• Neuropsychology in Ann Arbor: What is a Neuropsychological Assessment and Why Is It Important For the Assessment of Learning Disabilities?

    Roger E Lauer, PhD, Director
    (article originally published in LDA of Michigan newsletter, Winter 2013)

     

    • Background: Research has identified the precursors of learning disabilities as delays in developmental areas such as speech and language, memory, motor skills, and attention. Neuropsychological assessment evaluates these areas across the lifespan allowing parents to track the unfolding of skills in a thorough and effective manner.
    • Why Test Children?
      • Document the nature of developmental delay or disorders to improve diagnostic sensitivity.
      • Monitor the recovery and/or development of language, perceptual, motor or attentional skills.
      • Define treatment options.

    • Why Assessment?
      • Assessment is not only testing, but it is a relationship with the child and their family involving evaluation, intervention and management over time.
      • Assessment is dynamic not static meaning that children develop at different rates that change can occur suddenly and ceased just as quickly.
      • There is a larger range of “normal” or typical behavior in children. Young children displayed variability in their behavior, particularly as they master new skills. Assessment helps to delineate what is typical from a typical.
    • Why Neuropsychological Assessment?
      • Framework for thinking and organizing information from many sources including strengths and weaknesses of the child.
      • To assist with effective diagnosis, treatment planning and intervention.
      • Avoid “diagnosis by Swiss cheese”-parents being told their child has several “holes” in functioning without a coherent view of their child or a comprehensive plan of how to help.
    • What is Neuropsychology?
      • Understanding the relationship between brain (structure) and behavior (function).
      • Key question-What is the functional status of the brain?
    • Neuropsychology and Children:
      • Study of brain-behavior relationships in the context of developmental change and maturation.
      • Examine developmental delay of the nervous system within children and how it impacts skill acquisition (e.g., learning, thinking, language or attention).
    • Assessment Framework:
      • General cognitive or intellectual assessment: identify learning style and examine specific profile patterns of skills (e.g., verbal, visual or hands-on).
      • Academic achievement: comprehensive assessment of reading, writing and math including the component skills in each area (e.g., phonological awareness, orthographic awareness and internal number line).
      • Examined the component skills of learning across a neuropsychological hierarchy including the following:
        • Sensory-Perceptual (and vision, hearing and touch or input of information).
        • Motor (fine, gross, graphomotor, coordination or output of information).
        • Attention (short-term, sustained, focusing and shifting).
        • Memory and Learning (verbal, visual and cross-modal).
        • Language (articulation, receptive, expressive, pragmatic).
        • Visuospatial (part-hole, construction, orientation, representation).
        • Executive functions, problem solving, reasoning and analysis.
        • Psychosocial and Emotional.
    • Interpretation of Information in Treatment Planning:
      • Examine level of performance on each test along with the pattern of performance across tests.
      • Look for unusual signs within these performance patterns.
      • Compare performance within the child and between other children, as well as before and after any injury or brain insult.
      • Track processing across the hierarchy of skills cited above to see where learning is breaking down.
      • Develop an intervention or “action” plan custom-built for each client that focuses on building resiliency through strength-based skills while remediating areas of weakness.
      • Assist in managing interventions over time to insure appropriateness of approach and effectiveness of techniques.

    For more information on neuropsychological testing, or to schedule a consultation, please contact our clinic.