Services

Understanding neuropsychological assessment

A neuropsychological assessment is a detailed evaluation of thinking skills such as memory, attention, language, processing speed, and problem-solving.

Judging whether cognition is impaired requires us to —

• Estimate what an individual’s baseline or previous cognitive functioning likely was. This relies on their educational, medical, psychological, and employment history.
• Measure their current thinking skills in a standard way, to compare them to others of the same background (e.g., age, education).
• Evaluate personality and psychological factors, as these shape cognition; then
• Integrate the person’s history, test profile, and psychological factors with knowledge of neurological and psychological disorders.
• Use this information to explain the causes of any cognitive difficulties and determine whether a diagnosis is appropriate.

The key outcomes of assessment are objective statements about cognitive abilities, and any diagnoses. Generally, psychologists diagnose conditions listed in the DSM-5.

Some examples of diagnoses include ADHD, learning disorders, memory disorders, post-concussive symptoms, effects of epilepsy or brain injury, depression/anxiety-related cognitive difficulties, mild cognitive impairment, and dementia.

Common reasons for referral are outlined in Common referral questions on the referral page.

The following video provides additional detail.

What the assessment involves

The assessment process generally involves the following steps:

• Taking a detailed clinical interview, usually over Zoom;
• Reviewing relevant medical and background records;
• Cognitive testing, usually in person;
• Scoring and interpretation of results;
• Integration of the findings with your history and concerns;
• Formulating a comprehensive written report; and
• A feedback session to review the findings and recommendations together, usually over Zoom.

The larger portion of this work occurs behind the scenes in reviewing records, interpreting the test data, formulating clinical impressions, and preparing the written report. Assessment at Sparrow is completed by Dr. Christopher Benjamin, a neuropsychologist and Associate Professor (Adjunct) at Yale University School of Medicine with over 15 years of clinical experience in hospital, academic, and epilepsy/neurosurgical settings.

Some assessments require additional time or services depending on complexity, extensive record review, or urgent timelines. If this applies, it will always be discussed in advance.

Fees

Every assessment is tailored to the individual’s needs. The time required depends on the referral question, the complexity of the history, the amount of collateral information to review, and the preparation of the written report.

My professional fee is $250 per hour. Most evaluations have a typical time range, allowing an estimated total fee to be discussed before the assessment begins. Any adjustments to the estimated fee are discussed in advance.

There is no difference in the quality of care provided. Reduced fees, when available, are discussed individually and do not affect the thoroughness or quality of the evaluation.

Insurance and payment

• Neuropsychological assessments are services provided by a psychologist.
• Payment is by e-Interac transfer.
• Assessment is generally paid privately, with support from extended health benefits or third-party funding. Extended benefits coverage most often ranges from partial to full reimbursement, depending on the plan.
• Assessment is not typically covered by MSP, as MSP generally does not cover psychological assessment or treatment services.
• A limited number of reduced-fee appointments are available in cases of financial need. If cost is a barrier, please email to discuss this.

Assessment timeline

1. Interview (1–1.5h) — We review your history and concerns with you, typically over Zoom.
2. Testing (4–6h) — We complete tasks and questionnaires to measure your thinking skills the following day, and potentially a second day/session. Testing is typically in person.
3. Feedback (1h) — We meet to provide the results to you around 3 weeks post-assessment, typically over Zoom. The results are also forwarded to you and your referring clinician in a written report.

Preparing for your assessment

Before your appointment:

• Confirmation details will be sent to you via secure email.
• You will receive the assessment consent form to review.
• You will be asked to gather and forward relevant medical records. Providing records — such as a referring clinician’s reports, neurologist or specialist notes, MRI / CT / EEG results, prior cognitive testing, and hospital discharge summaries — allows for a more accurate assessment. See how to request your medical records in British Columbia for help gathering them.

On the days of assessment we will work together to get a good picture of your thinking skills. You do not need to prepare in any significant way. That said, please do —

• Avoid alcohol and marijuana for 24 hours prior to the assessment.
• Check that you reviewed and completed the consent form.
• Bring snacks and something to drink. We will take breaks throughout as needed.

In an assessment you really do simply need to show up and be yourself. Some of the tasks we do will be so simple they’ll seem trivial; conversely, some will be too difficult. This is the normal experience of an assessment, as our tasks have to be useful with people of every ability level. All you need to do is apply your best effort and do what you can.

Don’t hesitate to send any questions through by email before your appointment.