What is Neuropsychology?

Neuropsychology is a specialized area within the field of clinical psychology which focuses on the relationship between brain functioning and behavior. Specialized behavioral tests are used to measure cognitive abilities (e.g. attention, memory, executive functioning), and behavioral variables as well (e.g. emotional functioning), and this understanding is used to assist people experiencing brain injury or illness, so that they can better understand and cope with their challenges, and as much as possible, rise above them. 

What is a clinical neuropsychologist?

Neuropsychologists are clinical psychologists who have completed post-graduate training in clinical neuropsychology, typically a two-year residency in a formal training program. Board certification (e.g. the American Board of Clinical Neuropsychology) is the hallmark of a specialist in this area. 

Why might I need to see a Neuropsychologist?

Neuropsychological evaluations assist with two big questions:

1. What’s going on?
In many cases involving brain injury or illness, symptoms can be quite confusing, and even upsetting. Consider the following common scenarios:

  • Your mother seems to be getting forgetful. Is this normal aging? Is there something that could be done?
  • Your spouse had a mild stroke last month. He was only in the hospital a few days, and the doctors said he should be able to go back to work in a few weeks. But he seems confused at times. Is he ready to go back to work?
  • Your college student was in a car accident last semester. She was briefly unconscious at the scene of the accident, but by the time you got to her in the hospital, she was able to talk to you. She doesn't seem to remember very well the week she spent in the hospital. The doctors told her to take several months off from school. She seems to be recovering fairly well, but how do you know if she is really ready to resume classes?

In each of these cases, neuropsychological evaluation can provide detailed information about specific brain abilities and behaviors, so you can have confidence about what to do next, which leads to the next question. . .

2. What can I do about it?
After detailed evaluation is completed, it becomes much clearer to consider what steps need to be taken to address the problem, or how to cope with the situation. 

  • For memory loss, forgetfulness may be present, but not pervasive, suggesting more of an early or isolated problem rather than a dementia. Plans could be made to monitor the memory functioning over time, and detailed recommendations can be provided to help boost brain functioning, and also to address safety concerns (e.g. driving, living alone, managing finances).
  • In the case of a stroke, a person may be making a good recovery, but still have some lingering symptoms, so recommendations can be made for work accommodations to allow for an easier transition back to full work duties. 
  • In the case of brain injury, sometimes there are symptoms that are hard to understand, and even emotional changes that make it difficult to function, especially when there are challenges to face to return to normal responsibilities (e.g. college courseload, challenging work schedule). Knowing what is reasonable to expect, and how to avoid common pitfalls, can help facilitate the path to a better recovery. 

Getting a detailed picture of the person’s functioning can help cut through the confusion and pave the way for the next step.

 

For those of you who enjoy history . . . 

The study of neuropsychology began as early as the 1930s and was deeply informed by the examination of solders coming back from World War II with brain injuries. Over the decades since that time, a variety of tests have been developed and closely studied in a range of clinical populations. These decades of research provide a wealth of information to assist those with suspected or known brain injury, illness, or abnormality. An examination of test findings and patterns, and observation of the person’s behavior, can assist with diagnosis, and provide a detailed understanding of their functioning. This can be used to make recommendations to improve the person’s life (e.g. assist with how best to approach school or work, or address basic safety and functioning within the community, etc.). Clinical neuropsychology complements the work of neurologists, who are physicians whose focus is on the functioning of the nervous system, although neuropsychology focuses mostly on a detailed evaluation of higher-level cognitive abilities.

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