Neuropsychological versus School-based Evaluation: What’s the Difference?

Your child has been referred for a neuropsychological evaluation, but you have no idea what that means
or what it will lead to. This is a commonly encountered scenario when I meet with parents and other
caregivers in my office for an initial clinical interview. Parents can be understandably hesitant or unsure,
especially if they have been referred by a member of their child’s treatment team, and be particularly
unclear about how a neuropsychological evaluation can differ from the evaluation that was recently
completed at their child’s school. There are several primary differences between what your child would
receive through a school evaluation (often called a psychoeducational or special education evaluation)
and a neuropsychological evaluation by a board certified neuropsychologist.
First, a school evaluation is almost always designed to identify whether your child meets eligibility
criteria for special education services under one of the numerous categories. Among the thirteen
categories are Specific Learning Disability (SLD); Autism (AU, which encompasses all levels of Autism
Spectrum Disorder); and Other Health Impairment (OHI), which can be appropriate for children with
Attention-Deficit/Hyperactivity Disorder (ADHD), epilepsy, and other brain-based conditions that can
impact learning. Second, school evaluations are completed to determine what services,
accommodations, supports, and modifications are necessary to facilitate a child’s success in the school
environment. Indeed, a school evaluation may include a wide variety of assessment measures, typically
administered by licensed professionals such as speech therapists, occupational therapists, physical
therapists, and school psychologists. Some evaluations may be quite brief and consider only needs
related to speech articulation and/or language functioning, while others may be extensive and consider
many domains of functioning. That said, this type of evaluation can certainly be helpful, but may be
quite limited in depth and breadth.
A neuropsychological evaluation, particularly those completed by board certified neuropsychologists, are
designed to address three primary areas of need: clarification of diagnoses (if any), delineation of
neuropsychological strengths and weaknesses, and assistance in any kind of treatment planning.
Treatment planning may be as simple as the need for medication support and as complex as the possible
ramifications of neurosurgery for someone with a brain tumor or unrelenting seizures. Should a child
have ADHD, understanding whether other factors are exacerbating the symptoms can be quite helpful,
especially when medications are being considered along with therapeutic interventions. Should there be
concern for memory problems, a neuropsychological evaluation can determine to what degree such
memory problems exist on their own or are a function of other issues, such as depression,
motivation/effort, or medical factors. In the end, the measures utilized by a neuropsychologist may be
the same as those that could be used by school assessment personnel; however, it is the interpretation
of the results from those tests in light of the full context from which a child lives that sheds greater light
on the situation and can yield greater utility from the evaluation results.

Author Bio