What Is a Neuropsychological Evaluation?

A neuropsychological evaluation measures how well the brain is doing its everyday jobs: paying attention, remembering, understanding and using language, solving problems, working at a reasonable speed, and managing emotions and behavior.

It uses standardized tests that have been given to large groups of people of the same age. That lets a psychologist compare one person's scores with what is typical, and, just as important, compare a person's skills with each other. A child whose reasoning is well above average but whose reading is far below it has a very different profile from a child who is a little below average across the board, even if their report cards look alike.

It Is Not a Brain Scan

An MRI or CT scan shows the structure of the brain. A neuropsychological evaluation shows how the brain is functioning. The two answer different questions. Many people with real, measurable problems in thinking or learning have completely normal scans, which is common after a mild brain injury and almost always true of learning disabilities and ADHD.

What It Measures

Visual and auditory attention
Visual and auditory memory
Expressive and receptive language
Visual-spatial processing
Processing speed
Motor dexterity
Cognitive flexibility
Verbal and visual reasoning
Working memory
Executive functioning: planning, organizing, starting and finishing
Academic skills: reading, writing and math
Social, emotional and personality functioning

How It Differs From Other Kinds of Assessment

A screening questionnaire

The short forms used in a pediatrician's office or a school flag that something might be going on. They are useful, but they can't say what is causing a problem or what else might be contributing.

An IQ test on its own

Cognitive ability (IQ) testing is part of a neuropsychological evaluation, but it is only one part. A single IQ score can hide large gaps between skills, and those gaps are often what explains the struggle.

A school evaluation

A school's evaluation is mainly designed to decide whether a student qualifies for special education services. A neuropsychological evaluation asks a wider question: why is this happening, and what will help? See educational vs. neuropsychological evaluations.

Therapy

An evaluation is an assessment, done over a short period, that ends with a report. Therapy is ongoing treatment for symptom relief, for example for anxiety or depression. An evaluation often helps decide what kind of therapy makes sense.

When Is One Needed?

An evaluation is worth considering when a problem with learning, attention, memory, behavior or mood is affecting daily life, and the explanations so far haven't held up. Typical situations include:

A child is working hard but falling further behind
Attention, anxiety, learning and social problems overlap and it isn't clear which is driving the others
Parents or teachers wonder about autism or ADHD
A gifted child is struggling in ways that don't match their ability (twice-exceptional, or 2E)
A school, college or testing agency needs current documentation for accommodations
An adult's memory, concentration or mood changed after a brain injury
A personal injury case needs an objective picture of what changed and what treatment may help

What You Come Away With

A feedback session to go over the results, and a written report that explains the findings in plain language, gives any diagnoses that fit, and lays out recommendations for home, school or work, and treatment. You can read more about each step on what to expect.

Evaluations for children and teens are described on the child and teen page, and evaluations for adults after an injury on the adult page.