Developmental Diagnostics, Therapy for children and adults, St. Joseph, MN, Dr. Holly Clausen

Neuropsychological Assessment

Neuropsychological assessment is an approach to testing based on an appreciation of functional neuroanatomy and normal brain development. As a neuropsychologist, Dr. Clausen is interested in how a child obtains specific test scores, and how the child is functioning in comparison to expectations for that age level. The pattern of test scores helps the neuropsychologist break skills into component pieces, defining a pattern of strengths and weaknesses.

Once the "pieces" of the puzzle are obtained, they are reassembled into a comprehensive whole picture of the child. The bigger picture is interpreted in the context of neuroanatomy, appropriate developmental stage, and accompanying social, behavioral and emotional factors. The completed puzzle is then used to define an intervention plan, including recommendations for treatment, education, and parenting. As a result, the completed puzzle, composed of its individual parts, can lead to “peace of mind” for parents and caregivers, assuring them of the most accurate diagnosis and providing them with a clear direction.

Although Dr. Clausen may use some of the same tests as a clinical or school psychologist, the difference between neuropsychological and other forms of assessment lies in the neuropsychologist’s ability to determine how the child arrived at these scores, as well as their pattern of strengths and weaknesses. For example, a child may have difficulty following a direction because he/she did not pay attention to the direction, did not understand the direction, or did not remember the direction. Dr. Clausen works to understand where the child is having trouble and why.

What is a Neuropsychological Evaluation?

Dr. Clausen looks at a broad range of skills, evaluating abilities not usually tested by the clinical or school psychologist. A neuropsychological assessment may include tests of the child’s ability to:

  • File information in memory and to retrieve this information once it is learned (memory skills)
  • Interpret what the child hears, sees, and touches (auditory, visual, and tactile processing skills)
  • Coordinate what the child sees with his/her hand movements for activities such as drawing, writing, and manipulating objects (visual motor and fine motor control)
  • Understand what people say to the child and put words together to share information, thoughts and feelings with others (receptive and expressive language)
  • Initiate work, turn directions into a plan of action for doing the task, modify the plan if it doesn’t work, and keep track of materials needed to do the task  (organizational skills)
  • Pay attention, focusing attention on what is important for doing a task, and remaining attentive until the task is complete (attention skills)

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When is a Neuropsychological Evaluation needed?

Neuropsychological assessment can help with learning, attention or behavior problems related to:

  • A history of known or suspected brain insult
  • A history of genetic disorders or Neurodevelopmental disorders that may impact on brain development
  • Medical problems such as diabetes, seizures, chronic heart or respiratory problems, and chemotherapy/radiotherapy for malignancies, all of which may impact  brain development
  • Exposure to neurotoxins such as lead, street drugs, inhalants or prenatal exposure to street drugs or alcohol
  • Failure to respond to what appear to be appropriate interventions
  • A gradual or sudden unexplained change in the child’s usual functioning

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Why is a Neuropsychological Assessment helpful?

Neuropsychological evaluation results are helpful for several purposes. Results will:

  • Assist in establishment of a diagnosis
  • Establish a performance baseline for use in documenting the functional effects of a medical intervention such as introduction of medications, changes in medications, neurosurgical procedures, or organ transplantation
  • Obtain baseline levels in individuals at higher known risk for brain injuries, including football, hockey or soccer players
  • Help parents and teachers understand a child’s cognitive strengths and weaknesses

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What happens during a Neuropsychological Evaluation?

It is important to reassure your child that no shots or painful procedures will be involved in the visit to the neuropsychologist. For school-aged children, it is appropriate to describe testing as like school. You can tell your child that he/she will be doing many different activities. Some activities involve listening and talking while other activities involving looking at things, building and drawing.

For preschool children, you can describe neuropsychological assessment as playing games involving listening, talking and remembering. Let the child know that Dr. Clausen and her assistant will have toys like blocks and puzzles to use.

Dr. Clausen also has specialized training in developmental psychology, which encourages a combination of developmental knowledge with information about brain/behavior relationships in children.

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How are results used?

The neuropsychological assessment and report will provide you with:

  • A description of the child’s pattern of performance relative to his/her peers, identifying cognitive strengths and weaknesses
  • Suggested interventions for remediation of weaknesses or to compensate for weakness
  • Appropriate treatment modalities, such as the implementation of a behavior plan or specific types of psychotherapy
  • A means of assessing the functional effects of medical treatment
  • A way for parents to understand the child’s developmental pattern so that parents can set appropriate expectations for the child
  • A means by which parents can understand what they need to do to help maximize their child’s development
  • An understanding of the causes, prognosis, and treatments for the child’s problems, leading them to the correct resources to aid in treatment and education

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