Neuropsychological Evaluations

I recently received an email from a parent about getting a neuropsych. for her daughter. I thought it was important enough to post as a blog entry, not just respond to her directly. So here’s my 2 cents…

A comprehensive neuropsychological evaluation is not the only way, and generally not the best way to diagnose ADHD. The “gold standard” for diagnosis of ADHD is an in depth clinical assessment by a qualified MD or PhD. For kids this involves a thorough history, evaluation scales, parent surveys, and often teacher surveys. 

I rarely recommend a neuropsych. for adults. I very often recommend them for kids though, especially in cases where it is important to ascertain whether or not the child is dealing with comorbidities. 80% of ADHDers have at least one co-occurring condition. However, there can be as much as a 30% false negative for attentional issues because the test is delivered one on one in an environment that is designed to be minimally distracting. Also, particularly bright kids will often not fully demonstrate their weaknesses in such on such a test because their intelligence compensates in some ways. And, there always is the issue of whether the test administer/evaluator is adept enough to see more subtle deviations from the norm. Plus they are really expensive and very often not covered by insurance. 

So, if you are primarily concerned with ADHD and there doesn’t seem to be any other issues, seeing a competent clinician for an evaluation and (potentially) medication treatment is probably the best place to start. If medication gets complicated, the symptoms aren’t adequately addressed, or the clinician thinks there may more going on, that would be the time to seek further testing. Or, if the school system demands it in order to allow accommodations. Though, then you can usually get them to administer and pay for it. But, you have to be careful about how good their people are. 

Standard Disclaimer:  In an effort to foil my own perfectionist tendencies, I do not edit my posts much… if at all. Please excuse and typos, mistakes, grammatical errors, or awkward phrasing. I focus on getting my content down. An imperfect post completed is better than a perfect post that goes unposted.

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