Neuropsychological tests are standardized and are used to assess performance in various cognitive domains. Cognitive domains are based on models of brain functioning, and evaluate different (but sometimes overlapping) cognitive functions. These tests have been given to thousands of people, so we know what the average performance should be on these tests in neurologically normal individuals. By comparing the test-taker’s scores to those of many people, the neuropsychologist can find out how the test-taker’s brain is doing. It is important to remember, though, that test scores may not be a direct reflection of day to day functioning. It is important that the examiner also assess for performance validity, or effort/engagement, to ensure that the scores obtained provide a valid estimate of current cognitive functioning.
You may be familiar with IQ testing; however, this estimate is too “global” and broad to identify specific cognitive functions affected. Neuropsychological testing breaks out neuropsychological tests (scores) into specific indicators of specific functions (although tests can assess more than one function and are not always thought to reflect a “pure” measure of a particular function). The evaluation in totality tells us if what we are seeing in the scores is the result of a clinical syndrome (in some cases we can see that a particular pattern of performance in the test scores is consistent with a particular neurologic syndrome or psychiatric factors, for example), or whether what is observed day to day represents an “everyday” memory lapse that can be seen in neurologically normal samples.
Areas of cognitive ability that are commonly assessed include attention, processing speed, learning and memory, language, visual spatial skills, executive functioning, and motor functioning, among others. Areas assessed may depend on the nature of the question being asked.
Neuropsychological tests can be used as part of a comprehensive neuropsychological assessment to potentially link cognitive difficulties seen on testing to everyday functioning, guides treatment planning, and can help make deficits or problems known.
With regard to whether neuropsychological testing should be conducted after a traumatic brain injury (TBI), anyone who feels there is a possibility they have a TBI should be seen by a medical doctor. You can first see a rehab medicine doctor, neurologist, or primary care doctor, who will evaluate your balance and other physical symptoms, in addition to memory and other thinking changes. This person will likely provide a diagnosis and may refer you to a variety of other specialists based on your symptoms. While some TBI types may resolve without further medical intervention, a medical doctor may refer the patient with a TBI to a neuropsychologist, who is a psychologist with advanced training in how brain injuries can affect memory problems, attention, and behavior/day to day functioning.
The neuropsychologist gives neuropsychological tests that are sensitive to the effects of a brain injury, as part of neuropsychological evaluation. Neuropsychological evaluation also has a major role in diagnosis, treatment, rehabilitation, and educational and vocational planning for individuals who have experienced TBI. This will tell you about your prognosis and what types of supports or workplace and academic accommodations may be needed and beneficial.
Some people worry a lot about taking the tests, or feel that they must prepare. However, the tests are intended to be relatively new to the test-taker; preparation is not advised. One of the goals of neuropsychological testing is to identify cognitive strengths and weaknesses. The neuropsychologist does not expect you to get every problem “correct.” Some questions will be more difficult than others. Some tests may be auditory in nature and others may be more visual in nature. Testing can take 2-6 hours or more, depending on the type of evaluation. Tests do not involve drawing blood or invasive procedures. Memorizing words or solving problems are examples of tasks included in the testing. Examinees should be prepared to do their best. Some examinees report they even enjoy the neuropsychological tests!
Individuals with questions about neuropsychological testing and evaluation can read more about the specialty through the following link provided by the Mayo Clinic: http://www.mayoclinic.org/diseases-conditions/alzheimers-disease/basics/tests-diagnosis/con-20023871