Neuropsychological Evaluations: What You Need to Know

The phrase “neuropsychological evaluation” may sound a little scary. But it’s really just a series of questions and activities like putting puzzles together and naming pictures. The way kids complete these tasks helps neuropsychologists see how their brains work.

A neuropsychological evaluation measures things like attention span and memory. It looks at other areas too, like language and thinking skills. Many kids get this kind of testing to figure out why they’re struggling in school.

Neuropsychological testing can pinpoint problem areas. It also looks at strengths and recommends ways to help kids thrive.

The Goal of Neuropsychological Evaluations for Kids

A neuropsychological exam looks at a wide range of brain functions and skills to see what might be affecting learning or behavior. The goal is to find the reason why kids are struggling.

For example, many kids get this kind of testing because they’re having trouble with reading. Their families want more specifics. Are kids struggling with one reading skill in particular? Are they having trouble with focus? Is slow processing speed making it harder to keep up with their peers?

For a struggling reader, a neuropsychological exam could lead to a diagnosis of dyslexia or ADHD—or both, or neither. The tests also look at other aspects of childhood development and mental health that can affect learning.

Not all evaluations end with a diagnosis. But the findings are still likely to specify which kind of teaching and support can help kids make progress.

What Happens in a Neuropsychological Evaluation

The testing takes place in a doctor’s office. It’s done one-on-one and is usually very low-tech. Kids answer out loud or use a pencil and paper or in some cases a computer.

The evaluation can take up to six hours total but is usually spread out over a couple of days. It measures a lot of things. These include:

• Academic skills in reading, math, and writing
• Executive functioning skills (like planning and organizing)
• Intelligence
• Language skills
• Memory
• Motor skills (like drawing and handwriting)
• Visual-spatial processing (like predicting what a square would look like if you folded it in half)
• Social-emotional skills

The evaluation includes going over the student’s personal history. This may include medical and school records. Some doctors also try to go to kids’ schools to observe them in their classroom.

The overall process might include meeting with families before and after the testing. The doctor might recommend more tests and may also want to meet with school officials.

Neuropsychological Evaluations and Schools

Neuropsychological assessments are done in a private clinic. They’re a lot like the evaluations that school psychologists do for free. But the school-based one has a different name. It’s called a psycho-educational evaluation.

School-based testing can be as comprehensive as a neuropsychological exam. But a school-based evaluation tends to involve more than one specialist. Schools have evaluation teams. For example, the school psychologist may do part of the testing. A speech therapist may do another part.

Schools do these tests at no cost to families to help figure out which kids need special education services. So why do some families turn to private clinics? Here are a few reasons:

• Some families worry about stigma and don’t want anyone to know they’re getting their child tested.
• Asking for a school-based evaluation doesn’t guarantee families will get one. These requests can get denied if schools think there aren’t enough signs a child is struggling.
• Some families want a “second opinion” after getting a school evaluation.

Schools don’t have to agree with a private evaluation. But by law they have to at least look at it when deciding if a child is eligible for special education.

Paying for Neuropsychological Evaluations

A neuropsychological evaluation can cost thousands of dollars. In some cases, health insurance will cover it. It’s also possible, but rare, for a school district to pay for it. In most cases, families have to pay for it out of pocket.

One reason neuropsychological exams cost a lot is because they look at the whole child. But many kids may not need a comprehensive evaluation. They may benefit from targeted tests like those for speech and language problems.

Learn more about the difference between school-based and private evaluations. And find out what to ask before hiring an evaluator.