What is Pediatric Neuropsychology?

Pediatric neuropsychology is a specialty that focuses on the relationship between brain function and expressed behavior within the context of a child’s neurodevelopment. A pediatric neuropsychologist is a licensed psychologist with specialized training and certification in how learning and behavior are associated with the development of brain structures and pathway systems. The pediatric neuropsychologist administers evaluations, interprets test results, and makes recommendations. The neuropsychologist may also provide treatment, such as cognitive rehabilitation, neuro-cognitive therapy, behavior management, or psychotherapy. The neuropsychologist will consult with parents, physicians, and school personnel to provide appropriate intervention.

Why your child may need Pediatric Neuropsychological Assessment?

Children may be referred by parents, physicians, school professionals, or other allied health care professionals.  Referrals often have to do with:

·    Difficulty in learning, attention, impulsivity, behavior, socialization, or emotional control

·    Disease process, inborn developmental problems (fetal exposure to illicit drugs and alcohol), or birth trauma that negatively affects brain function or development

·    Accidents resulting in brain injury, such as motor vehicle or sporting accidents.  This may also include infantile neglect or shaken baby syndrome

A pediatric neuropsychological evaluation assists parents and professionals to better understand a child's functioning across domains such as executive functioning and attention, learning and memory, language, visual and spatial abilities, sensory and motor abilities, intellect, and academic achievement.  These measures also shed light on a child’s behavioral presentation and personality development. Test results help parents and professionals to select and implement intervention to meet the child’s unique treatment needs.

How Does a Pediatric Neuropsychological Evaluation Differ From a School Psychological Assessment?

School psychology assessments are usually administered to determine whether a child qualifies for special education intervention. They focus on intelligence and achievement, and behavioral outcomes as opposed to origins. A neuropsychological evaluation takes into account that a child is more complex than simply intellect and achievement. It takes a whole brain to function; therefore, all neuropsychological elements need to be examined and considered to accurately determine how and why a child can or cannot access the general school curriculum.   

What does a pediatric neuropsychological evaluation include and assess?

·    Diagnostic interview with parents

·    Review of the child’s academic and medical records

·    Intellect

·    Academic Achievement

·    Executive Functions(i.e., organization, planning, inhibition, and mental flexibility)

·    Attention and Inhibition

·    Learning and memory

·    Language

·    Visual and spatial abilities

·    Motor and sensory abilities

·    Developmental from gestation to the child’s current age

·    Behavioral and emotional functioning

·    Social skills

·   Feedback Session and comprehensive report

Each child’s testing and problem solving behavior is closely observed.  This ‘qualitative’ analysis helps to fully understand and explain the statistical data obtained through standardized testing.  It is often more important to understand how a child missed a testing item than only relying on the outcome score.  A child’s motivation, cooperation, effort, and behavior can positively or negatively affect testing outcomes.

What Will the Results Tell Me About My Child?

The pediatric neuropsychologist creates 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, or a reading disability. Testing results identify what skills to work on, as well as selecting strategies to help the 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 pediatric neuropsychologist may work with your physician to combine results from medical tests, 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. When we know what a child can or cannot control in their behavior or achievement, we are then in a position to empathically intervene and avoid seeing the child as being willful or malicious.

What Should I Expect?

A pediatric neuropsychological evaluation usually includes a comprehensive interview with parents about the child's history, observation of and interaction with the child, and standardized assessment. This may involve 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 (psychometricians and/or advanced doctoral students) 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 presenting problem. Comprehensive testing typically requires more than one session.

 

·         Make sure your child gets enough sleep before testing. Make sure to bring your child’s glasses, hearing aid or any other prescribed device they use. If your child has special language, vision or hearing problems, please alert the pediatric neuropsychologist prior to testing.

 

·         If your child is prescribed stimulant or other medication, check with the pediatric neuropsychologist and the prescribing physician beforehand to coordinate dosage and administration time.

 

·         If your child has had school testing, an individual education plan, or has related medical records, please bring or send copies of these records to the evaluation session.

 

·         What you tell your child about this 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." Inform your child that you wish to find out the things the child does or does not do so well.  If we find out things they do not do well, then we will help them improve. You may also tell the child that "nobody gets every question right," and it is important to "try your best." Many children find the neuropsychological evaluation interesting.

More Information: What is Clinical Neuropsychology? click to read more...