The neuropsychological assessment
Do you need to do a neuropsychological assessment for your child and you don’t know who to turn to?
What is a neuropsychological assessment?
It is the evaluation of cognitive abilities in a person at a time T. What are cognitive abilities? These are attentional capacities, memory, executive functions (inhibition, flexibility, working memory, planning, etc.), the famous IQ test.
The neuropsychological assessment is done by a neuropsychologist. The neuropsychologist is a psychologist specializing in neuropsychology, that is to say science at the crossroads between neuroscience and psychology. He is a graduate of a faculty of psychology and has at least a bac +5.
How is a neuropsychological assessment carried out?
The assessment can be done at the hospital, in a structure or in private practice.
Generally at the hospital there is a waiting period, in the structure not everyone is necessarily accepted, for lack of space. Most of the time, therefore, there is only the balance sheet made in town.
The family makes contact, on the recommendation of a doctor, another health professional or the school, with the neuropsychologist. The latter offers a first appointment called the anamnesis interview. The main purpose of this first meeting is to be able to review the course and development of the person concerned. It is a question of approaching schooling and learning, behavior, management of emotions and social interactions. Go back to the various assessments or follow-ups carried out so far as well as the daily life and any complaints if there are any.
Then the neuropsychologist determines what type of assessment should be proposed according to the needs and the strengths and weaknesses to be highlighted in order to be able to subsequently propose adjustments or at least recommendations.
The IQ test
Most of the time, when we wonder about the cognitive functioning of a person and no other assessment has been carried out until now, the neuropsychologist proposes an assessment of intellectual efficiency, it is the famous IQ test.
This assessment, which is based on the WPPSI test for children under 6, the WISC for children aged 6 to 16 and the WAIS for those over 17, provides a snapshot of a person’s cognitive functioning. at a time T. It is quite global. In my opinion there is no need to sanctify the IQ but the results of this assessment, if it is well done, are still to be taken into account from the moment it is a test battery standardized, therefore a tool for comparison with the performance of other people of the same age group, independently of the view of those around them and independently of the level of requirement of the environment. The IQ finds its interest only if we are faced with 2 profiles, the High potential profile or a global delay. Without a fairly rigorous homogeneity between the results, the IQ cannot be interpreted.
This report is based on the assessment of 5 areas of competence. There are also optional areas where it becomes interesting to take into account the results when the mandatory scores are not necessarily interpretable.
These areas are: verbal skills, i.e. vocabulary level assessment, verbal abstraction skills, and social and adaptive skills. The whole thing is to see if the person has the knowledge of the good social codes, without necessarily applying them but at least is that the person has knowledge of them.
The second domain is visuo-spatial with and without manipulation of objects.
The third area is logic with and without quantitative notion.
The fourth area is working memory. It is therefore the ability to be able to process information over a fairly short period of time. This combines attentional capacities, short-term memory and self-confidence.
Finally the fifth area is the processing speed with and without graphic production.
The neuropsychologist obtains scores within the exercises, called Standard Scores, which allow comparison with the age group. A score between 9 and 11 or between 8 and 12, depending on the references, is an average score, therefore highlights performances that follow a development in the norm.
The neuropsychologist also obtains scores called Indices, which are the scores for each domain. A score between 90 and 110 is within the average and therefore also follows normal development.
The results of this test already make it possible to determine whether there would be a need to go deeper into a particular area which could be below other performances by completing the assessment with neuropsychological tests or by directing the patient to another professional who could offer a more in-depth assessment in this area. For example, if the results highlight more fragile language skills, it would be wise to complete the assessment with a speech therapist who can offer an oral and written language assessment. If the results finally attest to standard skills but the child has a lack of confidence and, for example, performance anxiety, it will be interesting to refer you to a psychologist specializing in emotional management.
The results also make it possible to determine whether there is a correlation between a mode of cognitive functioning and particularities on the behavioral, emotional and psychological levels, as is the case for the HP profile, for example. You will then need to refer you to a professional specialized in the HP population.
Other evaluations come under the name of neuropsychological assessment.
For each cognitive function, there are batteries of tests or subtests that allow specific assessment of the cognitive skills in question.
For example, if the entourage has questions about memory, it will be possible to carry out an assessment focusing on memory skills by taking into account the different modalities (short-term memory, long-term memory, auditory memory, visual memory, with indexing, without indexing, the quality of encoding, storage, recovery, etc.). The same will apply to the other cognitive skills mentioned at the beginning of the article.
This is why it is important to take the time to understand the patient’s request, to listen to his complaint, to properly investigate the patient’s journey. You don’t always need to do a full review. It is quite possible to do the tests step by step, if the need arises.
Once the assessment has been carried out, the neuropsychologist corrects and interprets the results. He writes a report that he gives to the patient during the return appointment. With the patient’s agreement, he may also be required to communicate it to other professionals or to the school.
The neuropsychologist takes advantage of this appointment to explain the results and give recommendations.
Mr. Gabriel Rafi
- Graduated in neuropsychology and cognitive psychology from University Paris Descartes, France.