Neuropsychologist
What is a Neuropsychologist?
According to the American Psychological Association, neuropsychology is "a specialty field within clinical psychology, dedicated to understanding the relationships between brain and behavior." A neuropsychologist focuses on diagnosing and treating brain disorders by assessing behavior and cognitive functions. Neuropsychologists have a deep knowledge of the relationship between cognition and behavior and the structures of the brain.
A neuropsychologist can help a patient of any age; however, some may specialize in pediatrics or geriatrics. They often treat patients who are beyond the expected concussion recovery time (2-4 weeks) and have lingering symptoms such as trouble focusing and issues with school or work.
How do they assess a concussion?
Assessments can vary depending on the provider and the situation. The Children’s Hospital of Philadelphia lists the following areas as possibilities for a neuropsychological evaluation:
Intellectual functioning
Attention and executive function skills (e.g., planning, organization, impulse control, cognitive flexibility)
Reasoning and problem solving
Language
Visual-spatial/visual-perceptual skills
Sensory-perceptual functioning
Fine motor abilities
Learning and memory
Academic achievement
Social skills
Emotional and behavioral functioning
Adaptive skills (independence in daily living activities)
A neuropsychologist may test for these areas by observing daily behaviors and interviewing the patients and their caregivers. They may also give in-person cognitive and neuropsychological testing, including various activities, questionnaires, and tests. Once the evaluations have been completed, a neuropsychologist will compile all of their information. Many of these tests are "norm-referenced, which means that a patient's performance on those tests will be compared to the performance of other people who are" similar to them in age and possibly education. When the neuropsychologist has come to a conclusion, they will offer you treatment plans or possibly refer you to another specialist to help with specific symptoms.
What treatments do they offer?
A neuropsychologist will recommend treatments once they have completed their evaluation. Keep in mind that these treatments vary significantly for each patient and their symptoms, so talking to a neuropsychologist with experience treating concussions is imperative. Dr. Talin Babikian from UCLA says that "if there's any pain or physical discomfort, that has to be addressed. And so that wouldn't be us, but we have to put that in the equation, because we can talk and talk and talk, but if someone's in excruciating pain, we're not going to be very helpful." The physical pain would be treated by a neurologist or a physical therapist, which happens before a neuropsychologist can help.
The neuropsychologist will most likely start with improving basic self-care habits. This mainly includes "sleep habits, nutrition, hydration and exercise." Dr. Babikian says that "if [she] were to write a prescription, [she] would write 'normalize your life as much as possible.'" Symptoms of irritability, sadness, headaches, and others can come from losing things that were in your life before the concussion. A neuropsychologist can help you with strategies to get back to the activities that make you feel normal and happy.
Where can you find a Neuropsychologist?
Neuropsychologists can be found at concussion clinics, outpatient rehabilitation centers, and hospitals. Dr. Babikian suggests looking for a local concussion clinic to find a neuropsychologist that has experience in concussions. You can also consult your primary care physician or another medical provider and ask for a referral.
The American Academy of Clinical Neuropsychology has a directory of board-certified members. You can search based on U.S. state or Canadian province, language, city, and if they have a pediatric subspecialty. This tool does not give much information about the neuropsychologists or their experience with concussions, but it does offer names and email addresses. If you have a sport-related concussion, the Sports Neuropsychology Society also has a search tool to find sports neuropsychologists in the United States and Canada.
Who might they refer you to?
The following occupations are possible providers that a neuropsychologist may refer you to in order to help with other symptoms:
*The links attached to these providers offer general definitions of that profession and do not specifically address concussion care. The Concussion Alliance recommends that you seek treatment from a provider with experience in concussion treatments.