NEUROPSYCHOLOGY is the scientific study of the relationship between the brain and mental life; clinical neuropsychology, of those aspects concerning the psychological assessment, management and rehabilitation of neurological disease and injury. It is based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system.
Clinical neuropsychologists address neurobehavioral problems related to acquired or developmental disorders of the nervous system. The types of problems are extremely varied and include such conditions as dementia, vascular disorders, Parkinson's disease and other neurodegenerative disorders, traumatic brain injury, seizure disorders, learning disabilities, neuropsychiatric disorders, infectious disease affecting the CNS, neurodevelopmental disorders, metabolic disease and neurological effects of medical disorders or treatment.
Clinical neuropsychologists consult with patients and their families in healthcare settings, such as hospitals or medical clinics, or in clinical neuropsychology practices. They also see some children in educational settings.
The referring physician gives clinical neuropsychologists the results from neuroimaging tests, such as CT or (computerized tomography) MRIs, (magnetic resonance imaging) and PETs (positron emission tomography). These tests pinpoint structural brain injuries or tumors within millimeters in the brain, localizing brain dysfunction to specific areas and regions of the brain. Physicians also forward the patient’s other medical records and results from laboratory tests to a clinical neuropsychologist to provide a complete case history of the patient.
The referring doctor or agency also develops a question or set of concerns about the patient’s cognitive and/or behavioral deficits that must be addressed in order to plan rehabilitative services and interventions. These concerns often involve answering specific “everyday functioning” issues, such as the ability of the patient to drive, independently take care of personal hygiene, finances, and work-related issues.
During the initial examination, the clinical neuropsychologist interviews the patient as well as any family members that are present, asking about the patient’s history and the patient’s opinion of the nature of the brain injury or deficit. Through this initial interview, the clinical neuropsychologist determines the patient’s awareness of problems, and his or her physical capacity and mental ability to undertake a more in-depth neuropsychological assessment consisting of a series of tests.
If the patient is able to sit through and perform a number of cognitive tests, the clinical neuropsychologist assigns a trained technician to administer the tests.
Many valid and reliable neuropsychological tests have been developed over the years designed to assess all areas of cognitive functioning, including:
o Intellectual function
o Memory
o Speech and language
o Visual perception
o Psychomotor/Psychosensory functions
o Planning, judgment, decision-making functions
o Attention
Based on the outcomes, the clinical neuropsychologist recommends rehabilitation plans, interventions, a plan to return to work, recommendations for daily living, or any other issues requested by physicians and healthcare personnel.