Neuropsychological Assessment in Schools
by William R. Merz, Sr., et al
Neuropsychological assessment is a tool that has traditionally been
used by hospital clinicians and clinical psychologists. However, now that
educators have begun to recognize the value of neuropsychological
assessment, many school psychologists are being trained to use it as a
regular part of assessing children with special needs.
This digest tells you what neuropsychological assessment is and why
it's important to educators. It explains how educators use
neuropsychological assessment and what some of its limitations are. It
also provides a list of sources where you can find out more about
neuropsychological assessment.
What is Neuropsychological Assessment?
In theory
Neuropsychology is the study of how the functions of your brain and
nervous system affect the way you think and behave. For some time now,
neuropsychology has helped hospital clinicians assess patients who have
experienced head injuries to determine how neurological damage affects
their patients' thinking skills and behavior. Clinical psychologists have
also benefited from neuropsychology because it helps them more accurately
assess the causes of some patients' behaviors.
Recently, education experts have begun to use neuropsychology to
explain why some children have trouble acquiring language skills, learning
to read, developing arithmetic reasoning skills, and so on. Using
neuropsychology in schools can help teachers serve children with learning
disabilities more effectively because a child who has neurologically
related disabilities does not benefit from the same teaching techniques
(such as repetition) that a student who learns at a slower rate benefits
from.
Neurological assessment is a tool for evaluating how much a child's
performance may be influenced by unusual functions of the brain and
nervous system. It helps school psychologists systematically measure a
child's skills and determine the best learning environment for the child.
In practice
A complete neuropsychological assessment requires gathering and
analyzing information about the child's development physically, socially,
and psychologically as well as the child's education. This information
comes from a variety of sources.
Parents' observations are a valuable source of information because
parents are the first observers to evaluate such things as their child's
motor skills, language acquisition, and the like.
Formal observation, for example, watching the child copy designs,
pronounce words, or figure out an arithmetic problem is also part of the
assessment.
Some standardized assessment measures with established validity and
reliability already exist--for example, asking a child to generate rules
from examples or to state socially accepted behaviors for given
situations.
Other tests are designed to help assess neuropsychological development
as well. The two most common tests are:
the Halstead-Reitan Neuropsychological Test Battery (which includes
the revised Wechsler Intelligence Scale for Children) and
the Luria-Nebraska Neuropsychological Battery.
Why is Neuropsychological Assessment Important for Educators?
Recent laws for the handicapped encourage it
Educators have turned to neuropsychological assessment in an effort to
comply with recent laws for the handicapped. The Education for All
Handicapped Children Act of 1975 (Public Law 94-142) and The Education and
Handicapped Act Amendments of 1986 (Public Law 99-457) require schools to
search for and serve all handicapped children who are three years old and
older. The act and its amendments require educators to screen, assess, and
identify children with learning disabilities early on so that these
children can receive an education that is best-suited to their needs.
Schools today offer a wide range of programs
Programs in most schools address a wide range of functioning levels
from the severely developmentally disabled to the gifted or talented. For
these programs to work effectively, the school psychologist must identify
the learning strengths and weaknesses of each child so that the children
will be placed in the educational environment that will help them reach
their full learning potential. The more extensive the psychologist's
repertoire of insightful tools, the more complete the evaluation. And, the
more complete the evaluation, the more appropriate the child's placement.
Learning disabilities are difficult to identify
Identifying learning disabled students has never been an easy task.
Students' ability to acquire learning skills can be affected by many
factors, ranging from physical make-up to home environment. It is possible
that Johnny can't read because he has not been in school enough, has
emotional problems that interfere with learning, is unable to listen to
instruction, or has a brain dysfunction that prevents the acquisition of
learning material through traditional methods. In order to separate the
many overlapping factors and provide the most accurate diagnosis possible,
the school psychologist must use the best diagnostic instruments
available.
Children with subtle problems benefit most from neuropsychological
assessment because they do not have severe disabilities that have obvious
symptoms; yet, these children do not function best within the normal
learning environment.
How Do Schools Use Neuropsychological Assessment?
Just as the medical practitioner uses diagnostic tests to rule out or
to corroborate diagnoses, the school psychologist assesses abilities using
neuropsychological assessment. Most students are not formally assessed. If
a teacher notices that a child seems to have learning problems, the
teacher may modify teaching methods accordingly. If the student fails to
respond, then more extensive assessment may be done to determine the best
instructional approaches to meet the student's needs.
What Are Some Limitations of Neuropsychological Assessment?
One of the advantages of neurological assessment is that it can
accurately detect neurological damage or dysfunction without the need for
obtrusive medical tests. However, some limitations should be kept in mind.
To perform neuropsychological assessments well, you must be a
thoroughly trained professional.
The results of a neuropsychological assessment are not an absolute
score or completely accurate proof. You must use results along with data
that are compiled from many different sources.
Many experts question the validity of basic norms of neuropsychological
assessment because the norms were originally derived from groups that were
predominantly adults; only a very small sample of children were
represented in the populations that were studied to produce the norms.
Neuropsychological assessment batteries are long and extremely time
consuming when used in their complete form.
Additional Readings
Franzen, M. & Berg, R. (1989). Screening children for brain
impairment. New York: Springer Publishing Company.
Kestenbaum, C.J. & Williams, D.T. (1988). Handbook of clinical
assessment of children and adolescents. New York: New York University
Press.
Sattler, Jerome M. (1988). Assessment of children, (3rd Ed.).
San Diego: Jerome M. Sattler.
Siegel, M.G. (1987). Psychological testing from early childhood
through adolescence. Madison CT: International Universities Press.
Swiercinsky, D.P. (1984). "Evaluation of Neuropsychological
Impairment." In S. J. Weaver (Ed.) Testing children: a reference
guide for effective clinical and psychoeducational assessments. Kansas
City, MO: Test Corporation of America.
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This publication was prepared with funding from the
Office of Educational Research and Improvement, U.S. Department of
Education under contract number R88062003. The opinions expressed in
this report do not necessarily reflect the position or policies of OERI
or the Department of Education. Permission is granted to copy and
distribute this ERIC/TM Digest.
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