Neuropsychology

Dr JC Coetzee provides Neuropsychological assessments and treatment in Centurion, Gauteng and Mossel Bay, Western Cape on request. The Neuropsychology assessments include Neuropsychological Screening Evaluations (NSE) and Comprehensive Neuropsychological Evaluations (CNE).

A Neuropsychological Screening Evaluation (NSE) is a short form neuropsychological evaluation that screens for neuropsychological deficits in the following domains: Attention/ concentration, processing speed, language, visuospatial, psychomotor, executive functions, memory as well as soft signs of neurological impairment. It is designed to within a short space of time give an indication if there are signs of possible neuropsychological impairment and in which domains the impairment is likely to be present. If the possibility of neuropsychological impairment is indicated through the Neuropsychological Screening Evaluation (NSE) a Comprehensive Neuropsychological Evaluation (CNE) can be done to provide more specific and in depth information on the neuropsychological impairment that is present.

A Comprehensive Neuropsychological Evaluation (CNE) is essential in the diagnosis of cognitive disorders. A Comprehensive Neuropsychological Evaluation (CNE) consists of a battery of neuropsychological tests through which one can acquire data about an individual’s cognitive, motor, behavioural, linguistic, and executive functioning. This information can lead to the diagnosis of a neuro cognitive disorder or deficit or to the confirmation of a diagnosis, as well as to the localization of organic abnormalities in the central nervous system (CNS). The information can also guide effective treatment methods for the rehabilitation of impaired individuals.

There are several specific uses of neuropsychological assessment, including collection of diagnostic information, differential diagnostic information, assessment of treatment response, and prediction of functional potential and functional recovery

Please email us to request a quote for a Comprehensive Neuropsychological Evaluation (CNE) or to schedule a Neuropsychological Screening Evaluation (NSE) consultation.

When should a patient be referred for a Neuropsychological evaluation?

Patients are referred for a neuropsychological evaluation for a number of reasons. A person may be experiencing mild to severe changes or difficulties in their cognitive functioning (thinking, memory, speech, attention, concentration, reasoning ability), personality, or other behaviours that interfere with their normal day-to-day functioning. These kinds of changes or difficulties are often described as:

  • Forgetting conversations or losing articles around the house (memory)
  • Difficulty focusing on a task or being easily distracted (concentration)
  • Changes in ability to make sense of maps or drawings or making sense of what you see
  • Not being able to read as well as in the past or not being able to read what you have written
  • Thinking thoughts that are not logical, forgetting or not recognizing where you are, or not remembering what day or time it is (orientation)
  • Having trouble coming up with the name of a common object, using the wrong word, or decreased fluency when speaking
  • Saying things you would not normally say or noticeable changes in patience
When is a Neuropsychological evaluation recommended?

A neuropsychological evaluation is recommended when a patient suffered a brain related illness or injury. An illness or injury to the brain can cause a sudden decline in a patient’s cognitive functioning and abilities. The following conditions may require a neuropsychological evaluation:

  • Neuropsychiatric disorders
  • Dementia (including Alzheimer’s Disease)
  • Multiple Sclerosis
  • Seizure Disorders
  • Stroke or other neuro-vascular problems
  • Brain Tumors
  • Attention Deficit Disorders
  • Central Nervous System Infections
  • Traumatic Brain Injury (TBI)
  • Severe chronic substance abuse
What is the purpose of a Neuropsychological evaluation?

Neuropsychological evaluations have a number of important functions. They can:

  • Establish a patients level of neuropsychological functioning before problems are readily apparent and assist with interpretation of possible changes that may show in future neuropsychological evaluations
  • Identify problems related to medical conditions that can affect memory and thinking, such as diabetes, metabolic or infectious diseases, or autoimmune disorders
  • Differentiate among illnesses that have similar clinical presentations, e.g., Alzheimer’s, depression or stroke
  • Aid in the planning of interventions and treatments where cognitive functioning is found to be impaired

Neuropsychological evaluations are designed to measure patterns of strengths and weaknesses in cognitive processing. Neuro Cognitive domains include Attention, Concentration, Learning, Memory, Problem Solving, Planning and Reasoning.

Other useful applications on a Comprehensive Neuropsychological Evaluation (CNE) include: treatment planning for cognitive rehabilitation; evaluation of learning and academic abilities; legal proceedings; and evaluation of vocational abilities.

What happens at a Neuropsychological evaluation?

The neuropsychological evaluation involves a number of different tasks and tests, most of which are done sitting at a table. The evaluation will be guided by the referral questions with regards to a patient’s neuropsychological functioning.

Firstly a clinical interview will be conducted with the patient that will cover the patient’s mental state, their medical, psychiatric and family history as well as their educational background and past cognitive functioning.

The neuropsychological evaluation will assess a number of cognitive abilities: problem solving, attention, memory, language and motor skills. Evaluations typically extend over a 4-8 hour period, including an interview. Testing is broken up into several shorter tasks so there is plenty of time to stop or take a break. The amount of time required for each test ranges from a couple of minutes to about 15 minutes. Areas that may be evaluated include:

  • Attention
  • Executive Function
  • Language
  • Sensory-motor Functioning
  • Learning and Memory Functioning
  • Personality
  • Social-Emotional Functioning

It is important to understand that a neuropsychological evaluation involves a specific series of tests. Specialized training allows a clinical neuropsychologist to select, administer, and interpret the tests and procedures that will provide the most comprehensive understanding of an individual’s neuropsychological strengths and weaknesses. Each evaluation is specific to the needs and clinical history of the patient.

The Comprehensive Neuropsychological Evaluation (CNE) also requires the clinician to review medical records, score the tests, write a report of the evaluation, and to spend time with the patient providing information and feedback from the evaluation.

What happens after a Neuropsychological evaluation?

The results of the neuropsychological evaluation are used in conjunction with neurological and other medical evaluations as part of clinical decision making. A patient’s test scores will be compared to scores from large groups of healthy people who share similar key attributes so we can judge whether or not the patient’s scores fall within the normal range for their age and educational background, and to help determine their unique strengths and weaknesses.

Frequently the patient will return a few months later to receive additional help integrating and/or tracking progress or other changes; the pattern of your their test scores helps the neuropsychologist estimate whether or not there have been changes in any of the patient’s cognitive abilities.

How will the Neuropsychological test results be used?

The results of the neuropsychological evaluation can provide an accurate formulation on a patient’s neuropsychological functioning including the domains and severity of cognitive impairment, strengths and weaknesses. These results can help other medical professionals understand the nature and causes of changes in the patient’s cognitive abilities, and the extent to which the changes are affecting the person’s functioning. The neuropsychological assessment findings can also help the patient to understand their own and weaknesses with reference to their cognitive functioning.

The findings of a neuropsychological assessment can be useful in the following context:

  • Occupational abilities
  • Court proceedings where strengths functioning is in question
  • Career guidance based on cognitive abilities
  • Rehabilitation after illness or injury
  • Guidance of care and treatment programs after brain injury or neurological illness

Dr JC Coetzee is a Clinical Psychologist specializing in Neuropsychology, Forensic Psychology, Psycho-legal Assessment, Cognitive Behavioral Therapy in Tshwane, Centurion, Gauteng, South Africa.