Neuropsychological assessment: definition, procedure, in which cases?

Neuropsychological assessment: definition, procedure, in which cases?

What does a neuropsychological assessment consist of? Who is it for and how and by whom is it practiced? Update with neuropsychologist Elodie Gomez.

“A neuropsychological assessment can be quite different depending on the objectives”that is to say the reasons for its realization, but overall, “it consists of the study of a person’s cognitive functions”explains Elodie Gomez, neuropsychologist specializing in neuropsychology at Saint-Anne Hospital (memory and language neurology department).

What is a neuropsychological assessment?

Carrying out this assessment makes it possible to return to standards, depending on the age of the patient. Indeed, “there are batteries that address different functions, just like there is a way to examine by type of function”, details Elodie Gomez. For example, for children as for adults, these can be test batteries – which were previously called the assessment of the intelligence quotient (WAIS for adults, WISC for children up to 16 years old) – allowinghave global cognitive data, compared to a standard.

In what cases should it be practiced?

  • Neurodevelopmental disorders

Most often, neuropsychological assessments are carried out in younger children in the event of neurodevelopmental disorders. Particularly in children (from 2 and a half years old) when there is suspicion of attention disorder with or without hyperactivity (ADHD). In the case of neurodevelopmental disorders in the broader sense as well, which may include forms of dyspraxias like the autism spectrum disorders.

  • Due to an accident

In the event of an accident leading to head trauma or following a stroke (cerebrovascular accident), the patient may be subjected to it in order to assess possible neurocognitive aftereffects.

  • Epilepsy

If a child is prone to epileptic seizures, we will also try to assess possible after-effects or learning difficulties caused, but also the progress madeonce the treatment has been implemented.

  • Neurodegenerative diseases

Concerning patients suffering from a neurodegenerative disease, carrying out a neuropsychological examination will make it possible toassess cognitive abilities : language, memory, executive functions (that is to say everything that involves planning, logic, attention) and more instrumental functions including gestures and visual field.

  • High potential

This assessment is also necessary for the diagnosis of possible giftedness (high intellectual potential). “Thanks to the score obtained on the subtest (psychological test), we can evaluate, in relation to the average of an age category, where the person is located”, deciphers neuropsy. So, performance indices make it possible to say whether the child or adult is above the average for his or her age and at what index level (above 136 for giftedness and below 100 for possible mental retardation).

  • Language or learning disorders

Finally, in the event of language or learning disorders, the issue, as Elodie Gomez explains, will be “to assess whether there is one area performing better than another, giving rise to possible cognitive disharmony”. Indeed, a child can have language disorders, but be very efficient on the motor level. Or the contrary. The WISC test in children will make it possible tostudy verbal and non-verbal cues which we call “performance indices”. “Once this test has been carried out, we will be able to turn to tests more focused on attention or the possible gap identified”she specifies.

Where and by whom can it be carried out?

Parents can go to specialized services, “but there is often a lot of waiting”, notes our expert. This is the case for some CMP (psychological medical centers) who are starting to have neuropsychologists on site offering parents complete support. There are also expert centers for autism spectrum disorders or more general neurodevelopmental disorders (dyspraxia, dysphasia, etc.). For adults, general neurology or geriatrics services offer targeted consultations on memory and other cognitive functions. The alternative ? Go to a private professional office, because the deadlines are often shorter.

With or without a prescription?

“Generally, patients come on medical prescription from their doctor, but this is not not mandatory, reports Élodie Gomez. We can therefore take the process directly by turning to professionals (psychologist or psychiatrist) carrying out this type of assessment to identify giftedness, ADHD, behavioral disorder or any other disorder. However, she concedes, “it is always preferable to work as a team with the doctor who will also receive the conclusions of the assessment and will be able to suggest additional examinations”.

How does a neuropsychological assessment take place?

Carrying out a neuropsychological assessment generally takes 2 hours maximum. “There is, beforehand, a contact with the anamnesis (interview allowing to determine the history of the difficulties)”, specifies the neuropsychologist. Different written tests are then offered to the patient to evaluate the memory storage of their episodic memory. They can be coupled with visual tests (on software) to assess the individual’s attention threshold.

What to do once the assessment is obtained?

The objective of this assessment is to allow us to know what type of support to offer then to the patient. It all depends on the need and the intensity of the difficulties. This may involve follow-up with a psychiatrist, a psychologist (and in particular CBT type therapy), a neurologist, rehabilitation sessions with a psychomotor therapist, a speech therapist or an occupational therapist. “This psychological evaluation may also have been carried out after request from the school, to decide, based on the results, whether specialized academic assistance can be granted to the student”note Elodie Gomez.

Neuropsychological assessment: cost and treatment

As the neuropsychologist reveals, for children, complete psychological assessments rarely cost less than 500 euros. As for a simple memory diagnosis for an adult, targeted to look for a potential acquired neurological disorder, it will cost around 350 euros. The price includes making contact, assessment and report. Note that some mutual insurance companies reimburse part of the balance sheets. “When the test is carried out following an accident, especially if it has resulted in a head impact or loss of consciousness, to assess cognition, a rehabilitation center may offer this type of test and it will normally be covered as part of hospitalization”specifies the specialist.