Measuring brain and mind:
- Reasoning and problem solving
- Visual-spatial functioning
- Language functioning
- Planning, organization, executive functioning
- Ability to work
- Personality, mood and emotional functioning
What is a neuropsychological examination?
Neuropsychological testing evaluates problems in brain functioning that affect thinking and behavior. Unlike CT or MRI scans, which show what the structure of the brain looks like, neuropsychological testing examines how well the brain is working when it performs certain functions (for example, concentrating or remembering). Testing can help establish a diagnosis, describe limitations and impairment in functioning, determine treatment needs, and estimate probability of recovery.
All tests are standardized, objective, and developed through well-accepted scientific methods. The types of tests administered will depend upon the questions that are important for the particular case.
In addition to testing, the independent neuropsychological examination includes a detailed interview, direct observation of behavior during the exam, and a meticulous review of relevant records.
The neuropsychological exam of adults typically requires one full day (8 hours). Exams of children typically require an interview of the parents and two 3-hour appointments for the child.
Every IME will include:
Assessment of effort and symptom magnification. In cases involving litigation, there is a potential incentive to exaggerate symptoms. I take steps to systematically evaluate the credibility of exam findings–the degree of effort the examinee puts forth on tests, whether there is evidence of honest reporting of symptoms, and whether there is evidence of malingering.
Review of records. I will carefully review medical records to determine prior level of functioning, the history of the injury, and appropriateness of treatment.
Estimation of pre-injury level of functioning. How do we know what a person was like before an injury? Records of pre-injury educational and occupational achievement are carefully reviewed to identify changes in functional level. Scientifically reliable testing methods are applied to estimate a person’s pre-injury level of intellectual and neurocognitive abilities. By these methods, it can be determined whether claimed impairment represents actual change due to injury or a pre-existing problem.
Short oral report. If requested, I will discuss with the client my preliminary findings immediately after the exam.
A detailed written report. Reports are tailored to the needs of the client. My report will clearly outline major findings, opinions regarding causation, plausible alternative explanations, prognosis, and future medical needs. Technical terms are explained in layman’s language so as to make the report most useful to decision-makers.