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Testing for Success – Primary Steps for Primary Care

Hearing the word “neuropsychological” can make any child feel confused and scared. The idea of testing may also bring up unpleasant associations with school tests or painful shots. At Cook Children’s, our program is developed with kids in mind. Tests are introduced as “games,” and most children find them fun and entertaining. Pediatric neuropsychologists are trained to communicate with young patients and use prizes and frequent playtime to create a relaxed, engaging environment. Because children who undergo neuropsychological testing often have a chronic or debilitating medical condition, adolescents and teens are also screened for depression and anxiety. In addition to educational strategies, a teen’s management plan may include a referral to a psychologist or counselor for additional guidance.

Neuropsychological testing is a critical first step in helping children with developmental roadblocks achieve their academic goals.

At Cook Children’s, pediatric neuropsychologists perform a unique set of evaluations to diagnose neurological cognitive deficits. As opposed to screening for behavioral problems or attention deficit disorder, a neuropsychological test is designed to diagnose cognitive deficits stemming from an underlying medical problem. Medical issues that may trigger neuropsychological symptoms include:

  • Brain tumor test
  • Concussion or traumatic brain injury
  •  Epilepsy
  • Side effects of cancer treatment
  • Stroke

Test day

The evaluation itself is an all-day event involving multiple formal and informal test sessions. The tests assess problem-solving abilities using:

  • Language-based and visual spatial problems
  • Math and vocabulary skills
  • General intelligence (IQ)
  • Visual and auditory memory
  • Attention and concentration
  • Speed of processing

If a child recently has undergone school evaluations, that information is incorporated into the overall evaluation, as well.

“Children also are re-evaluated one to two years after the initial evaluation to monitor the progression or new development of cognitive disabilities,” said Marsha Gabriel, Ph.D., a neuropsychologist at Cook Children’s. “For instance, neuropsychological side effects of chemotherapy may not manifest themselves for months or years after treatment. Brain injuries might affect a part of the brain a child isn’t currently using, but deficits might show up at a later developmental stage.”

When to refer

“A neuropsychological test is designed to help develop coping strategies for neuropsychological symptoms only when an underlying medical condition or disease is the cause,” Dr. Gabriel said. “Pediatricians and family physicians refer pediatric patients to us when they believe a patient’s decline in cognitive abilities is associated with a prior medical diagnosis.”

Referrals are most often made after a parent of a child with a medical condition notifies the child’s primary care provider of a decline in school performance. When a child’s grades begin to drop unexpectedly or he or she acts out more in class and can’t concentrate for normal lengths of time, these may be indications for neuropsychological testing.


Contributing author:

Marsha Gabriel Ph.D.

Marsha Gabriel, PH.D.
Senior Neuropsychologist


Our expertise

Great outcomes begin with great input. Having a medical system where every department, doctor, and care team member works together means that your child can have quick access to testing, diagnosis and treatment, and that means better outcomes now and in the future.

Contact the Jane and John Justin Neuroscience Center at Cook Children’s to refer a patient or ask questions: 682-885-2500.

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