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Michael N. Fulco, Ph.D.
CLINICAL NEUROPSYCHOLOGIST
Services

 

       I. Consultation 


Involves interviews, records review, and integration of information from collateral sources such as family, schools, and other treating professionals. Consultation may be required to determine if testing is necessary or if referral to other professionals or agencies is more appropriate. It can also be used to define the purpose of an evaluation and to frame questions. 

II. Neuropsychological Evaluation

This evaluation provides a systematic assessment of all cognitive processes designed to develop a complete profile of an individual's functioning that is informed by brain-behavior relationships. In other words, the goal is to reach a thorough understanding of how a person's brain works, so as to delineate strengths and weaknesses. The test findings are interpreted from a point of view that integrates the individual's unique personality characteristics, including sense of self and coping style. Neuropsychological evaluation includes the following:


Intelligence
Establishes a baseline of intellectual abilities, including strengths and weaknesses.

Executive Functions
Assesses reasoning, concept learning, planning, anticipating, and organizing. Answers questions such as: Are there any issues with problem solving; that is, are there problems learning from experience, maintaining flexibility, shifting gears, generalizing, applying, or carrying over new learning? Are planning, prioritizing, or organizing overly challenging? Any difficulty keeping track of more than one thing at a time mentally, or controlling and directing mental operations? 

Attention 
Evaluates all forms of attention. Ability to sustain attention, maintain execution (processing) speed, control attention, and divide attention. Related functions assessed include inhibiting and short-term memory/working memory. 

Memory
Examines verbal and nonverbal memory and is especially important to determine if there are problems in retaining what is newly learned. 

Language and Academic Skills
Assessment of expressive and receptive language, including use of language pertinent to academic deficits. Evaluation of learning disabilities, including delineation of dyslexic and dysgraphic syndromes (reading and writing disabilities) and mathematics disabilities. 

Perceptual and Motor Functions

Sensory, visual-perceptual, and visuo-spatial abilities are assessed, as well as fine motor control, motor planning, and visual-motor integration functions.

Emotions, Behavior, and Personality 
The findings are integrated with an understanding of the individual's personality derived from interviews, self-report inventories, and behavior rating scales. Comprehensive psychological testing is not typically included as part of the neuropsychological battery, but may be ordered if necessary (see the description of psychological evaluation below on this page). 


III. Psychological Evaluation 


Psychological evaluation may be requested as a supplement to neuropsychological testing, or as a primary assessment tool to assist in diagnosis and treatment. It may be included in the neuropsychological evaluation when the information obtained from behavioral surveys, interviews, and self-report inventories is insufficient to lead to an understanding of the client's treatment or educational needs. Referral for psychological testing is usually initiated by mental health providers seeking consultation for treatment planning, but may also be sought by individuals, parents, or agencies in search of guidance for treatment, educational, or vocational planning.


There are two components to the evaluation: (1) cognitive (if no neuropsychological testing has been done) and (2) emotional/psychological. The cognitive portion typically involves an intelligence test that samples a spectrum of cognitive abilities. The psychological component of the evaluation includes an interview and test procedures of two distinct types. Some are in the form of questionnaires or survey forms. The other types of procedures are open-ended or "projective" tests which ask the individual to respond in his or her unique way to pictures or other visual materials, and to complete drawings which may convey something unique about him/her. The psychological testing is useful to determine emotional status and typically includes the following:

 

  •      Assessment of symptom presence and severity (such as anxiety and depression)
  •      Judgment
  •      Capacity to evaluate situations realistically
  •      Resiliency, extent of development of coping resources
  •      Thought organization and content
  •      Capacity for interpersonal relationships
  •      Psychiatric diagnosis

 


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