Assessments are usually carried out by a consultant neuropsychologist and an assistant neuropsychologist working together as a team.
The goal of the assessment is to find out whether different aspects of cognition are working as they should, in relation to the age and background of the patient. No two assessments are the same. The consultant will review any medical records and scans that are available, then discuss the patient’s views on their problem in a clinical interview.
It is usually best if we can see the patient along with someone who knows them well and who can give another perspective on the problem.
The cognitive evaluation involves a range of specialist tests (selected from over 500 possibilities). These tests include:
We then score the tests and analyse the results, comparing the findings with background studies of the same tests based on many hundreds of volunteers. The final results are then interpreted in relation to what is known about brain function and the different types of difficulty associated with particular diseases.
The amount of time needed for an evaluation varies depending on the problem being assessed. It usually takes several hours to collect the information. After the assessment there is a debriefing session, where the preliminary results of our assessment are discussed with the patient (and their family if appropriate). We then provide a written report for the referring practitioners and (if requested) a written summary for the patient.
A single appointment is often enough for us to collect information to answer the referring doctor’s questions.
Diagnostic appointments last at least three hours, but may sometimes involve up to eight hours of testing.
Diagnostic assessments are often required to decide if patients are likely to be candidates for epilepsy surgery, or when diagnosing young onset dementias.
Most people complete their evaluation on a single day, but sometimes we need to ask people to return for a second or even third time.
We know our tasks are quite tiring and so we encourage people to pace themselves and take rest and refreshment breaks.
Return visits are organised when long or complex series of tests are required, when people have limited energy, or when we want to see if there has been any change in function across an interval of months or years.
Specialist assessments are carried out in close liaison with clinical and surgical teams.
These sessions may involve multiple assessments (for example carried out before and after a medical or surgical treatment), or a single extended assessment carried out while brain function is being measured at the same time (using brain scanning or EEG technology).
There are two main multi-disciplinary team meetings involving the neuropsychologists:
At these meetings, findings from neuropsychology are discussed with other members of the teams managing individual cases. Further follow-up investigations can then be arranged.