Neuropsychological assessment

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By Bonnie-Kate Dewar, Clinical Neuropsychologist

Following encephalitis, it is common for people to experience changes in their thinking, behaviour and feelings. These changes may make it challenging to take part in everyday activities such as work, driving, running a household, or making plans with friends or family. A clinical neuropsychologist can help to understand these changes through a comprehensive assessment to allow development of recommendations for rehabilitation, including cognitive and emotional support.

Who is a clinical neuropsychologist?
Neuropsychology is the study of brain and behaviour. A clinical neuropsychologist has specialised training and expertise in the assessment, diagnosis and treatment of people following acquired brain injury (ABI), such as encephalitis. Neuropsychologists have an important role in helping people to understand and manage the impact of encephalitis. In hospital, clinical neuropsychologists may conduct an assessment, assist with diagnosis, provide education and rehabilitation support. This role continues in specialised rehabilitation or outpatient settings, and extends into the community as individuals return to their everyday activities and environments.

What is a neuropsychological assessment?
A neuropsychological assessment aims to gather information about an individual’s cognitive functioning following encephalitis. The assessment evaluates functioning in a number of areas including: attention/concentration, speed of thinking, intelligence, learning and memory, language, perception, problem solving, planning, organisation, and mood. Neuropsychological tests are standardised which means that the tests are given in the same manner to all people and scored in a similar manner time after time. An individual’s scores on tests are interpreted by comparing their score to that of non-injured people with similar demographics (e.g. age and education) and to their expected levels of functioning. In this way the clinical neuropsychologist can determine an individual’s profile of strengths and weaknesses to help make a diagnosis and/or develop rehabilitation strategies.

What happens during a neuropsychological assessment?
The neuropsychological assessment can take from two to four hours, depending on the complexity of the issues to be addressed. The session can therefore take place over two sessions, particularly if fatigue is a problem.
The assessment starts with an interview in which the clinical neuropsychologist will ask questions about current problems, educational and occupational history, medical history and social supports. The neuropsychologist will also screen for any symptoms of low mood, anxiety or behavioural changes during this conversation. It can be useful to have a family member or someone who knows you well in attendance to provide further information about current problems.

The bulk of the assessment involves the administration of standardised tests, which involves pen and paper tasks, manipulation of materials such as blocks, and answering questions. Whilst many people report that the assessment process is like returning to school, it is important to understand that there is no pass or fail on the tests; rather it is important to try one’s best. The clinical neuropsychologist will help to put a person at ease so that they can perform to the best of their ability.

What happens after the assessment?
Following the assessment, the clinical neuropsychologist integrates information from the medical background, clinical interview and the assessment to identify a pattern of cognitive strengths and weaknesses. A written report of the results and recommendations is then produced. It can be very useful to arrange a feedback session for the person recovering from encephalitis and their family to discuss the results. This feedback session can be a useful starting point to plan a program of cognitive rehabilitation to help manage the practical and emotional impact of cognitive changes following encephalitis. The report can also provide useful information and education about the effects of encephalitis and the impact on everyday functioning.

How to organise a neuropsychological assessment?
Your GP or neurologist can refer you to the clinical psychology department at your local hospital/community health service. You can also see a private clinical psychologist/neuropsychologist. It is recommended that the clinical psychologist/clinical neuropsychologist should be registered with the British Psychological Society Division of Neuropsychology specialist register. You can find a clinical neuropsychologist using the Find a Psychologist Service on the British Psychological Society’s website or by phone: 0116 254 9568. This resource lists both public and private neuropsychological services.

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Date created: March 1999; Last updated: November 2020; Review date: November 2023

Disclaimer: We try to ensure that the information is easy to understand, accurate and up-to-date as possible. If you would like more information on the source material the author used to write this document please contact the Encephalitis Society. None of the authors of the above document has declared any conflict of interest which may arise from being named as an author of this document.

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