general information about neuropsychology

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A neuropsychological evaluation is used to obtain several types of information about cognitive functioning. Reasons for a referral may include:

• possible problems with brain functioning 
• identifying problems with learning
• differential diagnosis 
• defining cognitive strengths and weaknesses
• guiding treatment for personal, educational, and vocational needs
• making relevant recommendations
• documenting changes in functioning over time.

A neuropsychological evaluation typically involves assessment (testing) with a group of standardized tests that are sensitive to the effects of brain dysfunction.  Unlike CT or MRI scans which show abnormalities in the structure of the brain, or EEG, which shows electrical abnormalities in the brain, 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 (for example, memory and learning) form the necessary building blocks of successful living in the individual's daily life. Impairment in many of these functions may exist because of brain abnormalities that cannot be detected on CT or MRI scans. Therefore, neuropsychological assessment is a procedure with a unique purpose; it can be used to reveal or diagnose brain dysfunction when no structural brain abnormalities have been found, neuropsychological assessment provides a way to determine what functions may be impaired because of the structural defects, and to determine the degree to which they may be impaired..

The standardized tests used in a neuropsychological evaluation typically assess functioning in the following areas:

• cognitive abilities
• attention and memory
• problem-solving and other complex executive functioning abilities
• visual-spatial functions
• verbal and language functions
• sensory-perceptual functions
• motor functions
• academic skill development
• emotional, behavioral, and social  functioning
• adaptive functioning

The perspective of the neuropsychologist is frequently requested to understand subtle brain-related factors involved in academic failure or impaired emotional functioning, even when no biological causes are suspected.  However, the specific areas assessed depend upon the referral questions presented.  An interview with the individual and/or family members is included.  Observations in other settings, such as school or hospital, and review of school/medical records also may be included in the evaluation process.

The product or outcome of a neuropsychological evaluation is a written report that states a conclusion or set of conclusions made about the individual's functioning.  The product also includes specific recommendations to guide treatment or otherwise enhance the individual's functioning.  The conclusions and recommendations are developed by integrating information obtained from the standardized testing, interviews, records and other observations.

A clinical neuropsychologist is a licensed professional within the field of psychology with a specialty in the applied science of brain-behavior relationships.  A neuropsychologist has a doctoral degree in psychology and additional training in the specialty field of clinical neuropsychology.  A Diplomate of the American Board of Professional Psychology in Clinical Neuropsychology is a neuropsychologist who has made a significant achievement beyond the mandatory educational requirements of the specialty of neuropsychology. Diplomate status through board certification is awarded to practitioners as designation to the public that they possess advanced competency in their areas of specialization. The credentialing process follows licensure and is a very rigorous process that involves a written examination of knowledge and having a practioner’s work directly examined by a committee of specialists including having an oral defense of their work experience, knowledge base, work samples, and clinical judgment. The in-depth self-evaluation, continuing education, and peer review of credentials required is a voluntary process. In addition to the basic and applied generic core courses that all clinical psychologists must have, competency in neuropsychology requires a foundation in the clinical neurosciences, including neurology, neuroanatomy, and neurophysiology.

Health insurance will typically pay for neuropsychological services when it is related to a medical/neurological condition or injury.  Health insurance will not  cover neuropsychological services related to academic, educational or legal issues. Payment is fee-for-service, with the exception of Worker's Compensation and No-Fault insurance.  Dr. LaMarca will assist patients in filing the appropriate forms to health insurance companies for reimbursement, if services are covered by the individual's plan.