The Virtues of Neuropsych Tests
I recently met with a family whose 16-year-old daughter, Paige, was refusing to go to school. Her parents reported that Paige was a bright student with a history of strong school performance. Recently, her grades had dropped, and her parents were puzzled about what was going on. They also said that she had distanced herself from longtime friends and was spending more time in her room. Once a compliant, friendly girl, Paige was now fighting with her parents who felt she was being willful and defiant in refusing to go to school; they could not understand why she was not open to reason and why she was willing to compromise her bright future.
Paige’s parents requested help in finding Paige a new school and surmised that her current school was too much of a “pressure cooker.” They were confident that she would do better in a friendlier, less pressured environment. As I met with this family and their daughter, I suggested that we slow things down and not move into a school change too quickly. I cautioned that sometimes changing campuses did not necessarily remedy situations and that it might make sense to take the time to try and explore the situation further. I recommended that the family take Paige for a neuropsychological evaluation to help us get a better understanding of their daughter’s academic and emotional functioning. I pointed out that it was quite likely that their daughter very much wanted to get to school every day and that rather than being unwilling to go, she was perhaps unable to do so. I explained that neuropsych testing could help us uncover the causes of Paige’s difficulties,
Many people assume that neuropsychologic testing’s only value is to determine the presence of a learning disability. While, of course, we rely heavily on evaluations for this purpose, neuropsych testing can also offer us other information. In Paige’s case, my hope was that it would shed some light on why school attendance was becoming so difficult for her. A comprehensive neuropsychological evaluation typically contains batteries that can help us better understand if a child is experiencing emotional issues such as anxiety, depression, feelings of low self-esteem, and anger, to name just a few.
In preparing both Paige and her parents for the testing, I explained my hypothesis, that Paige would be attending school if she could and that something was making it intolerable for her. Since Paige had a hard time articulating her inability to attend school, testing would help us uncover what was going on.
For Paige and her family, the experience of pursuing a neuropsychological evaluation was a positive one. For starts, testing ruled out an undiagnosed learning disability and demonstrated that in fact Paige was quite bright and belonged in a school with academic rigor. What the testing did reveal quite starkly, however, was that Paige was struggling with crippling feelings of anxiety, and in particular, social anxiety. The neuropsychologist suggested that any talk of a new school placement be put on hold and that instead, we work with Paige’s family to put in place an intensive, short term plan to address the anxiety. In the end, Paige took a three-month leave from school to attend a program to help her address her feelings of anxiety. During those three months, we collaborated with Paige’s family and her counselors and came to the collective conclusion that Paige’s needs could be met in her current school. As she transitioned back to school, we put supports in place to ensure Paige would maintain the gains that she had made in the program and that she would continue to receive the counseling support she needed.
I am happy to report that Paige is doing well. Neuropsychological testing was an important part of getting Paige back on track.