What is Clinical Neuropsychology?
Clinical neuropsychology is a speciality field within clinical psychology with focus on brain and behavior relationships. Neuropsychologists use standardized tests and clinical knowledge to evaluate an individual's higher order cognitive functions (i.e., intelligence, attention, concentration, learning/memory, etc.), behavior, and psychological state, in order to diagnose brain disorders or disease.
What is a Clinical Neuropsychologist?
A clinical neuropsychologist is an licensed, independent, doctoral level health care provider who provides assessment and intervention services to individuals of all ages, based upon the science of clinical neuropsychology. Training in clinical neuropsychology comprises education and clinical training in clinical psychology and also specialized training in neuropsychology. Beyond the general coursework in clinical psychology, neuropsychologists have additional education in the basic neurosciences, functional neuroanatomy, neuropathology, clinical neurology, general psychological assessment, neuropsychological assessment, and cognitive rehabilitation. Neuropsychologist usually specialize in either pediatrics or adults, but some are trained in evaluating individuals across the lifespan.
According to Houston Conference Guidelines for Speciality Training in Neuropsychology, preparation for practice as a clinical neuropsychology specifically entails:
1.) Completion of a doctoral degree (Psy.D. or Ph.D.) in clinical psychology from an accredited university training program.
2.) 2000 hour internship in a clinically relevant area of professional psychology (i.e., neuropsychology).
3.) The equivalent of two years of additional specialized training in clinical neuropsychology (4000 hour Post-doctoral Fellowship).
4.) State or provincial licensure to practice psychology and/or clinical neuropsychology independently.
Attainment of the ABCN/ABPP Diploma in Clinical Neuropsychology (i.e., board certification) is the clearest evidence of competence as a clinical neuropsychologist, assuring that all of these criteria have been met, but is not required and does not preclude a well trained clinician to practice as a clinical neuropsychologist.
What is a Neuropsychological Evaluation?
Generally, a neuropsychological evaluation is a comprehensive assessment of an individual's cognitive abilities and weaknesses, as well as special-emotional functioning. The neuropsychologist will conduct a clinical interview, obtain medical records, conduct collateral interviews (if required), and administer a battery of standardized tests and questionnaires to assess the individual's current cognitive abilities and psychological state.
The cognitive domains typically assessed during a neuropsychological evaluation include: intelligence, academic skills, problem solving, organization and planning, attention, concentration, language, visual perception, visual spatial abilities, sensory-motor functions, personality, and social-emotional functioning.
During the evaluation the neuropsychologist will administer a variety of tests to the individual being assessed. This is usually done sitting at a table face-to-face or at bedside if the person is hospitalized. Usually, there are no invasive procedures (i.e., no needles, no electrodes) required during a neuropsychological evaluation. The evaluation can take anywhere from 3 hours to 10+ hours of face-to-face time with the neuropsychologist, but the time required for the evaluation can vary depending on the referral question or what information is desired at the completion of the evaluation. Following the face-to-face evaluation, many more hours of indirect time are required for scoring tests, reviewing records, and completing a clinical report of the findings. Often, the neuropsychologist will schedule a feedback session with the individual to provide him/her with the findings from the examination.
Examples of What a Neuropsychological Evaluations Can be Beneficial for?
- Detailing a profile of cognitive strengths and weaknesses to guide rehabilitation, educational services/placement, and vocational services.
- Confirming or clarifying a diagnosis in order to provide proper treatment and supportive services.
- Help in determining what compensatory strategies would be beneficial after a brain injury (i.e., stroke, head injury).
- Monitor changes in functioning over time following brain surgery or treatment of a neurologic condition.
- Monitor functioning over time in individuals with psychiatric illness, due to possible complications from the illness or medication side effects.
- Determining cognitive strengths and weakness in a child afflicted by neurologic or psychiatric illness to help with diagnosis and treatment planning.
- Identifying intellectual disability and/or learning disabilities (i.e., Reading, Mathematics) in school-aged children for assistance in developing independent education plans.
To note: Findings from the neuropsychological evaluations may result in referrals to other specialists (neurologists, psychiatrists, clinical psychologists, school psychologists, speech therapists, social workers, special education teachers, vocational counselors, educational therapists, etc.).