Anatomy of the Neuropsychological Report
I will never forget the moment I fully understood just how impactful a neuropsychological evaluation can be on a child’s trajectory. I was attending a didactic as a practicum student at UCLA’s Semel Institute and was eager to hear the presenter. That day, a parent of a child with medulloblastoma, an aggressive childhood brain cancer, was scheduled to speak.
I listened attentively as she shared the initial symptoms of her then 3-year-old son. I listened as she described the horror she felt when her child’s diagnosis was given by an insensitive medical resident. As she detailed helpful behaviors from healthcare professionals. And as she outlined the developmental challenges her son faced after a combination of chemotherapy, brain radiation, and resection of the tumor. But one of the most memorable moments for me was when she pulled a crumpled-up packet of papers from her purse, her child’s first neuropsychological report.
There were creases on some of the pages, highlights, and notes in the margins. I was moved as she read excerpts from the report with emotion. She talked about the hope she felt from the evaluation’s identification of her child’s strengths and its plan of action to address his weaknesses. But the report was also a catalyst for educational services. It provided leverage for securing school accommodations based on objective evidence. I have carried that parent’s story with me for over a decade and it has shaped the way I think, listen, and practice.
What is a Neuropsychological Report
A neuropsychological report is not just a regurgitation of scores. It tells a story about a person’s strengths, challenges, and emphasizes why things may feel hard. It is designed to help understand a person’s unique profile, empower individuals and their families, and give clear next steps. My intention is to structure reports in a way that is clear and accessible. Below, I break down the key sections of the neuropsychological report.
Reason for Referral: This section defines the mission. It explains the questions we are trying to answer. Maybe you or your child were referred due to concerns with learning difficulties, memory problems, trouble focusing, or challenges with just managing daily life.
Background: This section is your brain’s origin story. It describes your medical history, school or work experience, mental health, medication history, developmental milestones, and socioeconomic situation.
Observations: This section explains how you looked during testing. It is the behind-the-scenes footage of your brain’s performance because context matters. This section describes your mood, motivation, behaviors, physical appearance, and any other thing that stood out during the appointment.
Test Results: Here is where we crunch the numbers and dive into what the tests showed. We describe what is working well and what isn’t working.
Impressions: This section connects the dots to give the big picture. It is the bread and butter of the report and what most referring providers hone in on. We bring everything together from the evaluation, explain your strengths and weaknesses, and give a diagnosis when warranted.
Recommendations: What now? This section gives practical advice and strategies based on the results. This could be school accommodations, therapies (e.g., speech and language therapy), home-based behavior strategies, counseling, etc.