What is a Neuropsychologist? The National Academy of Neuropsychology defines a neuropsychologist as follows: "A clinical neuropsychologist is a professional within the field of psychology with special expertise in the applied science of brain-behavior relationships. Clinical neuropsychologists use this knowledge in the assessment, diagnosis, treatment, and/or rehabilitation of patients across the lifespan with neurological, medical, neurodevelopmental and psychiatric conditions, as well as other cognitive and learning disorders. The clinical neuropsychologist uses psychological, neurological, cognitive, behavioral, and physiological principles, techniques and tests to evaluate patients’ neurocognitive, behavioral, and emotional strengths and weaknesses and their relationship to normal and abnormal central nervous system functioning. The clinical neuropsychologist uses this information and information provided by other medical/healthcare providers to identify and diagnose neurobehavioral disorders, and plan and implement intervention strategies. The specialty of clinical neuropsychology is recognized by the American Psychological Association and the Canadian Psychological Association. Clinical neuropsychologists are independent practitioners (healthcare providers) of clinical neuropsychology and psychology."
Clinical neuropsychology is focused on understanding the link between the brain and behavior. For example, how changes in the health of the brain may affect the ability to pay attention, remember, or solve problems. This understanding between how someone thinks and acts and how the brain works is used to diagnosis and treat brain disorders.
What is a Pediatric Neuropsychologist? Pediatric neuropsychologists are licensed psychologists. They have training in both clinical psychology and neuropsychology. They have special training in how the brain develops. They use this training to evaluate and help manage children with brain disorders. Such disorders may involve brain injury, medical disease, or developmental problems. Pediatric neuropsychologists help parents, teachers, and physicians to:
Understand how problems with the brain may relate to problems seen at school, home, or with peers
Understand how a child learns best
Understand why a child may have behavior problems
Help a child deal with thinking or behavior problems
Identify neurological or psychiatric problems
Help match expectations to a child’s specific strengths and weaknesses
Work with other doctors and teachers to develop the best treatment and school plan for a child
What does a Neuropsychological Evaluation involve? A neuropsychological evaluation involves examining thinking, behavior, and social-emotional functioning. The evaluation uses standardized tests and procedures. They also may talk to you and teachers and other doctors. Tests may be performed using paper and pencil or on the computer. Your child will be asked many questions and to solve different types of problems. Neuropsychological evaluations typically include tests that measure the following:
Planning and organization
Attention and memory
Control over hand movements
Depression and anxiety
Aggression and impulsive behavior
The neuropsychologist will also review your child’s medical and school records to help understand how the test results relate to daily life.
A typical neuropsychological evaluation with will entail 3 separate visits:
Clinical InterviewThis visit typically lasts 1-2 hours and entails conducting a clinical interview focused on the current concerns for the child, the history and progression of the concerns, and attempts to remediate the concerns at home and at school. Prior to this appointment, the neuropsychologist will have reviewed pertinent records such as previous psychological evaluations, medical records, psychiatry records, academic records including report cards and standardized tests and any other relevant records to better understand the current concerns. The child is typically asked to be present during this appointment. This visit may be conducted in-person or virtually (via a HIPAA-compliant telehealth platform), based on clinical appropriateness.
Assessment This visit is typically an all-day session. Testing begins in the morning and continues until the afternoon with a break for lunch. Each assessment battery is customized to the unique needs and concerns of the child. Given Dr. Tammy Martielli's background and training in pediatric neuropsychology, she is uniquely qualified to conceptualize and diagnose underlying psychological/cognitive disorders. The testing session could be completed in-person in our office, virtually (via a HIPAA-compliant telehealth platform), or via a combination of the two. Each assessment battery is different and this determination will be based on clinical judgment.
Feedback The final visit entails providing feedback regarding her findings and recommendations for intervention or management. At feedback, the neuropsychologist shares any diagnoses that the child meets criteria for according to the Diagnostic and Statistical Manual of Mental Disorders - 5th edition (DSM-5). Parents are provided with a detailed conceptualization about any areas of deficit noted on testing, areas of strengths and how these interact to influence a child's functioning. At this session, the neuropsychologist also shares with parents a detailed list of recommendations that are customized to the child's unique profile in order to help him or her succeed at home, at school, and with peers. In some cases, the neuropsychologist will recommend specific accommodations in the school setting such as extra time on tests, note-takers, and other academic accommodations based on the child's needs. Parents are encouraged to ask questions and collaboratively develop a plan for implementing the recommendations at home and at school. In most cases the child is encouraged to attend this appointment as well, but in other cases (depending on the child's age) he/she may not be required to attend this appointment. Following feedback, you will be provided with a detailed and comprehensive report that includes the child's background and history, tests administered, the child's performance on domains assessed, conceptualization, diagnoses (if warranted) and recommendations. This report can be used to help other providers in the child's care obtain a more detailed understanding of the child's strengths and weaknesses, help school personnel better meet the needs of the child in the academic setting, and inform parents about how to maximize the child's functioning at home. If individual therapy is recommended, we will attempt to arrange for follow-up with one of the providers in our clinic, and if this is not possible, or the needs of the child/family might be better served elsewhere, we will make every effort to provide the family with the name of a trusted colleague who can work with the child or the child/family in a therapeutic setting.
Can my child's school perform a Neuropsychological Evaluation? No. Pediatric neuropsychologists are independent licensed psychologists who perform medical procedures and provide diagnoses. Schools have a set of criteria that are used to determine if a child qualifies for funds/services through the school in order to receive a free and appropriate public education (FAPE). A school-based evaluation may result in a classification in order to receive services. This is not considered a diagnosis of a learning disability or any other neurodevelopmental, psychological, or psychiatric disorder. Individuals within the educational system who provide these evaluations are considered "Exempt" under the Missouri State Committee of Psychologists General Rules, which outline the legal educational, training, and licensing requirements to administer and interpret tests and provide diagnoses.
I'd like to learn more about obtaining a Neuropsychological Evaluation. What can I do next? Parents have many questions about whether or not a neuropsychological evaluation is right for their child. We are here to help answer those questions and support you in this process. You can contact us via email at info@neuropsychologySTL.com, you can submit a request to be contacted by phone in the contact form below, or you can always call us at 314-324-3800 during normal business hours.