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An educational pamphlet brought to you by the Public Interest Advisory
Committee, Division 40 (Clinical Neuropsychology), American Psychological
Association. For more information, visit the Web site at: www.div40.org
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
neuropsychologist 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 for 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
- 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 to 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 motivation,
cooperation, and behavior is a very important part of the evaluation.
Emerging skills can be assessed in infants and preschool children However,
the evaluation 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.
- Testing can 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.
- Testing can help detect the effects of developmental, neurological,
and medical problems, such as epilepsy, autism, attention deficit hyperactivity
disorder (ADHD), dyslexia, or a genetic disorder. Testing may be done
to obtain a baseline against which to measure the outcome of treatment
or the child's development over time.
- Different childhood disorders result in specific patterns of strengths
and weaknesses. These profiles of abilities can help identify a child's
disorder and the brain areas that are involved. For example, testing
can help differentiate between an attention deficit and depression or
determine whether a language delay is due to a problem in producing
speech, understanding or expressing language, social shyness, autism,
or cognitive delay. Your neuropsychologist may work with your physician
to combine results from medical tests, such as brain imaging or blood
tests, to diagnose your child's problem.
- Most importantly, testing provides a better understanding of the child's
behavior and learning in school, at home, and in the community. The
evaluation can guide teachers, therapists, and you to better help your
child achieve his or her potential.
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.
Many neuropsychologists employ trained examiners, or technicians, to assist
with the administration and scoring of tests, so your child may see more
than one person during the evaluation. Parents are usually not in the room
during testing, although they may be present with very young children. The
time required depends on the child's age and problem. Make sure your child
has a good night's sleep before the testing. If your child wears glasses
or a hearing aid or any other device, make sure to bring it. If your child
has special language needs, please alert the neuropsychologist to these.
If your child is on stimulant medication, such as Ritalin, or other medication,
check with the neuropsychologist beforehand about coordinating dosage time
with testing. If your child has had previous school testing, an individual
education plan, or has related medical records, please bring or send this
information and records to the neuropsychologist for review.
What you tell your child about the evaluation 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 with spelling," "problems
following directions," or "feeling upset." Reassure a worried child that
testing involves no "shots." Tell your child that you are trying to understand
his or her problem 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.
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