You are at a party and are making small talk with someone. When you ask what he or she does for a living, you probably do not expect to hear the words “clinical neuropsychologist.” And, when most people do hear that mouthful of jargon, they say, “You are a what?” So what exactly is a clinical neuropsychologist and what is neuropsychology for that matter?
Clinical neuropsychologists (CN) work to help people understand how the brain’s functioning relates to everyday life and one’s ability to interact with others as well as learn and function in a meaningful manner. This is what we call brain-behavior relationships. Most people know that the brain is responsible for all of our behaviors, abilities, thoughts and feelings. But how about when people don’t function exactly normally? Most of the work of a CN is to help their patients and families identify and understand the difficulties they may be having, and to help find ways for improvement – in school, at work, at home, socially - anywhere.
We diagnose psychological, cognitive, and learning disorders. A CN identifies cognitive and psychological strengths and areas of challenge which creates a framework for parents, teachers, psychiatrists, pediatricians, therapists, or other professionals to provide treatment for the individual. Suppose a child isn’t doing well in school, or granddad had a stroke, or an uncle was in an accident and had a head injury? CNs help to understand the effects of these problems and help find solutions.
A CN is a person trained from both the psychological and neurological perspective. Those in the field have a doctoral degree (Ph.D.) in either clinical psychology or neuropsychology. They have completed a clinical internship in neuropsychology and a 2-year post-doctoral residency in neuropsychology, typically in a medical/hospital setting. A CN’s expertise lies in understanding how behavior and skills are related to brain structures and brain systems. They are also trained in basic clinical psychology and understand psychiatric illness. CN’s can also complete board certification in clinical neuropsychology, which is an important step in competency. (See www.aacn.org).
So what happens during a neuropsychological evaluation? Well, the evaluation is a comprehensive exam that provides objective testing of skills that correlate with brain function, i.e., intellectual functioning, academic achievement, learning and memory, executive function, visual-perceptual abilities, fine-motor skills, and language abilities. The tests are standardized psychometric instruments used to evaluate multiple aspects of cognition and emotional/psychological functioning. The parents or individual being tested provide a detailed background history including developmental, educational and vocational history. Often times, previous medical or educational records are also reviewed to provide a thorough understanding of the person being tested. The objective test results, background history and clinical observations made by the CN are all integrated into the conceptualization of the person’s cognitive and emotional profile. A detailed report, which incorporates the results, diagnosis and recommendations, is prepared after testing is completed. Some diagnoses might be Math Learning disorder, Reading Learning Disorder, Attention Deficit Hyperactivity disorder, Autistic Spectrum disorder, Bipolar disorder, Major Depressive disorder or Generalized Anxiety disorder, just to name a few.
So who calls a neuropsychologist to make an appointment, you might ask? Well we often hear from parents, pediatricians, medical specialists (e.g., neurologists, psychiatrists, oncologists, etc.), psychologists/therapists, Child Study Teams, school counselors, attorneys or advocates. All referral sources are seeking in-depth knowledge of the individual’s cognitive and emotional functioning with the goal of understanding their problems and creating the most thorough treatment plan.
The next time you are at a party and someone says, “Oh I am a clinical neuropsychologist” you can now understand what that mouthful of jargon actually means.
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