Pediatric or child neuropsychology is a field of study involving the relationship of abilities, behaviors and mental skills (cognitive functions) in children. Clinical, pediatric or child neuropsychology (neuropsych) involves the application of this field to diagnostic assessment and clinical treatment of normal and abnormal child developmental, medical, psychiatric, and neurological conditions or problems. The field shares a knowledge base with other professions. A child or pediatric neuropsychologist may work with other pediatric specialists in behavioral neurology, developmental pediatrics, pediatric neurology, child psychiatry, pediatricians, occupational therapists and speech and language therapists.
Neuropsychologists are licensed as psychologists or in some states neuropsychologists. By definition, in almost all states, these individuals have doctoral degrees from accredited programs by the American Psychological Association usually in clinical psychology or neuropsychology. To be considered a neuropsychologist one must have formal graduate level training and clinically supervised experience in neuropsychology.
Most psychology licensing boards require a year of internship, which may be pre-doctoral as well as one year of supervised residency. Modern definitions of a neuropsychologist now usually require graduate level training and supervision and two years of supervised post-doctoral experience. A psychologist should not hold themselves out as a neuropsychologist with graduate training and supervision in the field. It is generally recognized that taking continuing education courses after licensure is not sufficient.
Neuropsychologists extensive training and supervised experience usually involves normal and abnormal brain anatomy, study of brain diseases and dysfunction, and extensive training in using psychological tests to assess brain functioning. In most states, calling an assessment a psychological assessment or neuropsychological assessment is limited to licensed psychologists. Sometimes unlicensed providers or individuals who may not be specifically trained as rigorously as neuropsychologists may call their assessment reports by other names.
Pediatric or child neuropsychologists have training and experience in applying neuropsychological assessment or treatment techniques to children. Since children mature, they are faced with varying age-specific challenges in terms of their academic and social development. Far more than a simple downward extension of adult neuropsychology, the pediatric neuropsychology involves an understanding of normal and abnormal child development and learning, developmental motor skills, and language disorders as well as diseases associated with children.
Pediatric or child neuropsychologists commonly assess children for attention problems such as Attention-deficit Hyperactivity Disorder (ADHD), learning disorders such as dyslexia or math difficulties, disorders of language and/or coordination difficulties. Evaluations are often more detailed than simply involving ability assessment and assumptions are made about brain-behavior relationships. Evaluations may also involve assessments of Autism Spectrum Disorders which inclue autism, Asperger's Disorder, and Pervasive Developmental Disorder (PDD). Assessments are aso performed to evaluate neurological conditions such as effects of a tumor, anoxia, birth complications, Cerebral Palsy, toxic exposures, head injuries or concussions. They may involve subtle or not so subtle deficits which may be involved with anemia, kidney disease or other metabolic diseases, and the effects of treatments or interventions which may impact on neurological or neuropsychological functions.
Since children’s skills go through periods of rapid change, and they are faced with increasing cognitive and academic demands with each passing year, there is often a need to conduct periodic re-assessments. Some conditions may not impact until later years, such as when facing the multi-tasking demands of middle school, or the increased volume of work and writing demands of high school.
Results of pediatric or child neuropsychology assessments may be used to assist in diagnosis, to assist with educational placement or remediation, clinical treatment planning, rehabilitation, formulating accommodations, disability determinations, determing the effects of medication or surgery, or in rarer cases in matters involving criminal responsibility or criminal competency.
Applications of neuropsychological assessment to legal proceedings or determinations is termed forensic neuropsychology.
When choosing a clinic or neuropsychologist to conduct a neuropsychological evaluation on your child, it is wise to ensure the individual providing or supervising the services is a licensed psychologist with training involving both neuropsychological assessment and with children and adolescents.
Asking how many child or adolescent evaluations are typically completed in a year or month may help you determine the level of experience with children the neuropsychologist or clinic may have. Asking about the extent of supervised experience in child neuropsychology and where this training was obtained is advised along with obtaining information as to the overall number of years of experience. Asking your pediatrician or family doctor for a recommendation is wise.
If a neuropsychologist is or has practiced child neuropsychology or trained in a hospital setting this would generally suggest the individual's credentials have been reviewed and that they likely had training in more serious and rare conditions.
The more assessments a neuropsychologist or clinic conducts, the more likely that the neuropsychologist may use psychometricians or psychology assistants to assist with test administration and scoring. However, the neuropsychologist is always responsible for the interpretating the results and producing a report. The neuropsychologist will always maintain an active role in observing, interacting with, questioning,taking developmental, neuropsychological, and social history, and examining the child.
Providing Neuropsychological and Psychological Assessment for Children and Adolescents for 25 years.
Clinical Psychology Associates of North Central Florida
Neuropsychological assessment is a proven method of evaluation which is sensitive to brain dysfunction even in cases where imaging studies such as CT scans or MRIs cannot find significant abnormality.
Pediatric Neuropsychological Assessment is often critical in assessing the abilities and impairments of childhood traumatic brain injury or children who have suffered anoxia or childhood brain tumors or cancer.
Executive functions which involve impulse control, attention, planning and organization are often problem areas in children with ADHD and those who suffer head injuries or anoxia.
Children who suffer Attention-Deficit Hyperactivity Disorder, predominantly inattentive type often have slower processing speed and since they are not as disruptive, may not get diagnoses as often or as early as the mixed or hyperactive subtypes. Females have a higher incidence of inattentive type than males and males have a higher incidence of mixed and hyperactive types.
Nonverbal learning disability is also often missed since it is less obvious, but can be associated with math difficulties as well as social skill and peer relationship difficulties.
Pediatric and child neuropsychologists often assess memory and learning. Information from such evaluations are often helpful in determing how your child or adolescent learns best.
Memory assessment will usually examine verbal and nonverbal memory, learning rates, retention rates and examine for retrieval difficulties. Thorough assessment will examine working memory, rote memory, supraspan memory, and memory for material that is provided in context. This has diagnostic utility and is important in establishing what may help the child compensate for any difficulties.
Children who suffer early brain injuries or early neurological conditions are often more difficult to assess, since functions may not be organized in the same way as a normally developed adult. Furthermore some deficits associated with early injuries may not be apparent until the demands and changes of adolescence or even adulthood.