Pediatric Neuropsychology
What Is Pediatric Neuropsychology?
Pediatric neuropsychology is a professional specialty concerned with learning and behavior in relationship to a child’s brain. A pediatric neuropsychologist is a licensed psychologist with expertise in how learning and behavior are associated with the development of brain structures and systems. Formal testing of abilities such as memory and language skills assesses brain functioning. The pediatric neuropsychologist conducts the evaluation, interprets the test results, and makes recommendations. The neuropsychologist may work in many different settings and may have different roles in the care of your child. Sometimes, the pediatric neuropsychologist is a case manager who follows the child over time to adjust recommendations to the child’s changing needs. He or she may also provide treatment, such as cognitive rehabilitation, behavior management, or psychotherapy. Often, the neuropsychologist will work closely with a physician to manage the child’s problems. Some pediatric neuropsychologists work closely with schools to help them provide appropriate educational programs for the child.
How Does a Neuropsychological Evaluation Differ From a School Psychological Assessment?
School assessments are usually performed to determine whether a child qualifies for special education programs or therapies to enhance school performance. They focus on achievement and skills needed or academic success. Generally, they do not diagnose learning or behavior disorders caused by altered brain function or development.
Why Are Children Referred for Neuropsychological Assessment?
Children are referred by a doctor, teacher, school psychologist, or other professional because of one or more problems, such as:
- Difficulty in learning, attention, behavior, socialization, or emotional control;
- A disease or inborn developmental problem that affects the brain in some way; or
- A brain injury from an accident, birth trauma, or other physical stress.
A neuropsychological evaluation assists in better understanding your child’s functioning in areas such as memory, attention, perception, coordination, language, and personality. This information will help you and your child’s teacher, therapists, and physician provide treatments and interventions for your child that will meet his or her unique needs.
What Is Assessed?
A typical neuropsychological evaluation of a school-age child may assess these areas:
- General intellect
- Achievement skills, such as reading and math
- Executive skills, such as organization, planning, inhibition, and flexibility
- Attention
- Learning and memory
- Language
- Visual–spatial skills
- Motor coordination
- Behavioral and emotional functioning
- Social skills
Some abilities may be measured in more detail than others, depending on the child’s needs. A detailed developmental history and data from the child’s teacher may also be obtained. Observing your child to understand his or her motivation, cooperation, and behavior is a very important part of the evaluation. Emerging skills can be assessed in very young children. However, the evaluation of infants and preschool children is usually shorter in duration, because the child has not yet developed many skills.
What Will the Results Tell Me About My Child?
By comparing your child’s test scores to scores of children of similar ages, the neuropsychologist can create a profile of your child’s strengths and weaknesses. The results help those involved in your child’s care in a number of ways.
• Explain why your child is having school problems. For example, a child may have difficulty reading because of an attention problem, a language disorder, an auditory processing problem, or a reading disability. Testing also guides the pediatric neuropsychologist’s design of interventions to draw upon your child’s strengths. The results identify what skills to work on, as well as which strategies to use to help your child.
• Identify the child's learning and behavioral needs.
• Design interventions and strategies to be implemented at home, school and elsewhere.
• Detect the effects of developmental, neurological and/or medical problems such as epilepsy, autistic spectrum disorder, ADHD, dyslexia or a genetic disorder.
• Obtain a baseline against which to measure outcome of treatment or the child's development over time.
• Differentiate childhood disorders and the areas of the brain involved.
• Develop a better understanding of the child's behavior and learning in school, at home, and in the community.
What Should I Expect?
A neuropsychological evaluation usually includes an interview with parents about the child’s history, observation of and interview with the child, and testing. Testing involves paper and pencil and hands-on activities, answering questions, and sometimes using a computer. Parents may be asked to fill out questionnaires about their child’s development and behavior. Parents are usually not in the room during testing. The time required depends on the child’s age and problem. Make sure your child has a good night’s sleep, and a good breakfast, before the testing. If your child wears glasses or a hearing aid or any other device, make sure to bring it and is in good working order.
If your child is on medications, please coordinate the time and dose for optimal performance during testing.
We will want to review all of your child's prior evaluations and medical records. It is a good idea to collect the names and addresses of all previous providers before you call to talk about your child and scheduling an appointment. We will arrange to obtain these records if you do not have them available.
What You Should Tell Your Child About this Evaluation:
This depends on how much he or she can understand. Be simple and brief and relate your explanation to a problem that your child knows about such as "trouble spelling," "problems following directions," or "feeling upset." Reassure a worried child that testing involves no "shots." Tell your child taht you are trying to understand his or her problems to make things better. You may also tell the child that "nobody gets every question right," and that the important thing is to "try your best." Your child will probably find the neuropsychological evaluation interesting, and the detailed information that is gathered will contribute to your child's care.