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Dr. Shahal Rozenblatt, Clinical Neuropsychologist, New York

Evaluations for adults

Adults request neuropsychological evaluations for a wide variety of reasons, most commonly following problems with a spouse, work, or academics. Older adults often report not being able to function as effectively on a day-to-day basis. A wide variety of neurological and mental health problems can be the reason behind the difficulties that you are experiencing. For example, disorders such as ADHD, anxiety, and bipolar disorder result in poor attention and concentration and impulsive behaviors. Conditions such as traumatic brain injury (TBI), epilepsy, stroke, multiple sclerosis or dementia also have a significant impact on how you function. They can make the simplest tasks seem extremely difficult.

The neuropsychological evaluation has several goals. One is to clarify the diagnosis, which means that we are looking to uncover the reason or reasons why certain problems exist. A second goal is to provide a detailed profile of your areas of cognitive and emotional strengths and weaknesses, allowing you to understand what you are able to do well and those areas where you can benefit from improvement. A third goal is to aid you, your family, and medical doctors in developing an intervention plan that will help to improve how well you do things.

Adults may seek a neuropsychological evaluation for the following reasons:

1. Accommodations for college and graduate school entrance exams is one of the most common reasons for obtaining a neuropsychological evaluation. Each examination has a specific set of criteria that are necessary in order to obtain accommodations. In this instance, the evaluation process is designed to determine what factors prevent you from taking the test under typical conditions, what accommodations you will need so that you will not be unfairly penalized, all the while adhering to the guidelines required for the specific entrance examination. Accommodations often include the need for extended time, use of a scribe or computer or to have questions and answers read to the test taker. The following links will provide you with additional information about the most common entrance examinations and requirements for determination of disability:

a. SAT, SAT-II, AP, PSAT - http://www.collegeboard.com/ssd/student/index.html
b. LSAT - http://www.lsac.org/LSAT/accommodated-testing.asp
c. GRE - http://www.ets.org/
d. PRAXIS - www.ets.org/praxis/

It is important to keep in mind that there is no guarantee that you will receive accommodations. It is frequently helpful if you have a history of learning issues that has been documented. For example, if you received any type of school-based accommodations, it is important to include those documents (e.g., prior assessments or a copy of an individualized education plan from the school district) with your submission.

2. The consequences that various neurological and medical disorders have on our functioning can range from mild (e.g., not thinking as quickly as we once could) to severe (e.g., an inability to perform even the simplest tasks). Individuals and families who have suffered or have loved ones who suffered head trauma, stroke, meningitis, or other medical issues are well aware of the impact on interpersonal relationships, emotional and behavioral functioning, speech and language, memory and attention. The impact on daily living skills can range from mere inconvenience (e.g., mild forgetfulness or telling off-color jokes) to something that changes the family forever (e.g., a spouse who suffers a stroke can no longer be the breadwinner and becomes wholly dependent on family for feeding and hygiene). Here, the goal of an evaluation is to help the individual and family to understand why certain behaviors and functions have changed and to provide them with ways of dealing more effectively with the life changes that have occurred.

3. Older adults often come for a neuropsychological evaluation at the request of a spouse or physician who is concerned about a possible decline in functioning. For example, many families that come for services report that a husband or wife is forgetting things more frequently than in the past or is showing personality change. While there could be many reasons for such changes, one of the most common fears is that the person may be showing the signs of dementia. The purpose of the neuropsychological examination is to determine if the person is showing a cognitive and emotional profile that is consistent with dementia or if there is some other causal factor (e.g., depression) that can mimic the signs of dementia.

4. Many adults who come for a neuropsychological evaluation are able to function fairly well, holding jobs, raising families, etc., but they report having always felt that they had to work much harder than the typical person in order to reach their goals. Or, they felt that they have under achieved academically and in terms of their work, resulting in less success than they are capable of. The goal of the evaluation is to provide the person with a better understanding of what it is that has been standing in their way and to provide them with methods of overcoming those barriers.

5. Individuals are sometimes referred for an evaluation by a medical doctor in order to clarify the diagnosis and determination of treatment needs, for instance, differentiating between mental health and medical causes of problems.

For additional information contact Dr. Rozenblatt at (866) 840-9790 or send an email to neuro@advancedpsy.com.
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