Pediatric neuropsychology is a specialty service that focuses on brain functioning. Whereas CT and MRI scans are useful in assessing physical changes in brain structure, neuropsychological testing provides information regarding how the brain functions. This is particularly useful in conditions where brain structure may be normal, as in mild traumatic brain injuries/concussion.
A pediatric neuropsychologist is a licensed psychologist with expertise in understanding various aspects of neurocognitive functioning and the impact of various types of injury on specific brain structures. Changes in brain functioning are evaluated through a detailed assessment of neurocognitive abilities. The neuropsychological evaluation typically involves a clinical interview, standardized testing, computer tests, and behavioral rating forms, which are completed by parents and teachers. Observing your student-athlete to understand their motivation, cooperation, and behavior is also a very important part of the evaluation process. The results of a neuropsychological evaluation are used to identify individual learning, emotional, and behavioral strengths and weaknesses, provide a diagnosis, if needed, and develop targeted treatment recommendations that use individual strengths to compensate for weaknesses. Treatment recommendations may include home, school, and community interventions, additional neuropsychological testing, or recommended care from a specialist.
A pediatric neuropsychologist may have many different roles in the care of your student-athlete. In addition to assessment services, including testing, diagnosis, and treatment recommendations, sometimes a pediatric neuropsychologist functions as a case manager who follows your student-athlete over time to adjust treatment to meet the student-athlete’s changing needs as they develop or recover from injury. They may also provide treatment, such as behavior management or recovery coaching. A pediatric neuropsychologist will work closely with your student-athlete’s physician, athlete trainer, coach, educators, and therapists to ensure success and desired treatment outcomes for your student-athlete.
Neuropsychological evaluations are requested by parents, physicians, athletic trainers, coaches, teachers, and therapists to better understand a student-athlete’s intellectual, academic, social, emotional, and behavioral strengths and weaknesses. Testing is typically recommended when there has been a change in functioning (e.g., decline in school performance, change in mood or behavioral control, social withdrawal, etc.) The change(s) may be due to a number of medical and/or psychiatric causes. A change in functioning, however, is not required for a neuropsychological assessment.
Common reasons why student-athletes are referred for a neuropsychological evaluation include:
- Difficulty with learning, attention, memory, socialization, behavior, and/or emotional control
- A disease or developmental problem that affects brain functioning
- Evaluation of developmental progress
- Establishing a baseline for comparison purposes over time
- Evaluation of recovery after a head injury during sports participation or other accident
- Determining effectiveness of prescribed treatment (e.g., medication and/or therapy)
Diagnostic clarification for children, adolescents, and young adults ages 2-22 with suspected:
- Traumatic Brain Injury/Concussion
- Neurodevelopmental Disorders (e.g., Intellectual Disabilities, Attention Deficit Hyperactivity Disorder, Autism Spectrum Disorder, Learning Disabilities)
- Neurological Disorders (e.g., Epilepsy and Seizure Disorders, Spina Bifida, Hydrocephalus, Brain Tumors, Stroke, Low Birth Weight/Preterm Birth)
- Genetic Disorders (e.g., Fragile X Syndrome, Williams Syndrome, Prader-Willi Syndrome, Down Syndrome, Turner Syndrome, Neurofibromatosis)
- Movement Disorders (e.g., Tourette Syndrome and Cerebral Palsy)
- Sequelae of Infectious Diseases (e.g., Meningitis and Encephalitis)
- Neurotoxic Conditions (e.g., Fetal Alcohol Exposure)
- Congenital Disorders (e.g., Agenesis of the Corpus Callosum)
- Central Nervous System Effects of Cancer and Treatment
- Migraine and Tension Headaches
- Psychiatric Disorders (e.g., Depression/Mood Disorders, Anxiety Disorders, Behavioral Disorders)
At CNS, you will gain a better understanding of your student-athlete’s functional strengths and weaknesses in many neurocognitive areas:
- Problem solving
- Responding to feedback
- Mental flexibility
- Processing speed
- Visual-spatial perception
- Overriding habits
- Motor coordination
A neuropsychological evaluation can also help detect the effects of neurodevelopment, neurological, and other medical problems on neurocognitive, emotional, and behavioral functioning to inform a diagnosis:
- Attention Deficit Hyperactivity Disorder
- Autism Spectrum Disorder
- Intellectual Disability
- Learning Disorder
- Langauge Disorder
- Depression/Mood Disorder
- Anxiety Disorder
- Other Neurocognitive, Emotional, & Behavioral Disorders
Neuropsychological testing can be very sensitive to mild functioning problems that might not be detectable in other ways. When problems are mild, neuropsychological testing may be the only way to detect them.
By using scores from large groups of people for comparison, it can be determined whether your student-athlete’s scores are within expected limits. The pattern of a student-athlete’s test scores can also identify individual strengths and weaknesses in specific neurocognitive areas. If available, test scores can also be compared to baseline test scores to determine whether or not there has been a change in neurocognitive functioning.
Neuropsychological testing can be used to establish a “baseline.” Baseline testing is used to establish a student-athlete’s functioning before there is a problem. Any changes that occur following baseline testing can be quantified and measured very objectively in comparison to a student-athlete’s actual performance rather than comparison to a normative sample. Baseline testing is most commonly used in sports to assist with monitoring recovery following a head injury/concussion, but may also be used to monitor developmental progress over time.
Test results can also be used to help with diagnostic clarification, which is important because appropriate treatment depends on accurate diagnosis. Different childhood disorders result in predictable patterns of strengths and weaknesses in neuropsychological test findings. These profiles of abilities can help identify a diagnosis and the areas of the brain that are involved. Your student-athlete’s physician can use this information along with results of other tests, such as brain imaging (e.g., CT and MRI), to provide the most informed diagnosis possible.
In addition to diagnostic clarification, neuropsychological test findings are used to plan targeted treatment that uses individual strengths to compensate for weaknesses. The results help to identify what problems to target and which strategies to use, creating positive and sustainable changes, ultimately enhancing the quality of life of your student-athlete and your family.