What is CBT?

​

The psychological assessment services offered at  NBI  are designed to facilitate understanding of how individuals function and learn by

using reliable neuropsychological, educational, and psychodiagnostic tests. An evaluation is most helpful when you suspect you or someone

you love has a learning disability or other cognitive problems such as difficulty with memory, attention, or executive functioning skill.

A comprehensive evaluation may also be helpful for individuals struggling with behavioral, social or emotional difficulties (e.g., anxiety,

depression, etc.) that seem to be interfering with social, cognitive, or academic functioning. Such evaluations may offer diagnostic clarity and

related treatment recommendations.

​

In general, a comprehensive evaluation is intended to offer increased awareness of why an individual may be struggling to meet developmental,

academic, or social milestones. The process often helps to confirm appropriate clinical diagnoses, but more importantly, works to identify

which intervention or support services will be most beneficial. As such, upon written consent, our team will communicate as needed

with physicians, psychiatrists, therapists, school professionals, and other psychologists to coordinate the management of the individual’s

treatment plan, educational programs, and/or other necessary referrals or placements.

​

​

What Is the Purpose of a Comprehensive Diagnostic Evaluation?

​

Evaluations increase our understanding of cognitive, emotional, and behavioral functioning in relation to difficulties that an individual is

experiencing, whether at home, school or in the workplace. This information goes beyond what can realistically be obtained via clinical

observations, interview material, or medical findings. Through an interactive assessment combining standardized written tasks, hands-on

activities, questionnaires, and computer “games,” a greater awareness about present functioning and future risk factors is gained.

​

Once an individual’s unique profile is understood, including areas of relative strengths and weaknesses, we can recommend therapies and

treatments tailored for their unique needs. These recommendations are often essential for the development of optimal treatment,

educational, or placement plans, or for qualifying for specialty services.

​

​

Diagnostic evaluations are also instrumental in re-evaluating current or past clinical impressions or identifying the presence of previously unrecognized:

​

• Pervasive developmental delays (PDD)

• Autism spectrum disorders (ASDs)

• Language or nonverbal processing deficits (NVLD)

• Learning disorders (LDs)

• Attentional difficulties (ADHD)

• and a variety of emotional and behavioral problems

​

These evaluations can be utilized to track clinical and/or educational progress over time.

​

Why Are Individuals Referred for Evaluations?

​

Evaluations can be particularly helpful when a person starts displaying signs of emotional or behavioral problems. A medical professional may

also recommend one when anxiety or social/emotional difficulties are interfering with an individual’s functioning or when it is important to

understand the psychological and/or cognitive ramifications of medical conditions (e.g., epilepsy, cancer, or Alzheimer’s).

​

Individuals often self-refer or are referred for assessment by a parent, doctor, teacher or other

professionals because of one or more of the following reasons:

​

• Difficulty in learning, attention, behavior, socialization, or emotional control.

• Teachers or work supervisors report persistent difficulties.

• Poor work performance despite adequate attendance and seemingly good attention and effort.

• Problems with retention of information.

• Inadequate achievement in school or at work despite sufficient effort.

• Family history of neurological or developmental difficulties known to affect the brain and/or brain systems.

• Suspected developmental delay (e.g., language, motor, etc.) which may or may not be accompanied by other areas of impairment.

• Traumatic brain injury or significant illness that impedes cognitive development.

• Specific medical disease or congenital developmental problem that affects brain functioning.

​

At What Age Should an Evaluation Be Considered?

​

It is best to conduct evaluations as soon as possible, especially for children. Nearly all professionals agree that early intervention plays a

significant and vital role in the treatment of developmental needs and long-term progress. Further, diagnostic evaluations and the resulting

reports serve as important tools for documenting the development and pattern of cognitive strengths and weaknesses over time.

​

Evaluations are appropriate for individuals over two years of age, although children under two may be seen as well, depending on the

specific circumstances and referral questions. Dr. Lyons is highly experienced in the assessment of infants and children with developmental

delays, Autism Spectrum Disorders, and general medical conditions. She has the requisite training to monitor infants as young as 6 months

of age, but standardized assessments can only begin later, in some cases after 12 months of age.

​

What Does an Evaluation Typically Consist Of?

​

NBI’s team of psychologists and neuropsychologists personally conduct each component of the evaluation process. Most evaluations include

the following:

​

Initial Intake: At the first appointment, the psychologist meets with the patient and his/her family in order to gain an understanding of the reason

for referral and obtain a detailed developmental, medical, psychological, educational, and depending on age, occupational history.

​

Evaluation: If a comprehensive evaluation is determined to be in the individual’s best interests, testing will usually begin immediately after

the initial interview. During testing, standardized measures are administered in a systematic manner in an appropriate environment. The same

tests are not given to every patient but created based on what we already know. Tests generally include a series of interactive activities

that assess language and perceptual processing abilities, attention and memory, school-based learning, cognitive skills, emotional functioning,

and behavior. Emerging skills can also be assessed in very young children. Parents and/or family members are usually not in the room during

testing, although they may be asked to be present with very young children or on a case-by-case basis. Testing time varies based on the

individual's An evaluation may take up to eight hours and may spread across several sessions, depending on the needs of the patient.

The evaluation of infants or preschool children is usually shorter in duration. Informal feedback may be provided to family members at the

end of each session, as appropriate and relevant to the process.

​

During the course of the evaluation, the following areas may be assessed:

​

• General Intelligence

• Academic Achievement

• Attention / Concentration

• Executive skills, such as organization, planning, inhibition and flexibility

• Learning and Memory

• Language and Communication Skills

• Visual-spatial Skills

• Motor coordination

• Social Interaction Skills

• Play Skills

• Adaptive Functional Skills

• Social-emotional Functioning

• Behavior

• Personality and other psychological factors

​

Some abilities may be measured in more detail than others, depending on individual needs.

​

Feedback Session: Approximately three weeks after the initial testing session, a feedback session will be scheduled. This timeline allows the psychologist

time to obtain and score teacher report measures and integrate and interpret all of the results gathered in the interview, testing session(s), and self-report

measures and/or parent and teacher checklists. During the feedback session, each test that was completed and the subsequent results will be discussed.

Based on the individual’s performance, individualized recommendations will be offered that draw upon the individual’s strengths and needs.

​

Report: A comprehensive written report documenting the test results, corresponding diagnostic findings, and subsequent recommendations will be

provided upon completion of the testing.

​

Families are also offered consultation services both before and after the evaluation process, as needed. Reports are disclosed to other persons,

professionals, or agencies upon appropriate written authorization unless specifically forbidden by legal or ethical concerns.

​

What Is a Standardized Test?

 

A standardized test is a measure that is administered and scored in a consistent manner and then compared with the appropriate age and/or group norms.

They are designed in such a way that all questions, materials, and testing conditions are consistent across administrations. One must possess specific

professional credentials to purchase, utilize, and interpret standardized tests. 

​

What Should a Child Be Told About the Evaluation?

​

Our team is trained to assist children with adjusting to the testing process once they arrive at the office. Regardless, it is often helpful to prepare

a child in advance. Most often, it is best to keep explanations brief and simple. For example, an older child might be told that they are going to be

trying memory games, puzzles, learning tasks and “brain teasers.” Younger children and toddlers can be told they are going to play puzzles and

“thinking games.” If a child asks, “Why do I have to do this?”, we may tell them that we just want to find out what kinds of things they're good at.

A further explanation may be given about trying to find ways to help them with difficult skills, such as paying attention, solving math problems,

or organizing homework. Some children find it helpful if explanations are related to a problem that the child is familiar with

(e.g., “feeling frustrated with school”). If the child seems anxious about performing “well,” reminding him or her that their only job is “trying”

is often beneficial.

​

Is There Anything Else I Should Know Before I Come Into the Office for Our Testing Appointment?

​

Since comprehensive evaluations often take an entire day, it is important to make sure there has been adequate sleep the night before an

evaluation and that the person doe not arrive to the session without eating. If special language needs are evident, it is important to be sure that

the psychologist is well aware of these. Similarly, if the individual wears glasses, a hearing aid, or any other device, please make sure to

bring them. If any medications are prescribed, do not refrain from administering them on the day of testing. If a child has had previous school

testing please bring copies of any relevant documents to the appointment for the case record. See our intake packet for additional information.

​

How Much Do Your Services Cost, and Do You Accept Insurance?

​

NBI is considered an out-of-network provider by insurance companies. Depending on the plan and deductible, reimbursement from your

company for consultations and neuropsychological evaluations may be available. Patients or their families are encouraged to submit superbills

to their carriers. These documents will be provided upon request. Our team will help facilitate reimbursement for the evaluation in any way

feasible. Full payment is required at the time of service. Please ask our office staff to answer any questions regarding fees, documentation, or

any other administrative matter.

​

​

How Is This Evaluation Any Different From a Testing Performed in the School?

​

School-based assessments (also known as psychoeducational assessments) are typically performed with one goal in mind: to determine

if a child qualifies for special education programs or therapies to enhance school performance. These evaluations focus almost exclusively

on intellectual and academic achievement skills needed for academic success, whereas comprehensive psychological and

neuropsychological evaluations provide detailed information regarding a child’s strengths and weaknesses across a variety of cognitive

domains. By objectively testing various skills, neuropsychologists are able to assess an individual’s overall cognitive, developmental, and

psychological functioning leading to a diagnostic formulation. Generally, school assessments do not diagnose learning or behavior disorders

caused by altered brain function or developmental problems. Moreover, although this type of evaluation suffices for some children, it is difficult

for a professional to responsibly diagnose any difficulty other than a clear specific learning disability with the limited amount of clinical

data typically gathered in a school evaluation.