Have you ever heard of the term “neuropsychological testing” but have been unsure what exactly it is? Or maybe your child’s school or pediatrician told you it could be helpful for your child? Sure, your child struggles to focus and learn sometimes but isn’t that typical of most kids his age?

Sometimes it is hard to know if neuropsychological testing is something that you need to pursue for yourself or your loved one, particularly if you are unsure what it really is and how it could be helpful.  And how can this type of testing help a person thrive?

Is a diagnosis really necessary?

Sometimes a person may be encouraged to get neuropsychological testing in order to clarify the possible presence of an issue and/or to get a diagnosis (if applicable). But, is getting a diagnosis really necessary? Could there be some cases where it could actually  be harmful? These are great questions to consider; let’s explore these questions a bit more.

When I have been asked the question “is a diagnosis really necessary?”, my response often is, “it depends.” Every person’s situation is different, and testing isn’t needed in every situation. However, the following are a few possible situations in which testing could be helpful to clarify the possible presence of a condition (which, in turn, could result in a diagnosis):

·      When progress in therapy has been slower than expected or you are feeling “stuck” and wondering if there could be more there going on?

·      Your child has struggled in some key areas (getting along with their peers, trouble with focus or learning, or feeling a lot of anxiety) and you thought it was “just a phase” or that they would have “grown out of it” by now. You aren’t sure what is considered “normal” for their age, but you are seeing it start to impact their progress in school, friendships and/or their self-confidence and you are starting to get concerned.

·      Your child makes comments like, “I am so dumb” or you see they are less motivated in school. This is concerning to you because they used to like school or feel generally okay about themselves. If there is an undiagnosed issue going on, it can impact their self-esteem and motivation with tasks. Sometimes the child assumes they are the problem and doesn’t realize something else could be contributing to their current situation (that has nothing to do with intelligence)!  Naming the problem and getting help for it can be a relief and can help your or your child understand what is making areas like focus, relating with others or learning more difficult for them.

·      You may be an adult who has struggled for years but you never had a “name” for it and you notice it holding you back in some important ways. These “un-named issues” have taken its toll on you over time, contributing to increased fatigue, frustration, or diminished self-confidence and it has created some barriers to getting to where you want to be at this point in your life.

·  Your partner or parent is showing some unusual behaviors (ex. Being more forgetful, confused or lethargic) and you aren’t sure if it is part of “normal aging”, part of a medical condition or something more. You are starting to wonder if she should still be driving, making big life decisions for themselves or if they are able to still live independently.

These aforementioned issues can be present for a variety of reasons and may suggest that something is going on that needs to be clarified. These are good reasons to pursue neuropsychological testing. The good news is that for all the above situations, there could be reasonable explanations for what may be causing or contributing to those situations and some specific treatments to help address them. Yet, the bad news is that oftentimes those good resources and treatments can’t be accessed without having clarity on what exactly the issue is. This is where getting a clear picture (which may include a diagnosis) could be helpful.

There are also times where getting properly diagnosed for a condition can help to advocate for you or your loved one’s needs. Just ask the student on her way to college who has struggled with debilitating anxiety or ADHD: she can tell you that testing helped her to get the accommodations she needs in college so she can show what she knows on tests (rather than feeling anxious that she is running out of time to even get through the test)! Or, by clarifying what is going on, you or your loved one can be prescribed the right medication or pursue the best natural approaches to finally address the issues needing some help.   Early intervention is critical and can change the trajectory of a person’s  progress academically and/or emotionally. Testing can also point you in the right direction with really helpful resources or recommendations of “next steps to take” to help address the difficulties going on.

Some may also wonder, though, if getting a diagnosis could be harmful. Are there situations where it could impact a student’s ability to get admitted to college or impact an employee’s standing at work? In most cases, the information that comes from a neuropsychological evaluation would not be shared with a school or employer unless you choose to share this information. The testing psychologist wouldn’t automatically share it without your written permission either (there are a few exceptions to this, particularly if someone is at significant risk of being harmed, in those cases, some information may need to be shared). If you used your private insurance to pay for the evaluation, your insurance company would have record of any diagnoses made, just as they would have information on other medical conditions you may have  (ex. Asthma, diabetes, ADHD) if you have used your insurance to cover the costs of your medical care.

Sometimes, a person may wonder if a diagnosis could be harmful  in how it “labels” a person. Yes, “being stuffed into a box or label” can feel bad and if testing is not done well, it could cause a person to feel a bit pigeon-holed. Each of us is so unique, with incredible gifts and strengths!  Most testing psychologists who do their work well get this and take seriously their call to see the person in their complexity and to tell their story well. Part of this could involve a making diagnosis, but more than that, the report is a way of describing the person’s current struggle and the barriers that have kept them from living most fully into their potential. 

What is Neuropsychological Testing?

So, now that we have reviewed some of the reasons why it could be important to receive an accurate diagnosis (if needed), let’s turn our attention to what exactly is neuropsychological testing.

Neuropsychological testing is a specific type of testing which takes a more in-depth look at a person’s abilities in thinking (ex. memory, intelligence, problem solving), executive functioning, language, and the ability to make sense of what is seen (i.e. visuospatial); at times, testing also includes other areas as well (social skills/emotional/psychological functioning, motor abilities, etc).

In addition,  Neuropsychological testing for learning issues/learning disabilities includes in-depth information in specific learning areas (reading, writing, or  math), including “what” the problem is (ex. Reading comprehension) and “why” it is a problem (ex. The underlying cognitive processes which support this specific learning area). This information regarding the “why” helps to provide more focused information to guide future tutoring/academic interventions.

Depending on the referral question, some testing batteries are more comprehensive and include testing in all of the aforementioned areas, while other testing batteries may not require in depth testing in each area. Most evaluations also include a picture of how the person is doing emotionally (ex. depression, anxiety) and/or behaviorally as these areas could impact neuropsychological abilities and vice versa. Your physician, therapist or a testing psychologist can help you determine what testing is best suited for you/your loved one’s specific situation.

Together, information in these areas will help to clarify  strengths and weaknesses, including any specific difficulties or diagnoses which are interfering with progress academically or functioning in other important areas of life (ex. relationships, work, home responsibilities, etc.). This will be summarized in a report which is given to you and to others (ex. medical provider, school/university, etc.) with your written permission to do so.

Speaking as a testing  psychologist for over 23 years, I can tell you it is a privilege to walk alongside a person as they seek clarity about themselves or their difficult situation. Good testing involves identifying barriers which could be keeping a person from living into their truest potential. This can lead to good recommendations to help them to navigate these barriers, chart a more positive path forward and into a place of increased thriving. 

Sandy Kruse, PsyD, ABSNP