Neuropsychological Testing
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Q:  Neuropsychological Testing

My 17 year old son was diagnosed BP this past summer after a bad manic episode.  We recently asked his psychiatrist if my son should have neuropsycholigical testing done.  He is having terrible difficulty in school (he can't really function at school).  Dr. said that he needs to be stable first.  Then she would start with psychological testing.  If the results warrent neuro, they would proceed further.  She also told us that we might just have to write this year off for school. He is obviously having deficits in different areas of his brain. We want to help.  What to do?


Dear Ms. C' -- 
Neuropsychological tests include a wide variety of routine tests to look at several different aspects of brain function.  Because often the question being asked is "how are we doing?", i.e. "is there any area of function that's really not looking too good here?", the number of tests is often quite high.  And thus the cost is pretty high too.  That leads doc's who are paying attention to the cost of medical care generally to worry about doing these tests too often.  And that leads to a desire to delay until the maximal improvement can be achieved, because if you test before that and then your son gets better, you wouldn't want decisions being made on the basis of the now-dated tests.  You probably have figured all that out already. 

A different situation arises sometimes when we want to use the tests to demonstrate in concrete terms just how bad things are right now.  This could be for some kind of disability determination, including for school placement or other decisions about school; or in adults, for disability insurance evaluations.  In this situation, you might be able to pick the area you think is looking worst, and confine the testing to that area (e.g. attention; or memory), which would make it cheaper and thus maybe lower barriers to doing it both now and again later.  

Finally, the school might need it to decide what particular education plan to craft for him.  Under these circumstances it's not unusual for the school to end up paying for this, if they don't have their own psychologist to do the testing.  So if that was the primary need, you could gently facilitate the school concluding that this was warranted now. 

Good luck with all that.  I hope I caught the question correctly. 

Dr. Phelps

Published January, 2003 


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