Through individual testing, interview, and medical record review, the neuropsychologist compiles data to elicit a brain-behavior profile. Testing involves evaluation of cognitive abilities. These abilities underly basic and complex skills involved in everyday functioning. In addition, intellectual, emotional and psychological functioning are evaluated, as well as academic functioning when appropriate. Results are correlated with brain functioning in light of the individual’s history, including medical and psychiatric status. A full report is written, explaining the findings and recommendations, which is followed by a feedback appointment to guide treatment and follow-up.
When brain dysfunction either occurs or is suspected, a neuropsychologist can determine if there is an effect on cognition and behavior. Referral occurs to assist in determining diagnosis, treatment, rehabilitation, care and planning.
A clinical neuropsychologist is a professional within the field of psychology with special expertise in the applied science of brain-behavior relationships. Clinical neuropsychologists use this knowledge in the assessment, diagnosis, treatment, and/or rehabilitation of patients across the lifespan with neurological, medical, neurodevelopmental and psychiatric conditions, as well as other cognitive and learning disorders. The clinical neuropsychologist uses psychological, neurological, cognitive, behavioral, and physiological principles, techniques and tests to evaluate patients` neurocognitive, behavioral, and emotional strengths and weaknesses and their relationship to normal and abnormal central nervous system functioning. The clinical neuropsychologist uses this information and information provided by other medical/healthcare providers to identify and diagnose neurobehavioral disorders, and plan and implement intervention strategies. The specialty of clinical neuropsychology is recognized by the American Psychological Association and the Canadian Psychological Association. Clinical neuropsychologists are independent practitioners (healthcare providers) of clinical neuropsychology and psychology. The clinical neuropsychologist (minimal criteria) has:
- A doctoral degree in psychology from an accredited university training program.
- An internship, or its equivalent, in a clinically relevant area of professional psychology.
- The equivalent of two (full-time) years of experience and specialized training, at least one of which is at the post-doctoral level, in the study and practice of clinical neuropsychology and related neurosciences. These two years include supervision by a clinical neuropsychologist.
- A license in his or her state or province to practice psychology and/or clinical neuropsychology independently, or is employed as a neuropsychologist by an exempt agency.
At present, board certification is not required for practice in clinical neuropsychology. Board certification (through formal credential verification, written and oral examination, and peer review) in the specialty of clinical neuropsychology is further evidence of the above advanced training, supervision, and applied fund of knowledge in clinical neuropsychology.
Neuropsychological examinations aid in understanding how a disease process has progressed and affected the individual. It is also used for differential diagnostic purposes and to evaluate effects of treatment and recovery. Furthermore, establishment of a baseline in individuals with a potential deteriorating illness allows for tracking of decompensation, understanding of the changes and appropriate preparation and planning for the individual. Cognitive changes that occur without obvious explanation, such as memory loss, confusion, or disorientation, are other reasons for seeking assessment. It should be noted that extreme stress or depression can also cause such symptoms.
Neurodevelopmental disorders occur when the brain does not develop as it should during growth. As a result, lifelong problems may exist. Evaluation helps to understand if and where cognitive dysfunction exists. For example, a reading disorder may be due to problems in visuoperception, attention or specific areas of language functioning. And many children who appear to have ADHD are misbehaving for other reasons that are not necessarily obvious and therefore they are misdiagnosed. Proper diagnosis and profiling of the brain-behavior relationship is a necessity before the problem can be properly addressed.