Subscribe for Free!

We'll send you our print magazine 6x per year!

Subscribe Now

Prefer email?
Sign-up for our email newsletter

iStock-1164644244_Feature_1168x760.jpg
Andrey Popov/iStockphoto

A neuropsychologist is someone who can assess people who are having problems with memory, thinking, or concentration or who have experienced changes in personality, behavior, awareness, or language. Neuropsychologists—who have doctoral degrees in psychology and specialized training in neuroscience and nervous system disorders such as dementia, stroke, and epilepsy— administer standardized cognitive and behavioral tests to better determine patients' levels of difficulty.

In addition to performing tests, neuropsychologists conduct thorough examinations, including reviews of symptoms and medications and interviews with patients and sometimes family members, who may provide more detailed descriptions of any changes they've observed in the patients.

During typical cognitive tests, a patient may be asked to review lists of words that the neuropsychologist will ask them to repeat at different points during visits. For another test, a patient studies a design on a piece of paper and re-creates it using colored blocks. Each test assesses memory or other cognitive functions such as reasoning, language, or visuospatial abilities. The neuropsychologist tries to identify patterns that point to different brain disorders. The interviews, the test results, and the history of the patient's symptoms help a neuropsychologist determine if the patient's responses are normal for his or her age, identify key abnormalities, and consider which disorder may be causing the disturbance.

Evaluations usually employ a set battery of tests. Additional questions are tailored to each person, based on education, occupation, and past experiences. For example, a memory test for someone with a graduate degree and a technical job might involve remembering a list of 15 words. For someone with a high school diploma and a job in the service industry, it might be a list of 10 words. This allows the neuropsychologist to detect patterns on a simpler test that might be missed on a harder test if it was beyond the scope of the patient's experience.

During the examination, the neuropsychologist may measure reaction time to questions and consistency of answers to provide a fuller picture of the situation and to make recommendations for care, if needed. As the specialty has grown, neuropsychologists have begun seeing patients at earlier stages, which allows patients and families to plan for the future and start treatments sooner.

Patients may need just one visit, which can last two to six hours, depending on the questions asked and level of the patients' function. After the examination, the neuropsychologist's assessments and recommendations are sent to the patient's doctor or neurologist. Recommendations may include referrals to occupational or speech therapists, brain scans, driving evaluations, and tips for making the patient's house less cluttered and confusing. Neuropsychologists also may provide referrals to support groups and counseling for caregivers.

The neuropsychologist may ask a patient to come back with a family member for a follow-up visit. If a patient has a progressive disorder, the neuropsychologist may schedule a later visit to assess any changes and make new recommendations.

Neuropsychologists may be part of a neurology or gerontology practice or may be in private practice. They also may work with neuropsychiatrists—psychiatrists who focus on behavioral illnesses related to brain disorders.

Not all insurance companies cover visits with neuropsychologists. Patients and families should check with their insurance providers. Medicare may pay some of the cost, and additional fees may be covered by supplemental insurance.

Dr. Weintraub is a neuropsychologist and professor of psychiatry and behavioral sciences at the Feinberg School ofMedicine at Northwestern University in Chicago.