In patients presenting with persistent symptoms for three months or more after a mild traumatic brain injury (concussion) a neuropsychological evaluation can be very helpful in providing diagnostic clarity and treatment guidance. A neuropsychologist is a psychologist who has specialized knowledge of the complex relationships between brain functioning, cognition (thinking), behaviors, and emotions. Neuropsychologists have many specialized tests, procedures, and methods to assess different aspects of thinking (e.g., memory, attention, language), emotions, behaviors, personality, effort, motivation, and symptom validity. For this reason, neuropsychologists are uniquely situated to assess patients presenting with persistent symptoms after a concussive injury.

Most neuropsychological evaluations involve several hours of testing, with the length varying according to the examiner and the complexity of the case. In some cases, patients will be asked to return over a period of several days to complete the evaluation. A common misconception patients have about neuropsychological evaluations is that they are just showing up to take a long paper and pencil test and then go home. The reality is very different. Most of the tests neuropsychologists use are interactive, such that the patient will be asked to perform a certain task by the examiner (e.g., remember information) and provide a certain type of response. Sometimes the tasks are verbal, but others are visual spatial, motoric, or sensory. There may be some lengthy questionnaires that need to be completed. In addition to the tests, a clinical interview will also be performed. The questions asked in the interview will generally be wide ranging and not solely related directly to the head injury. This is because test scores cannot be interpreted in a vacuum and the neuropsychologist needs to gain a broad understanding of the patient before rendering opinions. The clinical interview can last for hours.

Patients and providers sometimes do not know who to go when a neuropsychological evaluation has been suggested. Since the only state that issues a license for neuropsychology is Louisiana, this can lead to a great deal of confusion in the other 49 states in terms of who to go to. The other 49 states have a generic psychology licensing law, which allows psychologists to practice in specialized areas that they have the appropriate training in. Some people choose to find a neuropsychologist by looking in the phone book and some rely on the recommendation of their health care provider. Unfortunately, this is not a guarantee that you will be evaluated by someone who has been well trained in neuropsychology.

This is where board certification comes in. Board certification is a mechanism by which neuropsychologists become certified by their peers as meeting the strict requirements for specialized practice in this area. The board certification process involves a review of one’s education and training, a written exam, a review of work samples, and an oral examination. There are currently three boards in neuropsychology. The first, which the author of this website belongs to, is the American Board of Clinical Neuropsychology (ABCN). Of the three boards, ABCN has the greatest number of members and certifies the most number of neuropsychologists each year. It is also the only board associated with the American Board of Professional Psychology (ABPN), which has been certifying psychologists since 1947. The next board is the American Board of Professional Neuropsychology (ABPN). The most recent board is the American Board of Pediatric Neuropsychology(ABPdN), which only certifies pediatric neuropsychologists. However, the other two boards also certify neuropsychologists who assess children. All of these websites allow you to search for board certified neuropsychologists from the respective boards.

It should also be noted that there are many neuropsychologists who are not board certified or who are pursuing board certification who can also provide an excellent service. If you cannot find a board certified neuropsychologist in your area, it is suggested that you contact the closest board certified neuropsychologist in your areas and ask who would be a good person to see.