28 Aug Interpreting Results from a Neuropsychological Testing Report
Brooklyn Letters
1139 Prospect Avenue, Brooklyn
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Kanu Patel -
We had a very positive experience with Alissa as a tutor for our pod of 5th grade boys from January - June 2020. She cared a lot about the boys and worked hard to create meaningful activities for them. The pod experience was invaluable … More for all of our families during a difficult year and we were so grateful to have found this partnership! We also want to appreciate Craig for helping to match us with a tutor on very short notice after we had cycled through a few folks who were not able to see the commitment through. Thanks for sticking with us!
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Dusty was the exact person we needed to help our child finish out the school year. So grateful to him for the way he steadily encouraged her and helped her stay on track and organized. He is flexible, responsive to our needs/schedule as … More a family, and a delight to be with. We are also thankful that Craig at Themba Tutors really "gets it" and partnered us with such a wonderful tutor who was a great fit for our girl.
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Giulia Mercuri is a great Italian tutor! She was very responsive and accessible. Giulia put a ton of effort into preparing for each session and really helped our son with test preparation and projects. We are grateful that she was able … More to help, especially since our son did not receive any live teaching during COVID. We are happy that she was referred to us!
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I can wholeheartedly say after working with Themba for two years that I would not have finished my program without this organization. And I am so thankful I selected them. -
We were introduced to a wonderful tutor: Mcedwyn. He and our son, a freshman in college, worked well together. As a result, our son’s grades significantly improved. The tutor taught our son subject content and various methods to effectively … More study for quizzes and exams. Our son was also taught time management and organization. My son’s experience with the tutor made the first year of college a less intimidating experience.
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We have been with our tutor, Cailin Schiller, for two years, from 5th - 7th grade. She started as an executive functioning tutor with my daughter. From the start, she demonstrated a depth of expertise and a selective use of techniques skillfully … More adapted to my daughter’s ADHD and Math disability. Cailin made Math accessible and understandable to her in a way that even her teachers had not been able to do. She differentiated reading, writing and math tasks and assignments to tailor them to my daughter’s unique learning differences. Not only did it have an effect on her grades and her work efficiency, but she finally could do her work with less anxiety. Even my daughter’s teachers used Cailin’s guidance to modify their work with her. But most importantly, she became my daughter’s favorite resource. I can’t say how invaluable Cailin has been to my daughter’s progress and well-being. I’d recommend her a million times over. She is a gem.
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Victoria is a superb tutor. She helped my high school age daughter with her writing. Victoria's skills as a tutor, as well as her sense of humor and her engaging personality went a long way with my daughter.
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Themba Tutors provided a leaning specialist that was a perfect fit for my daughter. I told them what we were looking for and they delivered. Our tutor is responsive and flexible and makes it easy for my daughter to reach out to her own … More her own, which gives her an added sense of responsibility over her learning. As a therapist myself, I now regularly recommend Themba to my patients. A much needed and well provided service to the community!!
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The tutors at Themba are fantastic! Caitlyn McNeill helped our son academically, but also with getting organized in every subject, which he so desperately needed. She offered great advice and useful strategies that helped our son become … More a more successful student. We are using Themba tutors again this year for our daughter. We're so happy to have been referred to them!
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I'm so glad we were referred to Themba Tutors. After a great initial conversation to learn our needs, we were connected with an excellent tutor, Felicia, who is helping our high school daughter learn better organizational and executive … More skills. Highly recommended.
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We had a wonderful experience with our tutor Micaela. She helped our son not only academically but at every level. We will be forever grateful to have her in our lives.
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The tutors at Themba are fantastic! Caitlyn McNeill helped our son academically, but also with getting organized in every subject, which he so desperately needed. She offered great advice and useful strategies that helped our son become … More a more successful student. We are using Themba tutors again this year for our daughter. We're so happy to have been referred to them!
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Paul Smith at Themba has been an exceptional tutor for my son, both in terms of teaching the subject matter and teaching how best to approach the process of learning math and executing assignments. We feel very fortunate to be working with … More Paul.
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We were very lucky to have found Edwouine Swift, my son's therapist through Themba Tutors. Thomas is 12 years old, and it is extremely difficult to get him to write. Edwouine just works her magic with him, he adores her and is so … More eager to follow her guidance. I have no doubt she will be a positive driving force in his academic future.
Interpreting Results from a Neuropsychological Testing Report: An Introductory Guide
by Griffin Thayer and Dr. Dimitra Robokos
Neuropsychological testing is a critical tool for assessing cognitive functions and understanding the impact of neurological, medical, psychological, and social conditions on the brain. By administering various tests and procedures, these reports provide a detailed profile of an individual’s cognitive abilities.
Interpreting neuropsychological testing reports requires a nuanced understanding of both the data presented and the broader clinical context in which the assessment was conducted. Unless one is experienced in this field, the report can often seem confusing or overwhelming for parents, caregivers, educators, and other professionals.
This article briefly guides family and non-psychological professionals in understanding the testing process.
1. Understanding the Context
Neuropsychological testing is often a nuanced and specific process. In order to fully understand the report, the tester and reader need to identify the following clearly:
- Referral Question: Identify the specific reasons for the referral. For example, was the evaluation conducted to assess the impact of a traumatic brain injury on brain function, diagnose a neurodevelopmental condition such as Autism or ADHD, or evaluate for learning disabilities or cognitive and academic functioning that results from psychiatric or medical conditions?
- Patient Background: Review the patient’s medical, psychological, educational, and cultural history, including any previous psychological or neuropsychological evaluations. The patient background can often contextualize the referral question and current difficulties.
- Current Symptoms: Understand the patient’s presenting symptoms and complaints. Are there issues with memory, attention, language, or other cognitive domains? Do these impact everyday living or vocational activities? Are there mood-related issues that result from these symptoms? How do these symptoms align with the results of the testing?
2. Reviewing the Testing Battery
Neuropsychological assessments often involve a battery of tests, each designed to evaluate different cognitive domains. In each testing report, tests are chosen to help best answer the referral question while putting it in the context of the patient’s background and current symptoms.
There are countless tests that can assess different cognitive or neuropsychological functions, and each will be chosen to provide specific and nuanced feedback. Depending on each case, tests could evaluate various parts of the following:
- General Intelligence
- Executive Functioning
- Attention
- Memory
- Language
- Learning/Academic Skills
- Impulse Control and Regulation
- Problem-Solving
- Abstract Thinking
- Motor Coordination
- Social Skills and Perception
- Psycho-Educational Ability (Giftedness or Learning Disabilities)
- Personality
- Mood and Psychiatric Conditions
- Many others
Most neuropsychological tests are typically interpreted by comparing an individual’s performance on normative data from a similar population, comparing their performance to those from a similar background, and often considering factors like age, education, ethnicity, gender, and culture. This is to ensure their performance is put into an appropriate context.
3. Interpreting Test Scores
Upon administering the tests, the tester must then interpret the scores. The tester will take the Raw Scores (The actual number the test taker received on the test) and convert them into Standard Scores (e.g., percentiles, T-scores, scaled scores) to compare the test-taker to the normative data. You can find a list of various scores in the table below, along with an average score (also called the mean) and the standard deviation (how much individual scores typically deviate from the average).
For example, if the mean score on a test is 100 and the standard deviation is 15, most people’s scores will fall within 15 points above or below the mean (i.e., between 85 and 115). If your score falls within 85-115, you will likely have performed within the average range.
After finding the scaled scores for all of these tests, the tester will examine these results to identify patterns of strengths and weaknesses across cognitive domains (Such as Intelligence, Memory, Language, etc…). They will use these results to determine whether some consistent strengths and weaknesses could indicate a specific neuropsychological condition or whether there is just a more generalized decline/regression. The tester will also look for discrepancies between cognitive domains, which may provide clues about possible underlying conditions.
4. Considering Non-Cognitive Factors
Neuropsychological testing will also take into context and explore possible non-cognitive factors that could influence these results, including:
- Mood, Affect, and Psychiatric Conditions: Depression, anxiety, and other mood/psychiatric disorders can impact cognitive performance, particularly in areas such as attention and memory. Certain tests and measures may be used to explore possible psychiatric factors.
- Motivation and Effort: Suboptimal or low motivation can lead to deflated scores. Certain tests can be utilized to help assess the validity of test performance and might be used if that is a concern. On the other side, pressure to do well on these tasks can lead to test-taking anxiety, rushed thinking, and mistakes that might not reflect how a person does in a more ‘casual’ setting. This is why reports from people who know the person well (teachers, treating therapists, parents) help evaluate a person holistically.
- Fatigue, Medication, and Other Biological and Environmental Factors: Physical factors like fatigue, sleep deprivation, or the effects of certain medications can influence cognitive performance. Sometimes, even small factors like thirst or hunger can negatively impact results. Efforts are always made to mitigate these issues.
5. Interpreting and Communicating the Results
Once the tests have been scored and non-cognitive factors considered, neuropsychological testers place these results into the test-taker’s life history and context, showing how these results are consistent or inconsistent with what the patient, caregivers, providers, or educators have observed. They may also utilize data obtained from personal observation of the patient’s behavior through test administration or classroom observation.
Ideally, all of this information from life history, behavioral observations, and testing data will help the tester understand the presenting issue and come to a helpful conclusion about the nature of the problem.
Afterward, the tester will summarize their findings in a clear and succinct summary that includes the purpose of the testing, the findings, interpretations, and recommendations. It should be accessible to both the referring professional and the patient (or their family), avoiding overly technical language. The tester will review the report and these findings with the patient (and their family) and other involved parties.
6. Recommendations
Perhaps most importantly, the tester will then discuss recommendations. Based on the results, these recommendations should be actionable and designed to build on the patient’s strengths while finding ways to overcome or adapt to their weaknesses. These may include further medical evaluations, psychological interventions, cognitive rehabilitation, or accommodations in work or school settings.
In school settings, recommendations can often be specific for the patient, such as possible recommendations for studying, taking notes, or attending classes. There may also be particular recommendations that schools can accommodate, such as extended time, access to class notes, classroom positions, and others. Recommendations may also give some insight into what programs or environments may be of best interest to the patient, such as school programs, college support services, etc.
If you have any questions about the testing process, procedures, or recommendations, contact Dr. Robokos at [email protected] or (646) 233-0250.
Craig Selinger
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