What exactly is neuropsychological testing?

Key Takeaways:

• Neuropsychological testing is a form of medical examination focused on cognitive function.
• Taking anywhere from four to eight hours, neuropsychological testing can reveal problems with problem solving, memory, or mental health in general.
• Neuropsychological testing is usually administered by a licensed psychologist.

When a lot of people think of neuropsychological testing, they imagine a bird's nest of wires spilling from an array of hastily applied electrodes pulsing clinically on one's skull.

The reality of neuropsychological evaluation is much easier to digest. Rather than monitors flashing warning signs and scientists in lab coats frantically pulling levers, neuropsychological evaluation actually looks a lot more like a simple conversation, with the occasional worksheet or simple activity thrown into the mix.

Unfortunately, even after decades of scientific and social advancement, there is still a significant stigma around neuropsychological evaluation, as though the process is so mysterious that it demands skepticism.

Let's work to change that by going over a simple example of neuropsychological evaluation. Note that, while this article will demonstrate an example of a neuropsychological evaluation, yours may vary slightly.

Skip to information on a specific part of neuropsychological testing:

Initial Mental State Testing (also known as Mini-Mental State Examination)

English Language Skills and Short-Term Memory

Long-Term Memory

Color Recognition

Digit Span

Figure Copying

Post-Test Report

Neuropsychological Testing in Brooklyn: Williamsburg Therapy Group

Initial Mental State Testing (also known as Mini-Mental State Examination)

Most likely, when you visit a psychologist's office for neuropsych testing, the first exam will serve to measure your overall mental state, both to check basic cognition as well as to ensure that there is no severe disconnect between reality and what your brain is interpreting as reality.

This can include questions like:

• What is the current season?
• What floor of this office are we on?
• What is 7 minus 100?

These questions are fairly simple, so anyone with at least basic, healthy cognitive function should be able to answer them without problem.

If they don't, the psychologist will make notes and score their exam accordingly. If a patient scores poorly on this part of the evaluation, chances are something very serious is going on. If these cognitive symptoms have never presented before, the psychologist may enlist the help of a physician to ensure no head trauma has occurred. 

Usually, however, people testing at this level of cognitive dysfunction are in the process of recovering from a traumatic brain injury or are being treated for psychosis, so the psychologist is measuring their cognition in order to measure any changes.

English Language Skills and Short-Term Memory

The next exam one might encounter during a neuropsychological evaluation will measure the patient's ability to recall English words in the short-term.

The psychologist may speak a list of words to the patient and then ask them to repeat the list back in the same order.

Usually, the patient will have three attempts to get the list correct. This helps the psychologist determine whether the patient's working memory and linguistic skills are functioning within expected parameters.

If they aren't, the psychologist may note that the patient's short-term or working memory is not functioning at normal levels, which can indicate an array of conditions from ADHD to PTSD.

If the patient fails to remember a single word on the list, fails to get the order correct at all after three attempts, it can again indicate that a more acute condition is present.

Long-Term Memory

At some point later on, typically at least 20 minutes after the short-term memory exam, the psychologist will again ask the patient to repeat the list.

This helps the psychologist determine how well the patient's brain is converting short-term memory into long-term memory. If this process is interrupted by cognitive impairment or mental health disorders, the psychologist will make a note about it for use in analysis and diagnostic impressions later on.

Color Recognition

The next examination involves color recognition. Unlike the first exam, which tests for basic cognitive impairment, this test is refined to assess whether a patient's brain is:

• Correctly determining colors
• Correctly interpreting those colors into English words
• Isn't taking an inordinate amount of time to do so.

If a patient scores poorly on this portion of the evaluation, it can indicate a problem with visual interpretation or cognitive functioning.

This test may also involve a list of the names of colors, colored with a different color.

For example, the list may read:

• Red, but the text itself will be green
• Blue, but the text itself will be red
• Green, but the text itself will be yellow

The psychologist may ask the patient to read the list by repeating the colors of the text, rather than the words themselves. This shows the psychologist whether there are any problems with the patient's ability to use their attention selectively - one of the most important cognitive functions.

Digit Span

Another test one might encounter during neuropsychological testing or cognitive screening tests is similar to the word repetition test, but with numbers.

This test consists of a list of numeric sequences of progressive length. An example list would be:

• 4-2
• 4-1-4
• 6-2-6-6
• 2-7-3-2-7
• 8-5-3-7-4-5

And so on.

The psychologist will measure the patient's maximum number of recalled digits, and compare it to either average scores or past patient performance.

Figure Copying

Figure copying is a visual reasoning test that consists of a number of fairly simple figures on a piece of paper.

The patient's job during the test is to simply redraw each figure the way it appears. Poor performance in this section can indicate an issue with spatial reasoning skills, a cognitive impairment, or some mental health conditions.

Post-Test Report

After you complete your neuropsychological testing, which takes anywhere from 6 to 9 hours, your psychologist will take your scores and begin compiling a report.

Typically ready within 1 to 2 weeks, your report will contain your assessments on each section, as well as diagnoses and other impressions. It may also contain a treatment plan, if necessary, as well as suggested accommodations for school or work.

Neuropsychological Testing in Brooklyn: Williamsburg Therapy Group

If you think you may need a neuropsychological evaluation, our team of dedicated doctoral-level psychologists is ready to help.

Simply book an appointment online or give us a call to get matched with the right psychologist for you. Feeling better may be closer than you think.