Neuropsychology for the Attorney: Differences Between Neuropsychologists and Neurologists
Attorneys should understand the difference between what the 2 specialties of neuropsychology and neurology can provide, in a way that goes beyond “neurologists can prescribe medications and neuropsychologists cannot.” Although neurologists and neuropsychologists work as a team in the medical center setting, our roles are different. Whereas neurological evaluations are focused on identifying and treating specific lesions or diseases affecting the nervous system, neuropsychologists are more focused on understanding the relationship between the condition and day to day functioning. The neuropsychologist is especially focused on integration of a variety of factors (possible neurologic factors, psychological factors, social factors) to create a picture of the client’s daily functioning. The neuropsychologist is trained to conduct objective, standardized tests that provide important information about cognitive functioning in a way that a neurologic exam or brain imaging may not. Forensic europsychologists are especially able to consider the role of psychological factors and motivation/effort because they have a number of methods of assessing this.
Attorneys need to know that there is a vast body of research literature supporting the validity of the tests that forensic neuropsychologists use, including their predictive validity for day to day functioning. Neuropsychology is a scientific discipline with peer-reviewed journals. Forensic neuropsychologists have training in statistics and research methodology which enables them to appropriately interpret tests and form hypotheses. They may have more training in statistics and research methodology than does a neurologist.
In cases of mild TBI (concussion) it is frequently the case that brain imaging findings are normal and the patient has a normal neurologic exam. With these normal findings, the neurologist may be limited in drawing further conclusions to explain current symptoms. This is one area where forensic neuropsychologists can help attorneys and courts better understand the cause of current symptoms. In courtrooms around the country it is often forensic neuropsychologists who do the “heavy lifting” in these cases.
For more information about what a neuropsychologist is and does, including training, there is an excellent paper on the website of the National Academy of Neuropsychology: https://www.nanonline.org/docs/PAIC/PDFs/NANPositionDefNeuro.pdf. Do not hesitate to ask a forensic neuropsychologist about the differences between the specialties to help you better understand whom you might retain in your case.
About the author. Dr. Messler is a board certified clinical neuropsychologist and licensed psychologist who has provided thousands of evaluations where the question of traumatic brain injury was raised. She has also served as expert consultant and witness. She believes it is critical to provide an objective, scientifically defensible opinion, and to help the jury and court understand the implications of the neuropsychological aspects of cases before them.