When Neuropsych Testing Results Aren't What You Expected

Receiving neuropsychological test results can be a complex and emotional experience.

While these assessments provide valuable insights into cognitive and emotional functioning, it's not uncommon to encounter unexpected findings. Throughout more than a decade of experience in psychological and neuropsychological assessment, I have often given feedback to people who are surprised by the findings, or sometimes by what was NOT found on testing. For example, I have done psychological assessments with adults who have self-diagnosed with ADHD or autism or have been misdiagnosed by physicians without an assessment. On some occasions, the testing and overall data don’t support a diagnosis of ADHD or autism.

For many people, a mental health or cognitive diagnosis like ADHD is a big part of how they understand their own behavior and needs, and it is a huge adjustment in their self-understanding when test results aren’t what they expected. On the other hand, I have also done assessments in which someone suspected one diagnosis but received another based on testing. For example, I have diagnosed PTSD in cases where people suspected an anxiety disorder or bipolar disorder, but their symptoms actually indicate a trauma response. Unexpected neuropsych test results can be shocking and may feel devastating, as they raise many questions about how and why people were misdiagnosed before, or introduce a diagnosis that is hard to understand. Here are some thoughts about how to navigate that.

Understanding Your Results

The first step is to fully understand the results. This involves a thorough discussion with your psychologist. Don't hesitate to ask questions, seek clarification, and request additional explanations. It's essential to grasp the strengths and weaknesses highlighted in the assessment, as well as the implications for your daily life.

Remember, neuropsychological tests measure cognitive abilities in a specific context. They don't define your overall worth or intelligence. Results can be influenced by various factors, including mood, medication, and sleep patterns, and your psychologist should explain the results thoroughly.

I always tell my testing patients that they are welcome to reach out any time after a feedback session with questions. It can be overwhelming to receive testing feedback, and it’s easy to miss things when we’re overwhelmed. Never hesitate to call your psychologist to ask a question, even if you’ve already had feedback.

Processing Your Emotions

It's natural to experience a range of emotions when confronted with unexpected results. You might feel shock, disappointment, anger, or even relief. Allow yourself to process these feelings without judgment. Talking to a trusted friend, family member, or therapist can provide emotional support and help you make sense of your experiences. Please know that whatever you feel is ok, and it takes time to adjust to new information that may have a wide impact on your life.

Seeking Additional Perspectives

While your psychologist is the primary interpreter of your results, seeking input from other professionals can offer valuable perspectives. Consider consulting with a neurologist or a specialist in your specific area of concern. They can provide additional insights and potentially suggest alternative explanations for the findings. If this is recommended, usually your psychologist should let you know at the feedback session, and make this a written recommendation in your report, so you won’t forget.  Other common recommendations for consultation after testing include psychiatry and perhaps a therapist for a specific emotional concern.

Developing a Coping Strategy

Once you have a clearer understanding of your results, it's time to develop a coping strategy. This involves identifying specific challenges and exploring potential solutions. For example, if memory difficulties are identified, you might consider using organizational tools, seeking support groups, or exploring memory enhancement techniques. Your psychologist can usually recommend options that fit your needs.

Setting Realistic Goals

It's important to set realistic goals based on your strengths and limitations. Focus on what you can control and avoid comparing yourself to others. Celebrate small victories and acknowledge your progress, no matter how incremental it may seem.

Building a Support Network

Surrounding yourself with supportive individuals is crucial during this challenging time. Connect with family, friends, or support groups who can offer encouragement and understanding. Sharing your experiences with others who face similar challenges can also be helpful. I know many people are hesitant to seek out a support group because it can feel vulnerable, but learning from others who have dealt with the same diagnosis can be immensely beneficial, both in terms of the emotional support and the opportunity to learn practical ways others have managed.

Considering Further Evaluation

In some cases, additional testing or evaluation may be warranted. If you have concerns about the accuracy of the initial assessment or if symptoms persist, discuss these options with your psychologist.

Remember, You Are Not Alone. Seek Neuropsych testing in Los Angeles

Receiving unexpected neuropsychological results can be a daunting experience, but it's important to remember that you're not alone. Many people successfully navigate challenges related to cognitive difficulties. With time, patience, and appropriate support, you can develop strategies to cope and thrive. Dr. Reger can offer you support by following these simple steps:

1. Contact (424) 262-1925 to schedule your appointment

2. Meet with Dr. Reger for an evaluation

3. Come to a better understanding of your neuropsych results!

Other Services Offered by Dr. Reger in Los Angeles, CA

Neuropsychological and psychological assessments are not the only services offered by my Redondo Beach-based practice. Other assessments include cognitive and dementia testing, pre-surgical assessments, capacity assessments, and med-legal evaluations. In addition to evaluations, I also provide individual therapy, counseling for older adults, and mental health consultations and presentations. Visit my blog for more help today!

Ensuring Your Wishes Are Heard: Understanding Testamentary Capacity Assessments in California

I have been doing capacity assessments for over a decade, and even after many years of experience, each case is unique, because people have many different life experiences that come into play in these complex evaluations. I find that most people, apart from attorneys working in this area, have questions about exactly what "testamentary capacity" is, and how a psychologist such as myself, might conduct this type of assessment. In this article, I will try to clarify some common misconceptions about testamentary capacity, which is a crucial aspect of estate planning in California. Let's start with an easy one: What is meant by "testamentary?” This is simply the capacity, or ability, to create a will that decides where a person's assets, whether financial or in the form of property and possessions, are going to go after that person has passed.

California Law and Testamentary Capacity

In California, Probate Code Section 6100 states that anyone 18 or older who is "of sound mind" can make a will. "Sound mind" translates to having testamentary capacity, and this can get very tricky in situations where there is a question of a person's cognitive function or ability to make decisions. Questions about a person's "sound mind" often come up in situations of severe mental illness, such as schizophrenia, or when a person's cognitive function is impaired because of a disease process, like dementia. Here, the law defines mental competency for creating a will as having the ability to:

1. Understand the nature of the testamentary act (making a will).

2. Understand and recollect the nature and situation of their property (this includes money, real estate, possessions, and any other assets).

3. Understand the natural objects of their bounty (who they might typically leave assets, like close relatives).

Legal terminology can be overwhelming for those others who are not legal professionals, but in this case, the law simply means that a person needs to understand what it is to make a well, what property or money they have to give away, and who they might leave their assets to after their death. In some cases, this is very straightforward, and there is no question of a person's ability to make a will, know what they have to give, and know who they want to give it to. But in other situations, testamentary capacity is not straightforward at all, for example, in the case of a person with dementia who cannot understand the meaning of making a will, or in the case of a person with schizophrenia who holds a delusional belief that a family member is plotting against them, and wishes to cut that person out of their will as a result of this delusion.

California-Specific Considerations

While the core evaluation process remains similar, here are some California-specific aspects to consider:

• Presumption of Capacity: California law presumes a person has testamentary capacity unless proven otherwise. This is very important because it is a matter of respect for individual autonomy. This is something that all of us want and expect–to make our own decisions about our lives, including what we want to happen to our assets after we die.

• Undue Influence: California courts take undue influence on the testator (person making the will) seriously. A capacity assessment, like the ones I conduct, will pay close attention to potential manipulation or coercion, especially if the will significantly deviates from what the person would typically do. For example, I have seen cases in which an older adult with a dementia diagnosis wishes to change their will to leave assets to a caregiver who has become intertwined in their life recently, despite concern and suspicion from family members who believe the caregiver is asserting undue influence over the person.

Finding Help in California

California has a vast network of qualified professionals to assist with testamentary capacity assessments, including myself. Typically, either a person wishing to establish or change their will, or a concerned family member, will reach out to me with a request for a capacity evaluation to determine whether the person has the capacity to make these changes. The evaluation involves testing and interviews with the person wishing to change their will, as well as collateral interviews with family members, caregivers, and others who may have insight into this situation and the person’s history and values. These evaluations also sometimes involve looking at financial records and medical records, which may provide valuable evidence about a person's capacity. For example, if financial records show that a person has been unable to pay their bills independently, or has given away thousands of dollars recently to scams, this may be evidence to understand the person's capacity to make it well. 

Estate planning attorneys can also guide you through this process, and I often get referrals from estate planning and attorneys for testamentary capacity evaluations in California.

Remember:

• A testamentary capacity assessment conducted by a qualified psychologist in Los Angeles and throughout California strengthens your will's validity.

• Don't hesitate to seek an evaluation, especially if pre-existing health conditions might raise concerns down the road. By planning ahead, you ensure your wishes are respected and your loved ones' inheritance is protected.

Begin a Testamentary Capacity Assessment in Los Angeles, CA

I would be happy to use my years of experience in conducting capacity assessments to help you find the right path forward. You can learn more about the benefits of testing with Dr. Reger by and more by following these simple steps:

1. Contact (424) 262-1925 to schedule your appointment

2. Meet with Dr. Reger for an evaluation

3. Start evaluating testamentary capacity!

Other Services Offered by Dr. Reger in Los Angeles, CA

Capacity assessments are not the only service offered by my Redondo Beach-based practice. I’m also happy to offer multiple neuropsychological and psychological assessments. Other assessments include cognitive and dementia testing, pre-surgical assessments, and med-legal evaluations. In addition to evaluations, I also provide individual therapy, counseling for older adults, and mental health consultations and presentations. Visit my blog for more help today!

A Brief Guide to Neuropsych Testing in Los Angeles

A psychologist specializes in assessment, including neuropsychological assessments, I often get questions about neuropsychological evaluations, what they involve, with the offer, and why they cost so much! Here is some information that may help.

What is Neuropsych Testing?

Neuropsych testing isn't a single test, but a comprehensive evaluation that assesses several different areas of brain function. In Los Angeles, these assessments are particularly helpful for:

• Diagnosing ADHD: Unraveling attention, focus, and impulsivity issues in children, adolescents, and adults.

• Learning Disorders: Identifying specific challenges like dyslexia or dysgraphia that can hinder academic performance.

• Memory Concerns: Exploring the nature and severity of memory problems, which could be due to various causes.

• Autism Spectrum Disorder (ASD): Evaluating cognitive and social functioning in individuals suspected of ASD.

• Impact of Brain Injury: Assessing cognitive changes after a concussion, stroke, or other brain injuries.

• Dementia Evaluation: Differentiating between normal age-related memory decline and early signs of dementia.

Because I work only with adults and not children, I most often do neuropsych testing with adults who are curious about an ADHD diagnosis, cognitive concerns related to a stroke, traumatic brain injury, multiple sclerosis, or another medical event, or cognitive decline related to dementia. I also do evaluations for people who suspect a diagnosis of autism, though it is important to note here that ASD is often diagnosed (in adults) without a neuropsychological evaluation. The same is true of ADHD. I find that neuropsych assessment is valuable in cases where a clear diagnosis cannot be made simply through a clinical interview, for example, done during a psychotherapy intake with a psychologist who can diagnose. So, although neuropsychological evaluation is not always necessary to receive a diagnosis of autism or ADHD, it can be helpful if there are many complex factors that make the diagnosis unclear.

The Neuropsych Testing Process in Los Angeles

The process typically involves several steps:

• Initial Consultation: Discussing your concerns and reasons for seeking testing.

• Clinical Interview: An in-depth conversation about your medical history, educational background, and any specific challenges you're facing.

• Standardized Testing: Administering a battery of tests that assess memory, attention, language, problem-solving, and other cognitive functions.

• Feedback Session: Review the results, explain the findings, and discuss potential diagnoses or recommendations.

One important note here is that all of this work requires many hours, both in the evaluation face-to-face with you, and also before and after the evaluation, selecting a tailored test battery, scoring and interpreting tests, writing up a report, and reviewing records, in some cases. People are sometimes surprised at the cost of a comprehensive neuropsychological evaluation, but there are typically between 10 and 20 hours of work put into each assessment, in addition to the expertise gained by many years of education, training, and experience. Hopefully, this helps explain the cost.

Who Conducts Neuropsych Testing in California?

Licensed psychologists with a Ph.D. or Psy.D. in psychology and specialized training in brain-behavior relationships, conduct these assessments. Here in California, a psychology license is a general license that covers every specialty, so there is no separate license for neuropsychologists, child psychologists, forensic psychologists, or any other specialty. The most important factor when it comes to finding the right psychologist for your evaluation is the doctor's competence in assessing what you need to be assessed.

For example, as a psychologist with a great deal of neuropsych testing experience in adults with dementia, medical complexity, and disability, I am well-qualified to do neuropsychological evaluations for adults with questions of cognitive function in the context of aging, traumatic brain injuries, medical events, and neurodiversity. Other neuropsychologists specialize in assessing children, so their areas of expertise may be in diagnosing learning disorders and determining accommodations for school settings. So, competence is important, in addition to the fit with what you need.

The Benefits of Neuropsych Testing

Neuropsych testing offers a wealth of benefits:

• Accurate Diagnosis: Provides a clear picture of your cognitive strengths and weaknesses, leading to a more accurate diagnosis.

• Informed Treatment Plan: Guides the development of personalized interventions and treatment strategies.

• Improved Academic Performance: Helps identify learning disabilities and pave the way for appropriate academic support.

• Enhanced Self-awareness: Provides valuable insights into how your brain functions, empowering you to manage challenges more effectively.

Finding the Right Neuropsychologist in California

With so many qualified professionals in California, and in Los Angeles, choosing the right psychologist is crucial. Consider factors such as their area of expertise, experience working with your specific concerns, and your comfort level when talking to them. Don't hesitate to ask questions and ensure you feel comfortable with the chosen professional.

Begin Neuropsych testing in Los Angeles, CA

Neuropsych testing is a powerful tool for understanding your brain and optimizing your cognitive health. It empowers you to find answers, make informed decisions, and pave the way for a brighter future. So, if you've been wondering about your cognitive abilities or have questions about a diagnosis, consider scheduling a consultation with a qualified neuropsychologist in California. Dr. Reger is happy to offer support with a variety of assessments through neuropsych testing. Start the testing process by following these simple steps:

1. Contact (424) 262-1925 to schedule your appointment

2. Meet with Dr. Reger for an evaluation

3. Get a better understanding of neurological issues!

OTHER SERVICES OFFERED BY DR. REGER IN LOS ANGELES, CA

Neuropsychological assessments aren’t the only service I offer. I know that you may encounter more than one mental health concern at a time. I offer multiple psychological assessments as well. Other assessments include capacity assessments, cognitive and dementia testing, pre-surgical assessments, and med-legal evaluations. In addition to evaluations, I also provide individual therapy, counseling for older adults, and mental health consultations and presentations. Visit my blog for more helpful support today!

Debunking the Myth: Can You Fail a Neuropsychological Evaluation?

As a psychologist who does neuropsychological evaluations (neuropsych evals, for short), I often encounter misconceptions about neuropsychological testing. One of the most common questions I hear is, "Can you fail a neuropsych eval?" The answer? No, in the traditional sense of getting a passing or failing grade, you cannot.

However, there are some nuances to understand. Let's delve deeper into the purpose and process of a neuro-psych eval to clear up this confusion.

What is a Neuropsychological Evaluation?

A neuro-psych eval is a comprehensive assessment of your cognitive functioning. It's like a detailed map of your brain's strengths and weaknesses across various areas of function, including:

• Attention and concentration: How well can you focus and sustain attention?

• Memory: How well do you encode, store, and retrieve information?

• Language: How effectively do you use language to communicate and understand?

• Learning: How well do you acquire new information and skills?

• Executive functioning: How well do you plan, organize, and problem-solve?

• Processing speed: How quickly can you process information?

The Neuropsychological evaluation typically involves a combination of:

• Clinical interview: Discussing your social, medical, and mental health history, symptoms, and everyday challenges.

• Standardized cognitive testing: Administering specific tests designed to assess different cognitive domains.

• Review of medical records: Understanding any relevant medical conditions that might impact your brain function.

Why Don't You "Fail" a Neuropsych Evaluation?

The primary goal of a neuro-psych evaluation isn't to judge your performance but to create a detailed picture of your cognitive profile. This information is crucial for:

• Diagnosis: Helping identify underlying neurological or psychological conditions that might be impacting your thinking and behavior.

• Treatment planning: Informing the development of treatment strategies to improve your cognitive skills or compensate for weaknesses.

• Monitoring progress: Assessing the effectiveness of treatment interventions.

• Eligibility determination: Providing evidence for eligibility for educational support services or disability programs.

There's no single "correct" answer on any test. Everyone performs differently based on factors like age, education, and cultural background. Your scores are compared to “norms,” which means a large number of scores from people that let us know what scores we should expect on a given test. These tests are often adjusted for age, education, and other factors, so that you are compared to others similar to you in important ways. That gives us the best sense of where your scores fall in comparison to what we expect from others in your same age group.

The Importance of Effort and Validity

While you can't fail, putting forth a genuine effort is essential. Neuro-psych evals often include effort testing to ensure the results accurately reflect your abilities. Effort measures are built into testing and might involve tests where inconsistent performance raises questions about whether you're trying your best.

If a neuropsychologist suspects you're not putting in good effort based on these measures, they might flag the results as "invalid." This could limit the usefulness of the evaluation, hindering accurate diagnosis and treatment planning. There are many reasons people might not put their best effort into testing, but if that’s the case, we cannot trust the test results actually measure what we were trying to measure, and it would not be ethical to make a diagnosis or plan treatment based on invalid results.

Here are some tips for approaching your neuropsych evaluation effectively:

• Get a good night's sleep beforehand.

• Eat a good breakfast the day of testing.

• Arrive well-rested and alert.

• Ask clarifying questions if you're unsure about instructions.

• Do your best on each test, even if you find it challenging.

• Be honest about your limitations.

What Happens After the Evaluation?

Following the evaluation, the psychologist will analyze all the collected data. This includes your interview responses, test scores, and medical records. They then create a comprehensive report summarizing your cognitive strengths and weaknesses, offering potential diagnoses, and recommending appropriate interventions.

Here are some possible outcomes:

• Normal cognitive functioning: The evaluation may not identify any significant cognitive deficits.

• Specific cognitive impairments: The report might identify specific areas of cognitive deficit that could benefit from targeted interventions.

• Learning disorder: The evaluation might support a diagnosis of a learning disorder, informing educational support plans.

• Neurological condition: The evaluation might point towards a neurological condition, prompting further medical investigation.

Remember, the neuro-psych eval is a collaborative process. Discussing the findings with the neuropsychologist and your doctor allows you to ask questions, clarify results, and understand the next steps.

Start A Neuropsychological Evaluation in Los Angeles, CA

A neuro-psych evals is a valuable tool for understanding how your brain works. They don't involve passing or failing but rather aim to create a comprehensive profile of your cognitive functioning. By approaching the evaluation with a genuine effort, you can contribute to a more accurate and helpful assessment that aids in diagnosis, treatment, and ultimately, improved well-being. Start the evaluation process with Dr. Reger by following these simple steps:

1. Contact (424) 262-1925 to schedule your appointment

2. Meet with Dr. Reger for an evaluation

3. Get a better understanding of neurological issues!

OTHER SERVICES OFFERED BY DR. REGER IN LOS ANGELES, CA

Neuropsychological assessments aren’t the only service I offer. I know that you may encounter more than one mental health concern at a time. I offer multiple psychological assessments as well. Other assessments include capacity assessments, cognitive and dementia testing, pre-surgical assessments, and med-legal evaluations. In addition to evaluations, I also provide individual therapy, counseling for older adults, and mental health consultations and presentations. Visit my blog for more helpful support today!