is interpreting the information.
- Do not reject a diagnosis out of hand. Even though you may experience some pain or struggle in accepting a label for your child, the diagnosis can facilitate access to services that will help the child learn and grow to his or her full potential. If the report contains a diagnosis that is different from others your child has received in the past, ask the neuropsychologist to explain the criteria or reasons for it. Consider whether different terms are being applied to the same condition, or whether there is a substantive dispute about the nature of the condition.
- The final written report typically is offered after this meeting, sometimes days or weeks later. Read through and make sure you understand the report and recommendations; while you do not have to have a full grasp of the written infromation, you should read infromation that is consistent with what you discussed in the feedback session and some ideas about first steps in implementing the recommendations.
- Use AANE’s “Frame for Preparing for IEP Meetings” (www.aane.org/asperger_resources/parents_toolbox.html). The frame is designed to help families organize information, from the meeting with the neuropsychologist to the team meeting at school. It will help identify and track the most important issues, ensuring that they are discussed in the team meeting and incorporated into the IEP. The use of this frame is taught in the parent workshop “Advocating for Your Child with AS in Public Schools” or “Advocating for Your Teen with AS in Public Schools.” (See www.aane.org or contact Children’s Services or Teen Services for workshop dates.)
- If your school lacks expertise in in your child's diagnoses and/or conditions, ask whether the neuropsychologist can supply infromation that will help educators understand relevant strategies and explanations.
At the team meeting
- Make sure any independent neuropsychological report is available in advance to the special educator or administrator who will be facilitating the team meeting. The school psychologist should be present at the meeting to help transplate the infromation to the school staff.
- If there is no one on the team equipped to translate the report to the teachers, this role falls to the parents. This is when parents can request that the neuropsycholgist speak with team members in advance or be present in person or by phone to help communicate results effectively. Know that this request does typically incur an additional fee for service that is not covered by insurance companies.
- When the neuropsychologist is present to answer educators’ questions (and to listen respectfully to their opinions and concerns), educators are less likely to dispute the findings or misinterpret the recommendations. The neuropsychologist’s statements and responses will almost certainly be most effective in helping translate the findings into effective school adaptations and understanding of the child's challenges.