“I think my child has AD/HD and her pediatrician wants her to have a neuropsychological assessment. Is this something you do?”
“My child is struggling with reading, but his child study team won’t evaluate him because he is not failing his classes. A friend of mine who is a psychologist recommended he receive a psycho-educational assessment. Can these be done outside of school?”
“I’m struggling. I’ve seen a number of therapists and psychiatrists over the years and despite counseling, therapy, and medication, I don’t feel like I’m any closer to getting better. No one can tell me what’s wrong with me or what they’re treating me for. I feel like I’ve been grasping in the dark. My recent therapist suggested I receive a psychological assessment. What does this mean?”
The terms psychological, psycho-educational, and neuropsychological assessment are often used interchangeably, but involve different approaches by different psychologists with different training.
Each type of assessment is designed to understand the underlying causes of an individual’s presenting issues to assist in identifying causes and/or guiding intervention. However, the nature and breadth of each assessment can be very different depending on the referral question. Often, referral sources, prospective patients, or their caregivers are not aware of these differences and are unclear of the services they need and who can provide them.
First, let’s draw distinctions among the types of professionals who conduct these assessments, specifically, licensed psychologists, neuropsychologists, and school psychologists.
In New Jersey, a licensed psychologist is an individual with a doctoral degree (Ph.D., Psy.D., or Ed.D.) who graduated from an accredited institution and completed an internship to qualify for licensure through examination. Only licensed psychologists can refer to themselves as psychologists outside of exempt settings (schools, hospitals, etc.).
Some licensed psychologists refer to themselves as child or clinical psychologists based on their training. Licensed psychologists typically work outside of schools and in hospitals or in private practices. Though most licensed psychologists have had exposure to and some training in psychological testing and assessment, not all regularly conduct testing and assessment and may not be up to date on contemporary practices or current instruments.
Typically, licensed psychologists who specialize in psychological testing and assessment have had more intensive training within their program or post-doctorally. (Side note: psychological testing usually refers to the administration of one or several individual instruments in the absence of an integrated report while psychological assessment is much more comprehensive and in-depth, as described below).
A neuropsychologist is a licensed psychologist who has specialized training in neuropsychology which includes post-doctoral training on brain-behavior relationships including neurocognitive (brain functioning) and psychological and health factors.
A neuropsychologist uses knowledge of brain development, brain organization, and the effects of various forms of brain injury on development to guide this assessment and to interpret the results. Damage to brain functioning could be due not only to organic (physical) injury (e.g., a severe blow to the head, stroke, chemical and toxic exposures, organic brain disease, substance abuse, etc.) but also to non-organic means such as severe deprivation, abuse, neglect, mental disorders, and severe psychological trauma.
Neuropsychologists also typically work outside of schools and in hospitals or in private practices.
Both licensed psychologists and neuropsychologists are trained in testing and the process of assessment to identify and diagnose specific neurodevelopmental disorders (e.g., AD/HD, Autism Spectrum Disorder, Specific Learning Disabilities, Intellectual Disability, etc.) or psychological disorders (mood or anxiety disorder, conduct disorder, etc.). Neuropsychologists have additional specialized training on the effects of brain damage and organic brain disease and are uniquely qualified for testing and assessment in these areas.
A school psychologist in New Jersey is someone with either a master’s degree (M.A. or M.S.), Ed.S., or doctorate, who has completed coursework and internship within a school to qualify for certification as a school psychologist.
School psychologists do not practice independently outside of a school. Some school psychologists with doctoral degrees may qualify for licensure as a licensed psychologist and choose to also practice outside school settings. School psychologists are usually members of a child study team within a school district which is an interdisciplinary team composed of learning disability specialists, social workers, and others, who assist in identifying and classifying children for eligibility to receive special accommodations or services as part of an individualized education plan (IEP) or Section 504.
School psychologists working within a school system cannot provide diagnoses for a particular condition and often have a limited scope regarding their role within the child study team, which usually involves intelligence testing. However, school psychologists, as part of their training, usually have familiarity with many of the instruments used by licensed psychologists and neuropsychologists.
Now, for the different types of assessments.
Psychological Assessment is the process of identifying and diagnosing specific neurodevelopmental or psychological disorders by obtaining a detailed history of an individual’s developmental, medical, social, school, and psychological functioning in conjunction with behavioral observations and the administration of psychological testing instruments relevant to the referral question for treatment.
Psychological assessments in an outpatient or hospital setting are performed by licensed psychologists or neuropsychologists.
Psycho-educational Assessment is the process of administering measures of academic achievement, general cognitive abilities, and other relevant measures, to identify and remediate how specific neurodevelopmental or psychological disorders may be impacting learning.
These assessments seek to understand a child’s learning style and then guide the development of classroom accommodations and supports from an educational perspective. When they are conducted within the school setting, the purpose is to determine whether or not a student qualifies for special education services and accommodations for a specific learning disability as mandated by federal law and not to diagnose disorders or their underlying causes. School psychologists are an integral part of this process as part of a child study team which includes input from other professionals such as learning disability specialists, social workers, and others.
Psycho-educational Assessments are also conducted by licensed psychologists or neuropsychologists outside a school setting. Here, the licensed psychologist or neuropsychologist administers instruments that would have been administered by members of a child study team, including measures of intelligence, academic achievement, speech and language, and others, based on the referral question. Results are then compiled into an integrated report which provides diagnoses (if applicable) and recommendations for intervention. The report is then shared with the child study team to assist them in determining eligibility for special education services and accommodations.
Neuropsychological Assessment is the process of understanding the relationship between behavioral, cognitive, and functional deficits and underlying brain functions by focusing on learning and behavior in relation to an individual’s brain by administering standardized, norm-referenced tests and behavioral observations and incorporating knowledge of brain development, organization, and functioning into the evaluation findings.
Neuropsychological assessment typically includes psychological and psycho-educational testing components but are exclusively conducted by licensed psychologists who identify as neuropsychologists based on their education and training.
How am I to know which type of assessment is right for me or my loved one?
As mentioned above, referral sources, prospective patients, or their caregivers, may not be aware or may be unclear of the services they need and who can provide them. By discussing the types of psychologists and assessments that are involved in these referrals, you can appreciate that assessments for many neurodevelopmental or psychological issues are not entirely exclusive to licensed psychologists or neuropsychologists. That is, licensed psychologists and neuropsychologists often conduct assessments for common neurodevelopmental and psychological disorders including AD/HD, learning disorders, autism spectrum, etc.
Neuropsychological assessments, however, are nearly always conducted by licensed psychologists who identify as neuropsychologists based on their education and training and are preferred for referrals where there is suspected damage to brain functioning due to organic injury.
Finally, can Dr. Kot help me with these issues?
Dr. Kot received his doctorate in Combined Clinical and School Psychology and completed internships in both a clinical and a school setting. His education, training, and clinical practice provide for a well-grounded and unique approach to a variety of neurodevelopmental and psychological disorders whether in an educational or clinical setting. Read more about his background and experience.
If you are uncertain of or need clarification about which assessment is right for you, the best approach would be to contact Dr. Kot with your questions. He will be happy to provide you with the information you need to make an informed decision.
