CHILD NEUROPSYCHOLOGICAL EVALUATION

Also, click on the following links for additional information about neuropsychological testing:
How else can neuropsychological testing be useful for my child?
Frequently asked questions

We conduct evaluations of children and adolescents ages 3-18 years old (see "Adult
Neuropsychological Evaluation" section for testing of individuals 19+ years old).
Neuropsychological evaluations assess a child's functioning in various domains, including
intellectual, cognitive, academic, and emotional/behavioral functioning. Common reasons
for an evaluation include attention problems, learning difficulties, autism-spectrum disorders,
emotional/behavioral problems, and neurological illness/injury (e.g., traumatic brain injury). Test
results are used to determine a child’s strengths and weaknesses in various domains with the goal
of helping her/him to be more successful in school, social, and other situations. If a diagnosis
seems appropriate, test results can help determine if the child qualifies for reasonable academic
accommodations under the Individuals with Disabilities Education Act (IDEA). The results of the
evaluation are used to develop treatment recommendations and interventions.

The following domains are typically assessed in a neuropsychological evaluation:
  • Various forms of intelligence (e.g., verbal and nonverbal abilities)
  • Academic skills (e.g., basic reading, reading comprehension, spelling, written expression,
math calculations, math reasoning, and academic fluency/speed)
  • Learning and memory (both verbal and visual; important for learning academic material)
  • Attention/concentration (e.g., focusing and sustaining attention on tasks)
  • Language (expressive and receptive language; and phonological processing, which
contributes to reading and spelling)
  • Information processing speed
  • Visual-spatial skills/visual-motor skills
  • Executive functions (e.g., problem-solving, inhibition, planning, etc.)
  • Emotional/behavioral functioning

Evaluations involve a review of available records; interview of the parent/guardian, child, and
potentially school staff or other professionals familiar with the child; and psychometric testing.
Children are provided with several breaks throughout the day, including a lunch break. For
children with limited endurance or significant problems sustaining attention, a decision can be
made to finish the evaluation on another day.

Once the evaluation is completed, a report is written providing a summary of test results and
recommendations. A feedback session (usually 1.5 hours) is scheduled to review the findings
and recommendations with parents/guardians, and potentially with the child in a separate
feedback session (if desired). We provide  numerous recommendations related to
accommodations needed in school to improve performance and behavior, as well as
interventions that may be beneficial.

Parents/guardians are provided with various resource materials (e.g., handouts, contact
information of professionals and services available in the area, etc.) that may improve the child’s
functioning. If a child could benefit from counseling/psychotherapy or cognitive retraining, we
can provide brief interventions, and/or provide a list of referral sources in the area.

          POSSIBLE REASONS A CHILD MAY RECEIVE A    
               NEUROPSYCHOLOGICAL EVALUATION

Attention Problems (e.g., ADHD/ADD):

As previously noted, it has been estimated that at least 7-10% (and possibly as many as 17%) of
children in the United States demonstrate significant symptoms of Attention-Deficit/Hyperactivity
Disorder (ADHD or ADD).
Common symptoms of ADHD include failure to listen to instructions;
difficulty organizing school work; not finishing chores and homework; difficulty paying attention
to details; being bored easily; fidgeting/squirming in seat; excessive talking; restlessness,
interrupting/intruding on others; and being impulsive. Children with ADHD may show signs of
inattention, hyperactivity/impulsivity, or both. A common myth is that children with ADHD are
unable to focus their attention on most tasks. However, children with ADHD typically only have
problems focusing and sustaining attention on tasks they aren’t interested in, but are able to focus
on enjoyable activities (e.g., playing games) without difficulty. Therefore, the diagnosis is usually
not made until children enter school, at which time symptoms typically become more obvious.

Neuropsychological testing can help determine whether a child is experiencing significant
problems with inattention and/or hyperactivity/impulsivity related to an attentional disorder
(ADHD/ADD) or other causes. Cognitive testing includes computerized, paper-and-pencil, and
other tests that explore domains such as focused/sustained attention, processing speed, and
impulse control. We carefully rule out other problems that may resemble ADHD before making
a diagnosis. We then develop specific treatment recommendations for improving the child’s
attention/concentration; reducing hyperactivity and impulsivity; and improving functioning in
various domains (e.g., academic performance, social functioning, task completion, etc.).
Following the evaluation, brief re-evaluations can be conducted to determine whether there has
been improvement in areas of difficulty as a result of specific interventions.    

Autism-Spectrum Disorders (ASD):

As described in the "Autism Evaluation" section of this website, approximately 1 in 110 children
exhibit diagnostic criterion for an Autism-Spectrum Disorder (ASD), including milder
symptoms that do not meet full criterion for Autistic Disorder (e.g., PDD-NOS and Asperger
Syndrome).We carefully explore the underlying problems contributing to these symptoms to
determine whether an autism-spectrum diagnosis is appropriate. Cognitive testing includes
assessment of facial processing (e.g., identifying emotions on faces, memory of faces), "theory
of mind" abilities (i.e., the ability to understanding others' perceptions and beliefs), basic and
complex language, and various other domains. We thoroughly assess the child's strengths and
weaknesses to develop recommendations and interventions for improving the child’s
functioning. School personnel often benefit from neuropsychological test results to develop
accommodations and special services to help children with ASD and other diagnoses. The
information can also be used in determining whether a child could be eligible for services
through the Division of Developmental Disabilities (DDD; www.azdes.
gov/developmental_disabilities).

Academic/Learning Difficulties:

Neuropsychological testing is very helpful for clarifying the underlying reason(s) a child is
experiencing academic difficulties. For instance, children with reading difficulties may have
underlying problems related to phonological awareness (awareness and access to the
phonological structure of oral language), rapid naming (retrieval of phonological information
from long-term or permanent memory, and the ability to execute a sequence of operations
quickly and repeatedly), and/or reading comprehension. We evaluate the child’s strengths and
weaknesses, and this information is helpful for developing appropriate interventions for
improving the child’s reading skills.

Similarly, children who struggle in math may experience deficits in visual-spatial skills (e.g.,
writing out problems and carrying numbers), although these deficits may not hinder math
performance until later grades since earlier grades place less emphasis on complex math
calculations. Other children struggle with math because of limited math knowledge, and
subsequently benefit from drilling in math facts and concepts. Children may also experience
difficulties performing math story problems because of reading comprehension difficulties.
Neuropsychological testing can be used to determine the specific strengths and weaknesses
related to broad math skills, as well as other impairments (e.g., visual perceptual/spatial skills,
working memory, and planning skills) that may contribute to poor math performance. Test
results are used to develop specific recommendations for interventions and accommodations in
school to improve the child’s math skills and academic performance.

Finally, children with problems related to spelling and/or written expression may experience
problems with phonological processing and/or hand graphomotor skills (which may result in
sloppy handwriting or slowed written production). These children may benefit from participating
in occupational therapy to improve their hand motor skills. We also determine possible
accommodations that may be beneficial for these children in school, which may include
dictating test responses, receiving note-taking services, etc. We carefully evaluate various
problems that may underlie spelling/written expression disorders, including basic spelling,
written sentence/paragraph writing, hand graphomotor skills, and visual perceptual/spatial skills.

Neurological Injury/Illness:
Neuropsychological testing can also be useful for children experiencing symptoms associated
with a neurological injury/illness. Children with a history of neurological injury (e.g.,
concussion, stroke, brain tumor, etc.) often have problems performing tasks that require rapid
information processing, attention/concentration (e.g., sustaining attention for longer periods of
time, distractibility, etc.), and learning/memory.

Nonverbal Learning Disability:
Children with nonverbal learning disabilities (NLD) may have problems related to visual-spatial
skills, visual-motor coordination, social functioning, and organizational skills. These children
are often at risk for academic problems related to reading comprehension, written math
calculations, and written expression (particularly in higher grades). Neuropsychological testing
is very useful for diagnosing this disorder, as well as developing recommendations for
improving the child's functioning in academic, social, and other domains.

Emotional Distress and Psychiatric Disorders:
Children experiencing increased anxiety, depression, emotional dysregulation, and other
emotional symptoms often demonstrate reduced cognitive functioning (e.g., inattention,
difficulties retrieving learned information, slowed responding, etc).

Baseline Data:
Neuropsychological evaluations provide a baseline of a child's functioning in various cognitive
and academic domains, and this information is valuable if the child were to ever experience a
concussion or other type of neurological injury/illness. In those instances, repeat testing can
help determine whether there has been a significant change in functioning. Unless baseline data
is available before an injury/illness, it is difficult to determine whether there has been a change
in functioning above and beyond what could be attributed to longstanding strengths and
weaknesses before the injury. Dr. Baker provides parents/guardians with the raw test scores so
this information is available to other providers in case the child is re-evaluated in the future
.

Children seen for neuopsychological, psychoeducational, or psychological
evaluations can have a qEEG brain mapping assessment added to the
evaluation. Brain mapping data can help explain the underlying factors
contributing to a children's cognitive, academic, and emotional/behavioral
functioning.