Neuropsychological services offered by Professor Foster include:

 

• Medicolegal assessment of individuals who may have sustained traumatic brain injury;

• Assessment to determine the need for Guardianship, Enduring Power of Attorney and Management of Financial/Legal Affairs;

• Assessment of Decision Making Capacity including Testamentary Capacity;

• Assessment of fitness for duty, return to work and for rehabilitation purposes;

• Provision of strategies for overcoming cognitive problems;

• Cognitive assessment of the effects of mental illness (e.g. depression, anxiety), alcohol and/or drug use;

• Differential diagnosis of neurological and psychiatric conditions (e.g. dementia, psychosis);

• Memory assessment;

• IQ assessment (e.g. with respect to career planning);

• Assessment of learning disorders and/or ADHD;

• Rehabilitation and remediation sessions following neuropsychological assessment.

 

Professor Foster has undertaken assessments in a wide range of contexts including secure hospital facilities and prisons in addition to hospital and clinical suites.

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What is neuropsychological assessment?

 

Clinical neuropsychologists objective evaluate changes in thinking skills and related elements of behaviour that can occur due to a range of clinical conditions and situations.

 

Relevant conditions include head injury, epilepsy, stroke, drug/alcohol use, neurodegenerative conditions (e.g. Alzheimer’s disease and other types of dementia) and other neurological, psychiatric and developmental disorders (such as learning difficulty or ADHD).

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In addition to detailed history-taking, neuropsychological assessment involves the rigorous examination of cognitive skills including memory, attention/concentration, visuospatial skills, processing speed, language and executive functions (e.g. problem solving, planning, reasoning) in order to gain insight into neurocognitive/ neurobehavioural deficits and academic- and work-related skills.

 

Assessment may include involves paper and pencil type tests, questionnaires and/or computerized assessment.

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Everyone has relative strengths and weaknesses from a cognitive perspective. The goal of neuropsychological assessment is to determine these for the person being assessed. Each individual’s test scores are compared to people of a similar age and background in order to determine how they are functioning across different areas of capacity.

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An individual’s current level of functioning can then be compared with the expected level of capacity (calculated of course using established, peer-reviewed methods). A determination can then be made with respect to whether significant change/s of capacity have occurred, and if so in what areas of functioning. To answer this question, each person's pattern of results is analysed and combined with background information about educational, occupational, medical and psychosocial history either to help exclude or assist in diagnosing a specific brain-related medical condition or to provide valuable further information concerning an already established condition.

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The tests used in clinical neuropsychological assessment are standardised (i.e. they have previously been administered to groups of similar people without brain impairment, for purposes of comparison), are typically use internationally and are well researched. Many neuropsychological tests are used all over the world; it is the use of these tests and the interpretation (in the context of all of the other information available) of the relevant test findings that provides the foundation of the neuropsychologist’s expertise.

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Testing is not physically invasive.

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Assessments take several hours (including interview and rest breaks), depending on the purpose of the assessment.

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After completing the interview and testing, each person’s test scores are then compared to people of similar age and background in order to determine whether there are any cognitive problems, and how severe these may be. The pattern of results across tests is then analysed and combined with background information about educational, occupational, social and medical history to help with the diagnosis of brain-related disorders and/or help to explain the consequences of such a disorder.

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What is the purpose of neuropsychological assessment?

 

In contrast to self-report about one’s level of functioning (which is subjective and therefore potentially biased), neuropsychological assessment offers an objective, independent assessment of neurocognitive and neurobehavioural functions.

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Neuropsychological assessment therefore identifies whether a patient’s concerns or complaints about their level of cognitive and/or behavioural functioning has an objective basis.

 

Assessment can aid in diagnosis; e.g. possible ongoing effects of a traumatic head injury, presence of dementia (such as Alzheimer’s disease or frontotemporal dementia) or another neurological condition and help to determine what brain regions are affected. It can also rule out whether effects are simply due to the normal aging process.

 

Neuropsychological evaluation is often useful in identifying strengths and weaknesses for rehabilitation purposes and in monitoring changes in brain function over time (e.g. decline or improvement in thinking skills).

 

Assessment can also be informative in determining suitability for return to work after brain-related injury and can assist in making recommendations that may assist in rehabilitation.

 

Neuropsychological evaluation can help to characterise the effects of treatment (e.g. medications and other forms of remediation) and assist in determining decision-making capacity (e.g. with respect to living situation, medical decisions) and/or the need for guardianship, enduring power of attorney or assistance with management of financial/legal affairs.

 

Assessment can help in determining testamentary capacity and the presence of a developmental condition such as a learning disorder or ADHD/ADD.

 

IQ assessment can also be provided to individuals from a wide range of backgrounds (e.g. with respect to career planning).

 

In the medicolegal context, assessments help to determine whether a brain injury has occurred and what impact any brain injury is having or is likely to have on the capacity for self-care, independent living, current work capacity and/or future employment. The question of whether a person will be able to manage funds awarded via a potentially large compensation payout is also an important area in which neuropsychological assessment can be very valuable.  Assessment can assist rehabilitation providers in designing return to work programs. Finally, medicolegal neuropsychological assessments often help to assess whether other factors (e.g. symptoms of pain, psychological problems, inadequate effort/motivation) may be exacerbating the presence of any cognitive problems

   

What sorts of conditions is neuropsychological assessment helpful in?

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Neuropsychological assessment is relevant for any condition that can cause neurological insult to the central nervous system and/or cause cognitive problems including:

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• Traumatic brain injury

• Dementia (including Alzheimer’s disease)

• Alcohol and other substance abuse

• Psychiatric conditions (e.g. depression, psychosis, anxiety)

• Brain tumours

• Hypoxia

• Neurotoxic events

• Multiple Sclerosis

• Epilepsy

• Stroke

• Developmental disorders (e.g. learning disorders or ADHD/ADD)

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How much does neuropsychological assessment cost?

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Clinical assessments

 

Unfortunately, private neuropsychological assessments are quite expensive, and are not currently covered by Medicare or most private health funds. (However, if your patient has ‘extras’ cover they may be entitled to a small rebate.) The cost varies depending on the reason for the assessment. If your patient is a DVA Gold card member they should talk to their DVA-appointed case manager concerning whether DVA will cover the cost of the consultation.

 

The patient will be informed of the price once the reason for and extent of the assessment is established.

 

Medicolegal assessments

 

If there are medicolegal implications, a more in depth assessment and report are usually required. If there is an insurance company involved (i.e. if it is a work or car accident), your patient should contact their case manager to determine whether insurance will cover the full cost of the assessment. Otherwise, each patient is again informed of the price once the reason for and extent of the assessment is established.

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