Elizabeth Jerison Terry, PhD

Clinical Neuropsychologist • Licensed Psychologist PSY 20657

Bridges to Success

Child and Adult Neuropsychological Assessments
Cognitive Behavioral Therapy

Neuropsychological Assessments:
What? Who? Why? How? Where? When?

As a “neuro”psychologist, I apply my knowledge about how the brain works (and child development) to help understand a client’s thinking, behavior and feelings. I introduce myself to (especially younger) children as a “brain detective” whose job is to find out what kinds of things are easy for them and what is harder for them.

What is a neuropsychological assessment?

A neuropsychological assessment involves a series of appointments that include a parent intake interview, school observation, collateral contacts, testing sessions, a feedback session for the parents (followed by a written report), and a feedback session for the child.  I send out forms to give me information about your child’s history, and some rating scales to help me understand which behaviors (if any) cause concern.  Usually, I need a total of six to ten hours with the child (over several sessions) to do all of the tests. I do not give the same tests to each child, but try to give the tests that will best identify that child’s strengths and weaknesses.  By pulling together information from formal tests, informal observations, and the adults who know the child best (parents, teachers, doctors, therapists, tutors … ), I can describe the child’s abilities and provide recommendations.

GOAL:
Identify Strengths & Weaknesses

By pulling together this information, I can describe a client’s abilities and provide recommendations. I may evaluate:

  • Attention
  • Overall intellectual functioning
  • Memory
  • Language
  • Learning
  • Visual-spatial abilities
  • Behavioral and emotional functioning
  • Academic achievement (reading, writing and math)
  • Executive Functions: like planning, organization, flexible-thinking

Who would want a neuropsychological assessment?

Children and Adults

Known neurological history

  • Epilepsy (seizure disorder)
  • Traumatic brain injury
  • Stroke
  • Other neurological concerns e.g., long COVID, genetic anomalies
Doctors examining brain - Dr. Elizabeth Jerison Terry Neuropsychologist

Children

  • Giftedness?
  • Learning difficulties?
  • Attentional problems?
  • Behavioral concerns?
  • Unusual development?
  • Autism?

“Something
is not right!”

as Miss Clavel said in the Madeline books by Ludwig Bemelmans.

Specific diagnostic questions:

  • Autism
  • Anxiety
  • Is there AD/HD?
  • Depression 
  • Developmental delays
Hands unraveling strings of thought Dr. Elizabeth Jerison Terry Neuropsychologist

Why would you want a pediatric neuropsychological assessment?

Raising a neurodiverse child can be confusing and challenging. My goal is to support, educate, and inform you. Neuropsychological assessment may help evaluate the effects of developmental, neurological or medical problems on your child’s cognitive functioning. It may help you better understand why your child is having difficulty in school, and how to design interventions and accommodations that use your child’s strengths to help compensate for his or her weaknesses to help your child achieve his or her potential.  However, there are no guarantees of what you will experience. 

Why would an adult choose to have an assessment with Dr.Terry?

Short answer: kids grow up to be adults.

As a child neuropsychologist, I focus on issues that emerge in childhood even when they may look different in adults. I can directly compare childhood results with current assessments.

“I have a history of:

  • learning disabilities
  • AD/HD
  • neurological concerns diagnosed in childhood
  • autism”

OR

“I think I may have undiagnosed

  • learning disabilities
  • AD/HD
  • neurological concerns diagnosed in childhood
  • autism”

As a child neuropsychologist, my specialty is assessing for these specific concerns.

“Do I need accommodations for entrance exams in college, graduate school, law school,  or medical school?” 

“I am struggling. Could I have undiagnosed AD/HD? Or a learning disability?”

“I read so slowly that I can’t keep up with Law School reading.”

“My schoolwork takes so much longer for me than for my friend.”

When appropriate, based on my reports, clients have received accommodations on the ERB, ISEE, SAT, ACT, MCAT, LSAT, GRE, Bar, Medical Boards etc. as well as accommodations for elementary school, middle school, high school, college and beyond.

I can help negotiate the maze of ADA accommodations and modifications for work or higher education.

Call me! We will talk about your concerns. Would a neuropsychological assessment be potentially helpful? 

If we decide to do an assessment, I will send

  • Privacy Notice (describes the nuts and bolts of my practice e.g. meetings, how I handle private records, billing etc.)
  • History form (developmental, work, school, medical, family)
  • Sometimes rating scales (self-report for adults; parents/guardians for children)

Then once the forms are received, we can schedule an Intake Interview.

Intake interview (with client or parents/guardians only):

  • Allow two hours – may be virtual, if appropriate
  • Legal information: review Privacy Notice 
  • Clinical information: review History form
  • Why do you want an assessment? Why now? Family history, History of current concerns
  • ASK ME QUESTIONS
  • Sign consent forms and releases of information as necessary
  • Who else would you like me to talk with, if anyone? Teachers? Tutors? Therapist? Doctor?

Assessment Process

To evaluate I use:

  • interviews,
  • review of records,
  • rating scales,
  • observation, and
  • various formal measures of attention, motivation, motor and sensory abilities, language and spatial skills, problem solving, memory, intellectual functioning, and emotional or personality functioning.

Tests vary from paper-and-pencil (or online completion) tasks, hands-on activities with blocks and other materials, answering questions, looking at pictures, and sometimes use a computer. 

 
 
  • With permission, I may send out appropriate behavioral rating forms to teachers.
  • School observation, when appropriate (for children)
  • Testing sessions (6 to 10 hours total, usually)
    Different clients get different combinations of tests tailored to best evaluate the questions we are evaluating. 
  • Feedback session (2 hours)
    For children: parents or guardians only

Where does an Assessment Take Place?

Testing In-Person

COVID SAFETY: Because I use some tests that cannot be administered virtually, I conduct testing in-person. My office windows provide excellent ventilation when combined with a fan with UV capability. 

Although some neuropsychologists perform assessments entirely via telehealth, we are still evaluating the degree to which telehealth and in-person assessment compare; as such, I schedule testing in-person. 

Audiorecording

To assure accuracy in my records, I may audiorecord you or your child. These recordings will only be used by me and I will protect all audio records as I do all other records. 

When are neuropsychological assessments most often requested?

Of course, that depends on the referral question; however, the most typical times for an initial assessment  are:

  • Preschool: for children whose development seems different from that of their peers.
  • Around 1st grade, when children seem to be having more difficulty than their peers learning to read OR when children seem to be learning much more quickly than their peers.
  • Around 4th grade, when demands change so that instead of learning to read, children are reading to learn OR when children have difficulty adjusting to the increased planning and organizational demands in school.
  • When entering middle school, if children have difficulty adjusting to the increased planning and organizational demands of changing classrooms etc. 
  • When entering high school, for similar reasons to when entering middle school.
  • When adults require accommodations for school or work.

In younger children, most assessments occur when parents, school or a doctor want to know if something is a barrier to development. Some examples are:

  •     Delay in speech
  •     Unusual social interactions
  •     Possible giftedness

In addition, for accommodations on standardized tests, often the tests need to have been administered within a specific timeframe (which may depend on the test or the reasons for accommodations).

Foreseeable Risks and Discomforts

Risks and Discomforts

Neuropsychological assessment can have benefits and risks. A client may experience fatigue, although I will provide breaks as needed and will schedule additional appointments if necessary to obtain a client’s best performance.  It’s a good idea to bring a snack. In addition, a client may experience uncomfortable feelings like frustration or anxiety.  I will do my best to alleviate these feelings and to reassure the client.