The Importance of Seeking a Neuropsychological Evaluation that is Educationally Informed

86713_5_80x100 When individuals are experiencing learning and performance difficulties, there is a high probability that cognitive ability, neuropsychological processing, and/or executive functioning deficits are at fault. The job of the evaluator is to first take a thorough history (i.e. academic; developmental; medical), generate hypotheses about which of the above areas may be implicated, and then construct a test battery that will target the domains in question.

It is not enough, however, to just review test findings. They must be linked in a meaningful way to instructional strategies, accommodations, and modifications that address the areas of deficit. This is because academic subjects are really byproducts of these processes. Moreover, recommendations based upon the test data must be practical and realistic. That is, the evaluator must have knowledge and experience about how schools work, the kinds of recommendations that can be reasonably accepted by a child study team and implemented by teachers. Reports that are computer driven and yield reams of unreasonable and impractical recommendations are frowned upon by child study teams and not taken seriously. Even when a reasonable strategy is generated it may not be implemented due to unavailability of either school personnel who can implement it or equipment. In these instances, it is important to be able to create alternate instructional recommendations that are doable for a particular school or child study team.

This kind of educationally informed neuropsychological evaluation takes into consideration what is possible within the confines of a specific school. It is of equal importance to be knowledgeable about how child study teams work, how they view outside evaluations, and how to consult the team in a way that is not threatening and is collaborative rather than adversarial in nature. The best plans can get stuck in the “institutional mud” if they are not presented in a manner that brings everyone involved-student, parents, teachers, and child study team-on board and in agreement with the common goal of helping a student progress.

Since schools typically offer psycho-educational rather than neuropsychological evaluations, it is of paramount importance to write reports that can be easily understood by the audience of professional that will read it and written with an inclusive tone rather than one that makes school teams feel threatened or defensive as they must implement the recommendations.

Serving as a private evaluator and a member of child study teams has given me a view from both sides of the fence that allows me to navigate the school system and avert an adversarial stance. Similarly, when doing evaluations for the purpose of requesting accommodations on college admissions exams, I have extensive knowledge of how the reports are reviewed and am skilled at writing appeals when requests are declined.



Diagnosing Orthographic Dyslexia


Orthographic or surface dyslexia is a form of reading disorder characterized by deficits in visual processing of and visual memory for symbols. It is less well known than dysphonetic dyslexia and often overlooked.

In orthographic dyslexia, individuals have difficulty with: the rapid recognition of sight words; memory for specific spelling patterns; and encoding and retrieving shapes and contours of letters and words. Consequently, there is an over reliance on phonics which diminishes fluency, poor spelling, letter reversals and problems in quickly recognizing letters and words.

Instruments like the rapid naming subtests on the new WISC-V or the CTOPPS can be helpful as well as visual memory tasks. Individuals with visual processing deficits like visual scanning can also have difficulties with reading fluency because they frequently skip words or even lines.

It is important when assessing the presence of dyslexia to measure orthographic processing as well as phonological processing. Without this kind of comprehensive evaluation, a prescription of a phonics program for individuals with surface dyslexia can be incorrectly recommended and they will may little progress.