Neurological Assessments

Neuropsychological testing is a comprehensive evaluation of your cognitive and behavioral abilities using a set of standardized tests and procedures. It assesses the brain’s functioning and can yield valuable information about its structural and functional integrity. Although individual scores are important, the neuropsychologist looks at all of the data from the evaluation to determine a pattern of cognitive strengths and weaknesses.

Neuropsychological tests evaluate functioning in a number of areas including: intelligence, executive functions (such as planning, abstraction, and conceptualization), attention, memory, language, perception, sensorimotor functions, motivation, mood state and emotion, quality of life, and personality styles. The areas addressed in an individual's evaluation are determined by the referral question, patient's complaints and symptoms, and observations made during interview and test administration.

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Who Should Have a Neuropsychological Evaluation?

Neuropsychological services can be useful for many individuals with known or suspected brain dysfunction. Many conditions can affect brain functioning, including general medical conditions, neurological disease, and neuropsychiatric disease. Disorders may be developmental/genetic, acquired (e.g., concussions, traumatic brain injury), or of unknown etiology. BASICS routinely provides neuropsychological evaluation for individuals with:

• Acquired brain injury (concussion, CTE, and traumatic brain injury)
• Developmental delays (Autism, Asperger’s)
• Cerebrovascular disease and stroke
• Attention Deficit/Hyperactivity Disorder (ADHD)
• Learning Disability (i.e., dyslexia)
• Dementia (Alzheimer's, Lewy Body Dementia, etc.) and Mild Cognitive Impairment (MCI)
• Movement disorders (e.g., Parkinson’s disease, Huntington’s disease)
• Mood disorders (e.g., depression, anxiety, bipolar disorder)

Testing for Autism/Developmental Delays

Autism Spectrum Disorder (previously Autistic Disorder; Asperger’s Disorder) has gained increased recognition over the past several years, and there has been a significant rise in the number of children diagnosed with this disorder. Autism Spectrum Disorder is characterized by symptoms such as poor social communication (e.g. poor eye contact, inability to engage in normal back-and-forth conversation), failure to develop peer relationships, rigid adherence to routines and rituals, and abnormally intense fixations and/or preoccupations. There may be delays in spoken language, inability to initiate or sustain conversation with others, and repetitive use of language that may not make sense to others. Children with ASD may also be very sensitive to certain visual stimuli, sounds, tastes, smells, or textures.

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There is no single test to identify Autism Spectrum Disorder. A combination of assessments is used to identify social, emotional, and cognitive patterns consistent with this condition while ruling out other conditions that may have similar symptoms. At BASICS, we use autism-specific history-taking; the Autism Diagnostic Observation Schedule (ADOS) assessment; and other cognitive, language and adaptive behavior functioning assessments to reach a DSM-5 diagnosis. Our psychological reports focus on recommendations for specific treatment strategies, behavior and teaching methods and motivators—as well as the usual recommendations for hours and types of services.

Testing for School-Based or Testing Accommodations

We often get request from families who are confused or stressed about options for their children regarding Special Education (IEP or 504 plan) services or applying for accommodations during “high stakes” tests such as the SAT, ACT, GRE, LSAT, and MCAT. For some students, receiving accommodations such as extended time or frequent breaks can give them a better chance of reaching their academic potential. Advocating for your child in school requires the assistance of psychologists who are familiar with the process and will work tirelessly for your family. Common mistakes can jeopardize your student's chances of being granted accommodations they deserve.

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The Americans with Disabilities Act (ADA) allows students with a qualifying learning disability diagnosis to receive special accommodations when taking an exam. The documentation is extensive and must show that the learning disorder significantly interferes with the ability to take the test under regular conditions. Under the ADA and Section 504 of the Rehabilitation Act of 1973, individuals with learning disabilities are guaranteed certain protections and rights to equal access to programs and services. In order to access these rights, an individual must present documentation indicating that the disability substantially limits some major life activity, including learning. Documentation requirements are provided in the interest of assuring that the learning disabilities documentation is appropriate to verify eligibility and to support requests for accommodations, academic adjustments, and/or auxiliary aids.

While proper documentation cannot guarantee a specific outcome, BASICS has a thorough understanding of the laws and process by which students can receive accommodations for their disability. Requirements for documentation are presented in four important areas: (1) qualifications of the evaluator; (2) recency of documentation; (3) appropriate clinical documentation to substantiate the disability; and (4) evidence to establish a rationale supporting the need for accommodations.

FAQs

What are accommodations?

Accommodations are alterations in the way tasks are presented or taken that allow the student with learning disabilities to complete the same assignments as other students. Accommodations do not give students an unfair advantage or change what a test measures. They do make it possible for students with LD to show what they know without being impeded by their disability.

How does a student receive accommodations?

Neuropsychological Testing is the most effective method of providing appropriate clinical documentation to substantiate a learning disability and support the need for accommodations within school, at college, or for High-Stakes testing such as the ACT, SAT or MCAT. Once a student has been formally evaluated and a learning disability has been documented, the student or parent may request accommodations. The Individuals with Disabilities Education Act states that a child's IEP (Individualized Education Program) team which both parent and child are a part of – must decide which accommodations are appropriate for him/her. Appropriate accommodations should be written into a student's IEP.

What else will I need to request testing accommodations?

Make sure that the student has a documented record of receiving, using, and benefiting from accommodations in the educational setting well before the test. Any accommodations that the student will request from the testing service should already be a documented aspect of that student's educational program (e.g. 504 plan or IEP).

Is it necessary to have an IEP or 504 plan? I don’t want my child labeled as “Special Ed”.

Don’t make the mistake of letting your high school students 'get by' with informal accommodations granted by helpful teachers. For example, a kind teacher that lets your child turn in his work late, or one that lets him finish tests during lunch because she knows he will do well if given more time. Some students beg their parents to let them avoid a 504 plan or IEP so they will not have to feel different from their peers. Of course, many parents give in and do things like spend hours helping with homework or hiring tutors to help the student along. This will hurt the student when he or she then applies for accommodations from a testing company, because there is no documentation of what the student had to do differently from her peers in order to succeed. Without a formal 504 plan, IEP, Disability Support Services record from a college, or private school education plan, there is no documented history of a need for accommodations. If the student has been successful without accommodations for all of his educational, why should the testing company believe that your child suddenly needs them a month or two prior to a 'high stakes' test?

When should I schedule psychological testing if I want to request accommodations?

Schedule your psychological testing well before the deadline indicated by the company administering the standardized test. Parents and students frequently make the mistake of calling to schedule a psychological evaluation a few weeks before the test date. Waiting until the last minute can ruin your chances of getting your request for accommodations approved. Companies like the Educational Testing Service review thousands of applications for disability accommodations. They specify on their websites how much time they need in advance to review each student's case. Do not miss their deadlines. Families should make their testing appointment months in advance of the application deadline to ensure having results on time. Remember too that you may end up going through an appeals process or having to get extra documentation if you are denied, so allow extra time for that as well.

What are some examples of accommodations my child may receive for High Stakes Testing? Some common accommodations students may receive include:

• Timing:
  • Extended Time
  • Breaks during Test that do not count against the time
• Presentation:
  • Audio tape
  • Large print
  • Reduced items per page
  • Provide a reader
  • Present instructions orally
• Response:
  • Allow for verbal responses
  • Allow for answers to be dictated to a scribe
  • Allow the use of a tape recorder to capture responses
  • Permit responses to be given via computer
  • Permit answers to be recorded directly into test booklet
• Setting:
  • Administer a test in small group setting
  • Administer a test in private room or alternative test site
  • Provide preferential seating
  • Provide special lighting or acoustics
  • Provide a space with minimal distractions
• Test Scheduling
  • Administer a test in several timed sessions or over several days
  • Allow subtests to be taken in a different order
  • Administer a test at a specific time of day
• Other
• Provide special test preparation
• Provide on-task/focusing prompts
• Provide any reasonable accommodation that a student needs that does not fit under the existing categories

Additional Resources: To learn more about ADA and IDEA, please check these websites:

1. FAPE Law. 20 U.S.C. §1400(d)(1)(A) - http://www.law.cornell.edu/uscode/text/20/1400
2. IDEA Law. 94-142 (IDEA) – http://idea.ed.gov/
3. Council of Parent Attorneys and Advocates - http://www.copaa.org/
4. The National Dissemination Center for Children with Disabilities - www.nichy.org
5. The Council for Exceptional Children - www.cec.sped.org
6. ETS Documentation Requirements - http://www.ets.org/disabilities/documentation

Psychological and Psychoeducational Assessments

Psychological Testing by a trained psychologist can be extremely useful when there is lack of clarity or understanding regarding the reasons and causes of various emotional, psychological, learning, or behavioral problems of a child, adolescent or adult.

Psychological testing refers to the administration of standardized tasks and procedures which allow for a sampling of behavior, in order to understand and predict a given individual's psychological, emotional, and behavioral functioning in a variety of settings. It typically will include an examination of cognitive functioning and learning problems, which might impact an individual’s ability to be successful in school, at work or living independently at home.

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Psychoeducational testing can help to identify the particular learning style of a child, and determine if there is a learning disability, cognitive difficulties, or executive functioning problems which impede the learning process. Both psychological testing and psychoeducational testing assists the psychologist in formulating a mental health treatment plan and/or educational intervention strategy, and educates the school and family about a child's needs.

Common reasons why a psychological or psychoeducational evaluation may be recommended include:

• Behavioral and conduct problems
• Concerns about cognitive and intellectual factors
• Learning and academic problems; learning disability
• Understanding causes of emotional problems such as depression, anxiety, social skills deficits, low frustration tolerance or extreme anger, poor impulse control, mood instability, poor coping or emotion regulation skills
• Speech and language problems
• Recommendations for school or residential treatment placement
• Determine eligibility for special services
• Identify factors underlying problem behaviors
• Determine if there is a specific cause for a child's academic, social, or psychological difficulties

Pre-Operative Bariatric Surgery Evaluation

If you are considering weight loss surgery, your doctor may recommend a pre-surgery psychological evaluation. This evaluation is designed to provide your doctor with information about psychological factors that may influence how well you do. The goal is to maximize a positive outcome.

At BASICS, we follow psychological evaluation protocols consistent with those recommended by the American Society for Bariatric Surgery, and by the Veterans Health Administration. Our protocol includes a structured interview with a clinical psychologist, and a set of paper and pencil and computerized tests. These are scored and compared to appropriate norms, interpreted, and integrated with the information from the interview, and a written report is provided for your surgeon.

ADHD Assessment (Child/Adult)

Attention Deficit Hyperactivity Disorder (ADHD) is a cognitive syndrome that is seen in children and adults. It manifests as cognitive inattentiveness and/or hyperactivity with impulse control problems. It begins in early childhood and continues throughout adulthood, so the term "Adult ADHD" is simply a continuance of what that individual has experienced throughout the lifespan. Oftentimes, ADHD runs in families, so we often see the brain signs in at least one parent as well as the child.

     Frequently Asked Questions

What are the early signs of Attention Deficit Hyperactivity Disorder & Attention Deficit Disorder in children?

The three behaviors that are signals of Attention Deficit Disorder and Attention Deficit Hyperactivity Disorder are inattentiveness, impulsivity, and hyperactivity. While many children possess these traits to varying degrees, it’s how strong they are and the combination that should be the warning of a learning disability. Hyperactivity is definitely the most common, but can also be the most misleading. Just because a child is wild or out of control does not mean they suffer from ADD or ADHD. Likewise, the quiet daydreamer that sits in the corner could be suffering from it. Watch for things like not completing tasks before moving on to other things, losing interest easily, frequently loses things, and when your child says things without thinking first before considering if your son or daughter has a learning disability.

What testing should be done to determine if a child has a learning disability like ADHD or ADD?

Since Attention Deficit Disorder and Attention Deficit Hyperactivity Disorder show up differently in each individual there is not a single, standardized test for all children. As a result there is a broad range of criteria to determine a diagnosis. To be diagnosed with ADD or ADHD, a child must demonstrate a strong combination of the symptoms mentioned above. During the analysis doctors will look at the severity of symptoms and when or where the symptoms are most commonly demonstrated.