Clients often ask what comes next after neuropsychological assessment. For some people, having a diagnosis or an understanding of what is going on for them is enough. Others require more intensive follow up and guidance with remediation of their difficulties and/or implementation of strategies to help them overcome their cognitive difficulties. Sessions can be arranged to cover the following topics: psychoeducation for both client and carer about their cognitive problems, lifestyle factors that might affect their thinking, an understanding of how the brain works and the effects of other medical or psychiatric conditions on thinking; assistance with implementation of strategies to overcome cognitive problems (e.g. practical guidance of diary/calender use, use of alarms and reminders on a mobile phone etc); guidance with cognitive remediation through use of computer games, internet-based software programs specifically for enhancing cognitive skills and other activities that improve cognition. This usually takes between 4 and 6 sessions, depending on the client’s needs. Medicare rebates may be available if clients are under a Mental Health Care plan with their GP. Private health insurance rebates are usually available for people with extras cover.
Dementia: articles on this topic
Rehabilitation and Remediation
Monday, October 26th, 2009Decision Making Capacity
Tuesday, January 6th, 2009Sometimes people with a disorder affecting brain functioning (e.g. dementia, brain injury, intellectual delay, stroke) can have problems reliably making decisions about important issues such as whether they are capable of managing to live independently, whether they should be driving, whether they should undergo a medical procedure, financial management or even making a will. This is especially the case if they do not realise they have a problem with their thinking.
Neuropsychological assessment of decision making capacity is often carried out when such concerns are raised. They can form part of an application for Guardianship or Financial Management made through the Guardianship Tribunal. Solicitors with concerns about their clients capacity to make a will or decide on Enduring Guardianship or Power of Attorney may request an assessment to ensure their client can sign such a document.
In addition to the neuropsychological tests being administered and interpreted, the individual being assessed is questioned about the relevant issue to gauge whether they have remembered the relevant information, can weigh up the pros and cons of the decision and can accordingly make a decision with adequate judgement and reasoning.
If you have concerns about someone’s capacity to make such a decision, please talk to their treating doctor or their solicitor, as appropriate, to see whether neuropsychological assessment is warranted.
What is neuropsychological assessment?
Wednesday, December 17th, 2008Neuropsychological assessment is the detailed examination of cognitive skills (such as memory, attention, processing speed and problem solving), in order to examine brain-behaviour relationships.
The assessment involves paper and pencil type tests, as well as practical problem solving tests and the answering of questions. There are often some questionnaires to complete also. The tests used are standardised (i.e. given to a sample of people without brain impairment to provide a comparison) and well researched. None of the tests are physically invasive. Generally, assessments take between 3 and 5 hours (including interview and rest breaks), depending on the purpose of the assessment.
Skills assessed often include:
- Intelligence (IQ)
- Memory
- Attention/concentration
- Thinking speed
- Spatial skills
- Language
- Higher level executive functions (e.g. problem solving, planning, reasoning)
- Emotional/psychological functioning
- Academic skills (e.g. reading, spelling, maths)
After completing the tests, the individual’s test scores are then compared to people of similar age and background in order to determine whether there are any cognitive problems, and how severe they may be. The pattern of results across tests are then analysed and combined with background information about educational, occupational, social and medical history to either exclude or diagnose brain-related medical disorders and/or explain the consequences of such a disorder.
Worried about dementia?
Monday, December 1st, 2008Often people are referred to a Clinical Neuropsychologist after expressing concerns about developing dementia to their GP, neurologist or psychiatrist, who then feel further evaluation is warranted. A neuropsychological assessment is more likely to pick up early symptoms of dementia, especially if the problems are mild, but it may also put your mind at ease if no problems are found. There are some reversible causes of memory problems that might be picked up, such as stress or depression. Some people worried about dementia are often just experiencing age-related memory decline, which is normal (we all get more forgetful as we get older). The assessment also provides an accurate baseline of cognitive ability to allow for comparison if further testing down the track is required. However, prior to booking a neuropsychological assessment, please discuss your concerns with your GP or other medical specialist.
Recently in the news…
Monday, December 1st, 2008Gingko biloba not helpful in preventing cognitive decline
http://www.smh.com.au/lifestyle/wellbeing/herbal-memory-aid-a-dud-20100202-naiw.html
Fatty foods linked to Alzheimer’s
http://www.abc.net.au/news/stories/2009/09/04/2676540.htm?site=perth
Does brain training really work?
http://news.bbc.co.uk/2/hi/uk_news/8237945.stm
It is not so much about the brain training program you choose, but rather than general stimulation you engage in, regardless of the source
http://news.bbc.co.uk/2/hi/health/7912379.stm
Staying Sharp: Can you prevent Alzheimer’s disease?
http://www.time.com/time/magazine/article/0,9171,1147142,00.html
Memory and exercise
http://www.abc.net.au/science/articles/2008/09/03/2353939.htm
Reducing your risk of dementia by exercising
http://www.medscape.com/viewarticle/521660
Reducing your risk of dementia by doing crosswords
http://www.abc.net.au/health/talkinghealth/factbuster/stories/2008/03/05/1965056.htm
New medication for Alzheimer’s disease
http://www.abc.net.au/news/stories/2008/07/30/2318295.htm
Common memory concerns
Monday, December 1st, 2008People often experience memory lapses in day to day life, especially if they are very busy or stressed about something. Such lapses might include losing your keys, going to a room to get something and forgetting why you were there, losing your train of thought during conversation, forgetting what you just read, or forgetting to pass on a phone message.
It is often difficult for people to distinguish between what is normal, and what might be the start of something more worrying. This is where more in depth assessment of memory can be useful. If you are concerned either about yourself or a loved one, please speak to your GP to see whether neuropsychological assessment might be right for you.