What is a neuropsychological evaluation?

It's important for your child's overall health and development to understand how some medical conditions affect the brain, intellectual and cognitive functions, and psychological and psychosocial factors. A neuropsychological evaluation is an approach to identify and track these interactions in your child's development now and in the future.

The assessment may involve a broad evaluation of cognitive abilities or a more targeted assessment of specific areas of concern. The neuropsychology team at Children's Hospital of Philadelphia (CHOP) can help determine what kind of evaluation will be the best for your child.

A neuropsychological evaluation might assess any or all of the following areas:

• Intellectual functioning
• Attention and executive function skills (such as planning, organization, impulse control, cognitive flexibility)
• Reasoning and problem-solving
• Language
• Visual-spatial/visual-perceptual skills
• Sensory-perceptual functioning
• Fine motor abilities
• Learning and memory
• Academic achievement
• Social skills
• Emotional and behavioral functioning
• Adaptive skills (independence in daily living activities)

Neuropsychological evaluation is not considered to be medically necessary when used primarily for:

• Educational evaluation of possible learning disabilities or as part of vocational assessment to help plan job training
• Baseline assessment of function or screening purposes in individuals without medical conditions known to affect the brain
• Monitoring of chronic conditions when there is no significant new change in behavioral, mental state or cognitive functioning

What is included in a neuropsychological evaluation?

Neuropsychological evaluation usually includes an interview with the child and their parents or caregivers, observation of the child’s behavior and in-person testing.

Testing may involve hands-on activities, answering questions, computerized tasks, and paper-and-pencil tests. The neuropsychologist may also ask caregivers and teachers to complete standardized questionnaires about your child’s development, emotional functioning and behavior. Testing is usually completed in one day.

Once testing is done, the neuropsychologist summarizes the evaluation findings and recommendations in a feedback discussion with the family and in a written report. Depending on your child's age, the findings, impressions, diagnoses and recommendations will be shared with them.

The report will be shared with your child's referring medical provider and will be available to others also involved in delivering care, such as your child's specialists and primary care pediatrician. With your family's permission, information can also be shared with schools or outside services or agencies to facilitate further treatment and support for your child.

How do I add my child to the waitlist for a CHOP neuropsychological evaluation?

We ask that a medical provider or specialist involved in your child’s care submit a letter of medical necessity covering the reasons the evaluation is needed, along with relevant medical diagnoses (to help the insurance company understand the reason for the evaluation). Clinical documentation or office notes are also acceptable if a letter of medical necessity is not possible.

If your child’s provider is affiliated with CHOP, the letter of medical necessity can be submitted directly through your child's electronic medical record. If a provider outside of CHOP is referring your child, all documentation can be faxed to 445-428-4263. All incoming referrals are reviewed by a neuropsychologist to make sure they are clinically appropriate. Our administrative staff reviews the letter for insurance verification.

If your child’s clinical referral is appropriate for a CHOP neuropsychological evaluation, you will receive a letter from our group outlining the estimated wait, general information about the service and an option to be added to the cancellation list.

There may be a significant waiting period between your child’s clinical referral for an evaluation and your appointment. The exact length of time you’ll wait for an appointment depends on the type of evaluation your child needs.

If you have any additional questions about the referral process, evaluation procedures or the service in general, please direct your questions to neuropsychology@chop.edu or call 215-590-7555.