Specialist Neuropsychiatric Liaison Service
brain . mind . body integrative health
Neuropsychologists are interested in describing and quantifying brain functioning.
Generally speaking dysfunction is referred to as cognitive deficits.
Cognition refers to those mental processes that lead to the acquisition of information and knowledge, as well as the processing thereof which in tern drive how an individual understands and acts in the world.
Simply put, a Neuropsychologist mainly do question-and-answer tests in order to assess how well we acquire, process and apply information.
Neuropsychological assessments normally stipulate individual scores as well as scores relative to the general population.
Neuropsych tests are often very helpful in:
In broad terms the different brain functions are collectively referred to as domains. Domains are seen as distinct types of functions which the brain uses to execute behaviors.
Most Neuropsychologists describe six main domains, although some also include additional domains such as processing speed.
The standard domains tested are:
This domain deals with the ability to focus awareness on a given stimulus or task, to concentrate on that stimulus or task long enough to accomplish a goal, and to shift awareness if appropriate.
These abilities vary by individual, and may be impaired to the point of becoming a formal attention deficit disorder (ADD).
Problems in this domain can make focused searching and interaction difficult.
Language skills of various types are covered by this domain.
They are typically associated with the left (or dominant) cerebral hemisphere. Both oral- and written function is considered, mostly in terms of one’s abilities to comprehend, repeat and express in these modes.
Additional skills such as finding words and names quickly by category or sound are often assessed.
Problems in this area can make communication difficult in therapy and in life.
3. Visuospatial Skills
This domain deals with the abilities to make sense of the visual world.
These functions include being able to identify shapes, angles, larger gestalts vs details, as well as comprehending the meaning of forms—and to reproduce what one sees.
Problems here can affect a client’s ability to conceptualize complex ideas and relationships, and lead to an over-reliance on verbal expression.
4. Motor Skills
In broad terms gross, manual fine-motor, and facial fine-motor abilities are covered here.
Difficulties can make one’s facial expressions or gestures difficult to read, or affect one’s self-esteem due to trouble experienced with common every-day tasks.
5. Executive Functions
This domain deals with a variety of higher-order functions—planning, conceptualizing, organizing, evaluating—largely concerned with the working of the frontal lobes, the last to evolve and develop in the human brain.
Variations in frontal function vary widely in individuals and are implicated in ADHD, impulse control disorders of various kinds, antisocial behaviors, and the ability to achieve insight.
Difficulties in this domain can be of many kinds, and can make inner searching and insight particularly difficult.
Visual, verbal, and motor memory are the usual foci here, with olfactory and gustatory memory usually not having strong psychological implications (although they may be associated with dementia).
Memory disorder can be very brief, short-term, or long-term.
Learning is another dimension here, and can be measured in terms of free or cued recall, as well as by various forms of recognition (yes or no-, multiple choice-, forced-choice questioning) or cueing (semantic and phonemic).
Problems in this domain can affect recall from session to session in the verbal mode, or even within the session, forcing the therapist to adjust approaches accordingly (e.g., from insight to behavioral interventions).