What is neuropsychology?

Neuropsychology is a specialty area of Clinical Psychology that focuses on the structure and function of the brain in relation to psychological processes, emotions, and behavior. It is concerned with how a person’s thinking, feeling, and behavior are related to the brain and the nervous system focuses on studying, assessing, understanding, and treating behaviors directly related to brain functioning. 

 What is a neuropsychologist?

A neuropsychologist is a Doctor of Psychology who has formal training in the detection and differential diagnosis of neurological diseases based on quantitative assessment of cognitive abilities. A neuropsychologist helps medical doctors understand the effects of brain disorders or injuries on behavior, monitor the cognitive recovery or progression of brain disorders or injuries, and formulate rehabilitation and management strategies for patients with neurological disorders.

The National Academy of Neuropsychology defines a Clinical Neuropsychologist as an individual who has (1) a Doctoral Degree in Psychology from an accredited university training program, (2) completed an internship or its equivalent in a clinically relevant area of professional psychology, (3) completed the equivalent of two (full-time) years of experience and specialized training, at least one of which occurs at the post-doctoral level, in the study and practice of clinical neuropsychology and related neurosciences; and (4) is licensed by the state to practice psychology at the independent (not supervised) level.

Board Certification provides the best evidence of advanced training, supervision, and applied knowledge in Neuropsychology. Dr. Lewandowski is Board Certified through the American Board of Professional Neuropsychology (ABN) and is a Fellow of the American College of Professional Neuropsychology. Dr. Wheeler is Board Certified through the American Board of Professional Psychology and is a Fellow of the American Board of Clinical Neuropsychology. Dr. Kenniston completed post-doctoral training through the Academy of the American Board of Professional Neuropsychology. Dr. Pilnick completed post-doctoral training through the Academy of the American Board of Professional Psychology. 

What is a neuropsychological examination?

 A neuropsychological evaluation is used to learn about how the brain is working. The examination involves comprehensively assessing cognitive and behavioral functions of the brain using a variety of testing instruments.

The neuropsychological evaluation consists of three components: initial consultation, neuropsychological testing, and review. 

  1. The initial consultation is a one hour appointment in which information is gathered regarding the presenting concerns and symptoms as well as general information regarding background and history. 

  2. Neuropsychological testing is based on the patient's concerns as well as those of their referring physician and the information gathered during the initial consultation. It is typically completed in 3-6 hours and may be completed in one-full day or two-half day sessions based on the patient's schedule demands and energy level. All tests are individually administered and many are "hands on," requiring assembling, sorting, organizing, etc. A typical evaluation involves assessment of:

    • Intellectual abilities

    • Attention and concentration

    • Learning

    • Memory

    • Higher level reasoning

    • Problem solving

    • Language abilities 

    • Visual-spatial skills

    • Motor manipulation

    • Sensory skills 

    • Emotional and personality functioning 

  3. The review consists of a one-hour appointment in which the patient and/or family members discuss the results with Dr. Lewandowski or Dr. Pilnick. This appointment allows an opportunity for further questions or concerns as well as future directions and recommendations. The review is typically scheduled for two weeks after the completion of testing. 

A neuropsychologist uses neurocognitive testing as a diagnostic tool to determine brain functioning which is much like the other side of the "coin" of brain scans such as an MRI and CT scans employed by neurologists as they determine how a brain looks. 

 Why did my doctor refer me for a neuropsychological examination?

Neuropsychological examinations are used for many medical reasons and are ordered by medical doctors for a number of physical or neurological illnesses, diseases or injuries. 

Common concerns that are evaluated at Neuropsychological Associates include suspected changes in memory, thinking, emotionality or behavior that occur as a result of a neurological condition or brain injury. These can include difficulties such as a stroke, concussion, dementia, seizure disorder, tumor, multiple sclerosis, etc.  Neuropsychological assessment greatly enhances the ability of a medical doctor to diagnose and treat physical and neurological problems.

Neuropsychological examinations are part of the standard of care following trauma to the head as the result of a fall, motor vehicle collision, recreational activities, while participating in sports, and on-the-job. Sometimes these injuries are referred to as TBI’s (Traumatic Brain Injuries).

Additionally, neuropsychological evaluations are often instrumental in determining the nature, progress, and prognosis of various dementias (i.e. Alzheimer’s dementia Microvascular dementia, Lewy-Body dementia, senile dementia, etc.). This information is crucial to helping your physician determine the best treatment protocol for you.

A neuropsychological examination may also be used to diagnose learning limitations and attentional difficulties, and to help in determining medication use and effectiveness as well as academic and learning strategies. 

What is the initial consultation like?

Each neuropsychological examination is different depending on a patient’s specific individual needs. The initial examination by a neuropsychologist usually takes about 45 minutes. During this meeting, you will answer questions about many things including:

  • Your current symptoms

  • Information about any events that may be related to your symptoms

  • Your background

  • Your medical history

 Your neuropsychologist will also do a brief and preliminary examination of your brain functioning in order to best determine which tests are needed during your next visit.

Dimensions of functioning that may be evaluated include:

  • Intelligence

  • Problem solving

  • Concentration

  • Memory

  • Planning

  • Organization

  • Attention

  • Learning

  • Academic skills

  • Language

  • Perceptual and motor abilities

  • Emotions, behavior, and personality

What happens during neuropsychological testing?

Testing may take up to six hours, and is conducted here at Neuropsychological Associates in one of our two on-site labs. The tests are individually selected based on the patient's symptoms, history, and cursory examination of brain functioning. The tests are comprehensive and often progress from simple motor tasks to higher level reasoning and problem solving in order to create a full profile of brain functioning. 

You will meet with a technician who will administer your individualized testing battery. Some of the tests involve paper-and-pencil questions. Others will require you to answer questions out loud, or put together puzzles.

How will the test results be used?

Your test results will be shared with your referring physician and any other treatment providers you authorize. Typically, your physician will combine the recommendations that result from a neuropsychological exam with other information, such as neuroimaging studies, physical examination findings, lab studies, etc., to determine the most appropriate course of treatment for you. Test results may rule out suspected conditions or diseases, may confirm diagnoses of conditions or diseases, and indicate which types of treatment interventions might be most effective for you.

What should I bring with me to my initial consultation? 

You should receive a new patient packet in the mail prior to your first scheduled appointment. This packet includes two forms for your initial appointment: 

  • Registration form

  • Office policy 

You should also be sure to bring:

  • Insurance card

  • Driver's License

  • Reading glasses (if necessary)

  • Hearing aids (if necessary) 

You may also consider bringing:

  • A family member

  • Medication list

  • Relevant medical records

  • Names and addresses of doctors or other providers whom you would like to receive a copy of the report 

If possible, please try to arrive 10 minutes prior to your appointment to check in with the front office staff. 

Should a family member or friend be present in the room when a patient is being tested? 

While it is helpful to have a family member present in the initial consultation, it is not necessary for a family member to be present during diagnostic testing. In fact, the presence of a parent, family member or friend is not consistent with the standard of care in neuropsychological evaluations, and is known to distort or even invalidate test results, which could in turn, result in greatly diminished quality of care for you or your loved one.

What does a clinical psychologist do?

A clinical psychologist may have many roles within an organization including assessment, diagnosis, and treatment and may work in a variety of settings including private practice, community mental health, schools, etc. A clinical psychologist works to integrate science, theory, clinical experience and expertise to understand, prevent, and relieve psychotically-based difficulties, concerns, and issues to assist in personal development and well-being. A clinical psychologist will often practice psychological assessment and psychotherapy; however, they may be involved in a variety of other roles such as research, testing, forensic testimony, and program development. 

At Neuropsychology Associates, clinical psychologists provide individual and group psychotherapy, assessment, biofeedback, pain management, marital and family counseling, alcohol and substance abuse, behavioral support, and may refer patients for psychiatric medications prescribed by our consulting psychiatrist, Dr. James Eicher. 

What is psychotherapy?

Psychotherapy is a therapeutic relationship and treatment between a trained professional psychologist or counselor and an individual, couple, family or group. The issues addressed in psychotherapy are often psychological in nature with behavioral, cognitive, and/or emotional difficulties. Psychotherapy involves the assessment of the patient's difficulties as well as the possible variables that can influence the difficulties such as causes, triggers, and potential resources and resolutions. Psychotherapists may use a variety of techniques and tactics to promote relationship building, dialogue, communication, and behavior change. Psychotherapy may be brief or more of a prolonged treatment depending on the individual's needs and course of treatment.