The Department of Neuropsychology at
Neuro Foundation is well organised and being managed by full time senior consultants
with more than 10 years of experience with wide variety of neuropsychological
The Neuropsychology Service provides comprehensive assessment services for child, teenage,
adult, and geriatric patients in whom impairments of cognitive, neuropsychiatric, or
developmental functioning are evident or suspected. Our services include outpatient evaluation
and inpatient consultation services.
Neuropsychological assessment involves a systematic evaluation of higher cognitive abilities
such as intelligence, academic skill, memory, language, attention, problem solving ability,
executive abilities and visual motor skills, as well as sensory/motor and personality/emotional
We also provide specialty Clinic services:
Adult Neuropsychology Clinic
Focuses on comprehensive evaluations for teenagers and adults. Referral questions focus on
clarifying cognitive and psychological functioning, as well as assisting with differential diagnosis
and treatment planning in adults with known or suspected brain dysfunction.
Pediatric Neuropsychology Clinic
Focuses on the comprehensive assessment of infants, children, adolescents, and young adults
with a wide range of medical, neurodevelopmental, genetic, psychiatric, and learning disorders.
Evaluation and treatment planning emphasize the integration of neurocognitive, social,
emotional, and behavioral aspects of these disorders to help families better understand and
manage complex presentations.
Adolescent Mood Disorders Clinic
- Focuses on evaluations in adolescence and young adulthood, where a mood disorder
may be interfering with functional independence, including difficulty meeting educational
and vocational goals.
Memory and Aging Clinic
- Focuses on evaluations in mid and late life
- Referral questions focus on degenerative and reversible causes of cognitive problems in
this age range
- Specializes in co-morbid medical and emotional conditions that may also contribute to
cognitive problems in the aging.
Multiple Sclerosis Clinic
- Provides brief as well as comprehensive cognitive and psychological assessments for the
patients with multiple sclerosis (MS) and offers treatment recommendations for
improvement in everyday functioning.
The Neuropsychology Service and Clinics can provide assessment and treatment
recommendations for a wide range of conditions that may affect cognition and/ or behavior,
- Cognitive and emotional effects of various neurological conditions, including, for
example, Alzheimer’s disease, stroke, epilepsy, multiple sclerosis (MS), leukemia, brain
tumors, Parkinson’s disease, and chromosomal disorders
- Traumatic brain injury and electrical shock injury
- Cognitive decline in elderly patients
- Changes in thinking abilities associated with various medical conditions, including:
metabolic disorders, HIV infection, cardiac complications, liver disease, toxic exposures,
and autoimmune disorders (e.g., Lupus) among othersty
- Attention-deficit disorders
- Learning disorders
- Psychiatric and emotional disorders and symptoms
What is the purpose of a neuropsychological evaluation?
Neuropsychological evaluations provide detailed information about an
individual’s functioning across multiple domains that can help guide
recommendations and strategies to improve functioning at home, at work,
in school, and in the community.
Often, an evaluation is requested by a physician or specialist to help
localize possible areas of brain damage or dysfunction and/or to clarify a
differential diagnosis. An evaluation also might be requested to help
monitor for any changes in cognitive abilities, behaviors, and emotional
functioning over time. The information obtained from the evaluation can
provide important information and recommendations to the client and family
members, as well as to doctors, therapists, or other specialists working with
Key areas examined in a neuropsychological evaluation often include:
- Intellectual reasoning capacity, or IQ
- Executive functioning (skills like planning, organizing, problem-
- Concentration and attentional capacity
- Language abilities
- Visual-perceptual and spatial abilities
- Memory abilities
- Sensory/perceptual and motor abilities
- Social and emotional functioning
- Academic skills (although, these are typically assessed only if
there is a specific questions of a possible learning disorder)
Who would benefit from a neuropsychological evaluation?
Individuals who have known or suspected brain dysfunction. Often
individuals who have experienced cognitive changes in the context of a
traumatic brain injury, neurodegenerative disorders, or other medical
conditions that affect neurologic functioning can benefit from a
neuropsychological evaluation. Similarly, those with long-standing cognitive
issues since childhood or complex psychiatric histories involving mood,
anxiety, trauma, or other mental health concerns often seek out
neuropsychological evaluations to rule out other causes of their
cognitive/behavioral symptoms to target more effective treatments and
In some cases, individuals have experienced challenges that have been
difficult to sort out since childhood. It is not uncommon, for example, to
meet with clients who have consulted with many doctors, specialists,
therapists, and/or school personnel over the years and still not have a clear
understanding of their issues. Neuropsychologists synthesize information
from a variety of sources, including cognitive/behavioral test data,
structured assessment of social and emotional functioning, as well as
collateral report from family members, teachers, or others who know the
client well to help provide some clarity and guidance around these issues.
Why might a student want a comprehensive
Common reasons why a student might seek out a neuropsychological
evaluation often include any combination of these concerns:
- Struggling to pay attention in class
- Not following through or completing assignments
- Problems completing reading assignments because it takes too
long or not understanding what was read
- Low frustration tolerance
- Taking too long to organize their thoughts
- Needing extra time for examinations
- Lack of motivation
- Declining grades in school
- Being easily distracted or finding that impulsive behaviors are
interfering in completion of tasks
- Experiencing anxiety and/or depression related to school
- Disparity between grades in school and scores on standardized
- Experiencing particular difficulty with a subject, such as math,
Those who are frustrated by sub-optimal school performance often seek
out a comprehensive neuropsychological evaluation to (a) help clarify the
cause(s) of their difficulties and (b) to obtain recommendations for
academic accommodations when indicated. Assessment of academic skills
(e.g., reading, writing, arithmetic) certainly is useful (and necessary)
information, but it often is insufficient. There are any number of reasons
why one might struggle in school. Sometimes an underlying reading
disorder (e.g., dyslexia) represents the root cause of the difficulty. For
others, their school problems might be circumscribed to math or there
might be some issue related to poor motor control/speed or dysgraphia that
interferes with academic success. Some students struggle primarily with
attentional or executive functioning weaknesses, suggestive of a primary
attentional syndrome, such as ADD/ADHD. Still others may encounter
complicating psychosocial factors or co-occurring psychiatric disorders that
disrupt several areas of daily life, including school performance. Thus, it is
critical to understand the “whole picture” as much as possible to
characterize the reason(s) underlying these struggles so as to best target
recommendations that foster greater academic success and improvements
in overall daily functioning.
Can a neuropsychological evaluation help to diagnose ADD/ADHD?
Yes. Neuropsychological assessments are appropriate for targeting
specific learning disorders in reading, math, and writing, as well as
identifying other sources of interference with learning and academics, such
as Nonverbal Learning Disorders, Asperger’s disorder, psychiatric
conditions, among many others.
How long does a neuropsychological evaluation take?
A comprehensive neuropsychological evaluation is comprised of three
separate appointments and is described in more detail here. Keep in mind
each client is unique and designing an appropriate assessment will be
individualized based on your needs and the questions you want answered.
Broadly-speaking, however, a typical evaluation involves three appointment
dates, including (1) a one-hour initial interview, (2) the testing appointment,
which can last 2-6 hours, and (3) a one-hour feedback appointment to
review the results and recommendations from the evaluation.
How do I prepare for my evaluation?
- It is important that you eat before your evaluation appointment. It
is strongly recommended that you bring snacks and/or a lunch, as
the evaluation may last several hours.
- Bring a current list of your medications and their dosages.
- Please take your regularly prescribed medications, as scheduled.
However, consult with your physician about optional medications
that might cause drowsiness (like pain killers, anti-anxiety, allergy
medications), as these can affect your test results.
- Bring your reading glasses or hearing aids.
- Bring a valid photo ID and health insurance card.
- Please arrive on time and allow for extra time for traffic, parking,
and check-in. Late arrival may result in rescheduling your
What happens during a neuropsychology evaluation?
The evaluation involves a clinical interview that lasts about an hour with
you and, when possible, a family member (or someone who knows you
well). The interview is designed to understand your history and how the
cognitive and emotional difficulties you have experienced have impacted
your life and daily functioning.
On a separate date, you will then complete a number of computerized and
paper/pencil tests that can last anywhere from between 2-6 hours. You will
be tested alone in a quiet room. If you are accompanied by family members
or friends, they will be asked to wait in the waiting room.
Who receives the results of the evaluation?
Once the evaluation is completed, the findings will be summarized in a
written report that will be sent to your referring physician or specialist. In
addition, you will be provided a copy of your report, which can either be
picked up in person at the office, delivered to your home via standard mail,
or emailed to you, based on your preference.
Attention-Deficit/Hyperactivity Disorder (ADHD)
ADHD (also sometimes referred to as “ADD”) is a developmental disorder
characterized by symptoms of inattention and/or restlessness. These
symptoms first emerge in childhood and result in substantial disruptions in
Neuropsychological evaluations can be very helpful in guiding ongoing
treatment planning for individuals with suspected ADHD. First, ADHD is not
a “one size fits all” diagnosis; individuals tend to differ markedly with
respect to how—and in what situations—symptoms are expressed in daily
life. Also, comprehensive neuropsychological assessments often can
identify other conditions that might be mimicking the symptoms of ADHD,
but require an entirely different treatment approach. Likewise, it is not
uncommon for other conditions to co-occur with ADHD, effectively making
an individual’s symptoms—and level of impairment—even worse. Thus,
there is significant clinical value in neuropsychological assessment
approaches to help target the most effective interventions and/or
remediation strategies in individuals with suspected ADHD.
The term ‘dementia’ typically refers to chronic medical conditions that
cause progressive declines in memory and other cognitive/behavioral skills.
Alzheimer’s disease, for example, is the most common cause of
progressive cognitive decline, accounting for more than two-thirds of all
dementia cases. Still, there are many other medical conditions that can
result in dementia, including, but not limited to:
- Vascular dementia
- Dementia with Lewy bodies
- Frontotemporal dementia
- Semantic Dementia
- Parkinson’s disease
- Huntington’s disease
- Creutfeldt-Jakob disease
- Corticobasal degeneration
- Progressive supranuclear palsy
Neuropsychological evaluations can be very helpful in terms of evaluating
for possible dementia and ruling out other causes for an individual’s
cognitive difficulties. First, it is important to consider that at least some
cognitive declines are to be expected as we get older. Specialized
neuropsychological assessments can help differentiate between what
would be considered a normal, healthy aging process versus difficulties
that are suggestive of something else going on that is more pronounced.
Also, formal neuropsychological assessment can help discriminate
between potential causes of difficulties an individual is experiencing and
clarify a diagnosis that will inform potential treatments or supports. Finally,
repeated assessments often are requested to monitor an individual’s
functioning over time to determine the rate of decline, what areas are
remaining stable, and hopefully, which areas have been responsive to
The core features of frontotemporal dementia (FTD) typically involve
cognitive and behavioral changes that emerge from degeneration of the
frontal and temporal lobes of the brain. Although the initial presentation and
course can be quite variable, three main subtypes of FTD generally are
- Behavioral variant – Deterioration of social decorum and self-regulation,
often characterized by impaired judgment, insight, disinhibition, apathy,
and other personality changes.
- Semantic dementia – Impaired knowledge of word meaning, deficits in
word-finding (particularly for nouns)
- Progressive non-fluent aphasia – Demonstrating pronounced
impairments in speech production, including decreased output for
words, shortened phrases, and/or deficits in articulation.
Given the variability in presentation seen in FTD and the fact that many of
the initial clinical symptoms and behaviors overlap with other neurological
and psychiatric syndromes, referrals for neuropsychological evaluation are
commonly requested to clarify (or corroborate) an initial diagnosis, make
recommendations for treatment planning, and provide a baseline
assessment to monitor the course of progression.
Alzheimer’s disease (AD) is the most common degenerative disease of the
brain. Inside the brain, the hallmark feature of AD is the aggregation of
microscopic plaques and tangles in/around nerve cells that disrupt their
functioning, ultimately leading to the widespread neuronal loss and brain
atrophy. As the physical changes inside the brain evolve, individuals may
experience gradual mental changes, often involving memory decline and
forgetfulness as the most prominent initial symptom. As the memory
problems become more pronounced, changes in other cognitive areas tend
to emerge, such as declines in language or visuospatial functioning.
Although there is no cure for AD at present date, some treatments are
available that may help slow down symptom progression. A
neuropsychologist can contribute valuable information as part of an
individual’s health care team to help clarify a diagnosis of AD, while
considering other potential conditions that might be causing mental
declines. In addition, a comprehensive neuropsychological evaluation can
yield valuable information for the patient and treatment providers to monitor
progression over time and guide personalized behavioral modifications and
strategies that enhance the quality of life for those who are living with
Alzheimer’s disease and their family members.
A concussion is mild traumatic brain injury (mTBI) caused by a direct blow
to the head (or elsewhere in the body that generates abrupt movement of
the brain inside the skull). Although concussions only infrequently result in
loss of consciousness, it is not uncommon for individuals to experience a
range of symptoms post-injury, including headache, dizziness, balance
problems, nausea, fatigue, confusion, memory difficulties, mental
“fogginess,” low attention span, sleep disturbance, increased anxiety,
and/or depressed mood. Fortunately, rapid improvement of these
symptoms should be expected within the first 3 days, and the vast majority
of individuals (~85%) report complete resolution of symptoms within the
first week following injury.
Still, there are rare occasions when symptoms can persist for weeks or
longer after the initial injury. In these instances, formal neuropsychological
testing should be obtained to characterize any objective cognitive deficits,
screen for other contributing factors, and make personalized
recommendations for ongoing management that support a patient’s
recovery and resumption of normal daily activities (e.g., work, school,
Parkinson’s disease is a progressive movement disorder caused by the
death of cells in areas of the brain that control movement and coordination.
The core symptoms of Parkinson’s disease include tremor, slowness in
initiating and executing movements, muscle stiffness, and poor
balance/unsteadiness. Some individuals with Parkinson’s disease also
experience other neurobehavioral changes, including depression and
cognitive alterations. A neuropsychologist can play an important role in
evaluating these mood and/or cognitive changes over time to help guide
possible directions for optimal treatment and management of Parkinson’s
Vascular Cognitive Impairment /Vascular Dementia
Individuals with a history of high cholesterol, hypertension, obesity,
atherosclerosis, and smoking are at increased risk for developing
cerebrovascular disease and changes in the structure of blood vessels
inside the brain. At one end of the continuum, vascular cognitive
impairment can emerge from these risk factors and manifest in subtle
cognitive problems with learning and memory, attention, and/or information
processing. At the other end of the spectrum, more severe cognitive
dysfunction may be present, suggestive of vascular dementia, which often
can evolve out of a history of large vessel strokes, isolated cerebral
infarctions affecting critical brain regions, cardiac arrest (and resulting
depletion of blood supply to the brain), and/or widespread small-vessel
disease. Neuropsychological evaluations can provide essential information
to individuals, family members, and treatment providers who are seeking
clarity in terms of diagnostic considerations. In addition, formal assessment
will explore emotional factors and what supports and individual has to
inform appropriate referrals for treatment and ongoing management. In
addition, neuropsychological evaluations are necessary to accurately
monitor for changes in cognitive and functional status over time.