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What is a Forensic Neuropsychological Evaluation?

Neuropsychological consultation has long played a major role in diagnosis, treatment, rehabilitation, and educational and vocational planning.  The expert forensic neuropsychologist in America today can invite referrals of individuals with the following conditions or needs:

Ø       Acquired brain injury
Ø       Memory loss or attention problems where the question exists of whether these problems are due to some other occupational cause (e.g., toxic chemical exposure; mold exposure; electrical injury)
Ø       Concerns about dementia and whether a person can maintain his or her own person or estate, or make reasoned decisions about his or her medical care.

WHAT IS  A FORENSIC NEUROPSYCHOLOGICAL EVALUATION?
Forensic neuropsychological evaluation is a time-intensive assessment service providing detailed neurocognitive evaluation well beyond a brief mental status screening.  Neuropsychological evaluation serves as an objective “gold standard” in the evaluation of suspected neurocognitive impairment secondary to a variety of medical conditions (e.g., TBI, stroke, seizure disorder, dementia are classic examples).  Neuropsychological testing is conducted using a group of standardized tests that are sensitive to the effects of brain dysfunction, many of which have existed in some form since World War II.  Neuropsychological assessment is used to show the ways in which a person can or cannot perform certain functions or tasks that are dependent upon brain activity.  These functions or tasks (e.g., memory and learning) form the necessary building blocks of successful living in the individual’s daily life.  Impairment in day-to-day functioning may exist because of brain abnormalities that may or may not be detectable on routine clinical imaging.  Therefore, neuropsychological assessment is a procedure with a unique purpose:  it can be used to diagnose brain dysfunction when no abnormalities are seen, or to determine the degree to which functions and life activities may be impaired because of structural defects.  Neuropsychological assessment complements other critical data such as neuroimaging.

Neuropsychological tests are an important part of an overall evaluation because they provide an objective measure of an individual’s strengths and weaknesses and how they compare to that individual’s baseline or others their age.  Neuropsychological assessment provides a systematic evaluation of cognitive abilities such as intelligence, memory, language, attention, problem-solving ability, reasoning/judgment, visual-motor skills, sensorimotor abilities, personality/emotional functioning, and academic skills.  A typical evaluation involves administration of neuropsychological and psychological tests, record review, and a comprehensive interview conducted by the neuropsychologist with the patient and family member with the patient’s consent.  Neuropsychological tests usually involve paper-and-pencil or computer based measures.  A forensic neuropsychological evaluation is flexible and tailored to a specific referral question.  The results of the forensic neuropsychological evaluation can also help the legal system understand what treatments will be necessary over the short and long haul.

OUTCOME, EVALUATION RESULTS, AND FEEDBACK
The outcome of a forensic neuropsychological evaluation is a set of conclusions made about the individual’s functioning and fitness for duty or work, based on the integration of the expert forensic neuropsychologist’s interview, observations, record review, and testing.  Written and verbal feedback is tailored to the needs of the patient and the referral source.  Typically, a comprehensive report summarizing the findings, including comments on prognosis and the likely consequences of the patient’s difficulties in daily functioning/ongoing employment is prepared for the referring attorney.

HOW TO USE NEUROPSYCHOLOGY ASSESSMENT SERVICES
Referrals are typically requested by attorneys from the expert forensic neuropsychologist, but can also be requested by an IME company, insurance company, or workers compensation insurance group.  For more information on what is entailed in a forensic neuropsychological evaluation, an excellent reference is included below:

The National Academy of Neuropsychology’s Official statement on independent and court-ordered forensic neuropsychological evaluations:

https://www.nanonline.org/docs/PAIC/PDFs/NANIMEpaper.pdf

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 and symptom validity were raised.  She has also served as expert consultant and witness.  She believes it is critical to provide a scientifically defensible opinion, and to help the jury and court understand the implications of the neuropsychological aspects of cases before them.

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. As a prior active duty neuropsychologist, she has extensive experience in the area of military forensic neuropsychology.