TestingWhat Is a Neuropsychological Evaluation? What it is, what happens, and how to use the results at home and at school.

A regular psychological evaluation usually focuses on mood, behavior and emotional health. It often answers questions like: Is this depression? Is this anxiety? It may use interviews, questionnaires and a few tests.

A neuropsychological evaluation goes further into thinking skills. It measures things like attention, memory, processing speed, language, reasoning, reading, writing, math and executive function (planning, organizing, starting and finishing tasks). It also looks at mood, because anxiety or depression can change how well someone thinks on a given day.

The goal is a clear picture of how a brain works in real life. That picture helps explain why a smart student is struggling, or why an adult keeps hitting the same wall at work.

The best way to know what you are getting is to ask the provider what questions the evaluation will answer and which areas it will test.

Families often look into testing when they notice a pattern like these:

• Grades drop or stay low even with real effort.
• Homework takes hours, or work is started but rarely finished.
• Reading, writing or math feels much harder than it should.
• Focus, forgetfulness or disorganization keep causing problems.
• Anxiety or low mood seems tied to school or work stress.
• A student needs proof of a diagnosis to ask for accommodations.
• Past treatment has not helped, and no one is sure why.

Testing can help sort out overlapping causes. For example, trouble focusing can come from ADHD, anxiety, depression, poor sleep, a learning difference, or several of these at once. Each one calls for a different plan.

Adults benefit too. Many adults were never tested as kids and want to understand lifelong patterns, or need documentation for a college or a licensing exam.

The interview. The provider meets with the person being tested, and with parents if the client is a teen. They ask about the main concerns, development, school history, health, sleep, mood, family history and past evaluations. Parents and teachers may also fill out rating forms.

Testing sessions. This is the longest part. The person works one-on-one with the evaluator on a mix of tasks: puzzles, word and memory tasks, reading and math problems, timed tasks, and questionnaires. Some tasks feel easy and some feel hard. That is on purpose. Tests are built so that almost no one gets everything right. Testing commonly takes several hours in total and is often split across more than one day so the person does not get worn out. Breaks are normal.

Feedback. After scoring and writing, the provider meets with the family to explain the results in plain words. This is the time to ask every question you have. A good feedback meeting should leave you knowing what was found, what it means, and what to do next. A written report usually follows within a few weeks, though timing varies.

• Gather records: report cards, past test reports, any IEP or 504 plan, teacher comments, and relevant medical records.
• Write down your main concerns and a few real examples. Specific moments are more useful than general worries.
• Aim for a good night of sleep and a normal breakfast on testing days.
• Bring glasses or hearing aids if they are used, plus water and a snack.
• Ask ahead of time whether to take usual medications on testing days. Do not stop or change any medication without talking to the prescriber.

For teens, explain the testing simply and calmly. It is not a pass or fail test. It is a way to learn how they learn best.

If alcohol or other substance use is part of the picture, be honest with the provider. Stopping alcohol or benzodiazepines suddenly can be medically dangerous, so talk to a doctor before making any change.

A typical report includes the reason for testing, background history, the tests used, scores and what they mean, any diagnoses, and a list of recommendations. The recommendations are often the most useful part.

Recommendations might include things like extended time on tests, a quiet testing room, breaks, notes provided in class, reduced homework load, tutoring in a specific skill, or therapy for anxiety. They may also suggest a medication consult or follow-up testing in a few years.

For K to 12 students in public school, families can share the report with the school team when asking about a 504 plan or an IEP. Schools are required to consider outside evaluations, but they make their own decisions and may do their own testing. Colleges have disability services offices that review documentation for accommodations. Testing organizations like the College Board have their own documentation rules, so check them early.

Keep a copy of the full report. Share only what is needed: some families give schools a summary or the recommendations section rather than every page.

• What is your training, and how often do you test people this age?
• What questions will this evaluation answer? Does it cover ADHD, learning differences, mood and anxiety?
• Which areas will you test, and roughly how long will testing take?
• Will the report work for school, college or testing accommodations?
• Will there be a feedback meeting, and can the teen attend part of it?
• How long until we get the written report?
• Will you talk with the school or other providers if we give permission?
• What are the fees, and will you provide paperwork for insurance?

For more on payment, see our guide to paying for addiction and mental health treatment.

This kind of test, often called pharmacogenomic testing, usually uses a cheek swab or a blood sample. It looks at genes that affect how the body processes certain medications, including some used for depression, anxiety and ADHD. Results may suggest that a person breaks down a medication faster or slower than average.

Gene testing does not diagnose anything, and it does not pick the right medication by itself. It is one tool a prescriber can weigh along with history, symptoms and response over time. Blackburn Clinical Services offers both neuropsychological testing and gene testing, along with psychiatric evaluation and medication management, therapy and family coaching for adolescents and adults.

• American Psychological Association: Testing and Assessment
• US Department of Education: Disability Discrimination and Section 504
• US Department of Education: IDEA
• FDA: Table of Pharmacogenetic Associations
• MedlinePlus: Pharmacogenetic Tests

Write down what you are seeing, gather school records, and talk with your child’s school or doctor about your concerns. If you are not sure whether testing, therapy, mentoring or something else fits best, our Where to start page can help, and so can the guide on case management, mentoring or therapy. Parents can also find more on our families page.

You can call The Blackburn Group at (888) 305-5422 or email info@theblackburngroup.org.

If you or someone you love is in crisis, call or text 988 to reach the 988 Suicide and Crisis Lifeline. In an emergency, call 911.

Related help in Los Angeles: Neuropsychological testing in Los Angeles. Or call (888) 305-5422.

• ADHD Evaluation for Teens and Adults
• What Happens at a Psychiatric Evaluation
• Signs a Teen Needs Mental Health Support

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