What Is Neuropsychological Testing?

How does a neuropsychologist help diagnose cognitive issues and mental health conditions? One of our Keck Medicine of USC providers shares insights about this unique specialty.

When someone has a brain injury or disorder, they may experience changes in their behavior and cognitive function, such as thinking, reasoning and remembering. Neuropsychologists work with patients to test and diagnose these changes so that better treatment options can be recommended.  

“It’s unique to have a neuropsychologist working in a psychiatric program, but at Keck Medicine, we’re part of the team and help objectively and accurately diagnose and measure the extent of neurodevelopmental and neuropsychiatric conditions in both children and adults,” says Joey Trampush, PhD, a neuropsychology specialist at Keck Medicine of USC.  

In children and young adults, such as USC students, neuropsychologists mostly conduct evaluations for attention deficit hyperactivity disorder (ADHD); learning disorders, such as dyslexia (reading disorder); dyscalculia (math disorder); and nonverbal learning disorders and autism spectrum disorders, such as Asperger’s syndrome.  

Their work is a bit different for adults. While they evaluate many of the same conditions, they also test for emerging memory issues and dementias, such as mild cognitive impairment.  

“In both youth and adults, it is often the case that we are asked to help determine the underlying cause of attention and concentration problems, which can be due to ADHD, comorbid anxiety disorders and/or comorbid mood difficulties, such as depression,” Trampush says. “The end goal for all of our patients is to provide diagnostic clarification so that our therapists, psychologists and psychiatrists can better treat each patient in a more targeted, individualized and precise way.” 

Learn more about this specialty and the role it plays in a patient’s mental health care journey.

What is neuropsychology?  

Neuropsychology combines two fields, neurology and psychology, Trampush says. Neurology is the study of the nervous system. Psychology is the study of the mind and how it influences behavior.  

Neuropsychology brings both of these together. It is the study of the processes of the brain and nervous system that relates these biological processes to behavior and cognition, mainly relating normal functions to functions of people with brain damage, mental disorders or dysfunctional behaviors, according to the American Psychological Association. Testing and evaluation are a big part of a neuropsychologist’s job, Trampush says. This helps patients get more accurate diagnoses and treatments. 

Who goes to a neuropsychologist?  

In general, neuropsychologists test patients to determine the extent of cognitive function in people with disorders such as Alzheimer’s disease, dementia, Parkinson’s disease, brain injuries, learning disorders, attention deficit disorder (ADD) and ADHD.  

“By the time patients get to me, they’ve often seen multiple providers, usually because no one can really figure out why they’re not responding to their treatments,” Trampush says.  

“That’s when they get referred to me. We do comprehensive evaluations, performance tests and neuropsychological tests. Our objective, data-driven measures help us diagnose and understand a patient’s condition so that we can get them the treatment they need.”  

Our job is to tease apart nuanced differences in behavior to determine whether someone has ADHD, generalized anxiety disorder, personality difficulties, undiagnosed learning disorders or even substance abuse disorder.

Joey Trampush, PhD, a neuropsychologist at Keck Medicine of USC 

How does neuropsychological testing work at Keck Medicine?  

At Keck Medicine, neuropsychologists focus a lot on dementia evaluations and a range of neurological conditions, like Parkinson’s. They also offer testing and care for movement disorders, Alzheimer’s, Asperger’s, autism, learning disorders and many rare genetic disorders, where there’s risk for cognitive decline.   

 “Our neuropsychological tests measure someone’s strengths and weaknesses to determine what treatment should focus on. I dedicate a lot of time to figure out what’s going on with a patient,” Trampush says.  

Evaluations may be done over several hours and may involve different memory, word reasoning, auditory attention and verbal tests, as well as personal evaluations and feedback from friends, family or teachers.  

“Our neuropsychology program has also expanded due to a rise in patients seeking mental health care during the COVID-19 pandemic,” Trampush says. “There’s been an explosion in people being referred for testing to determine if they have ADHD.”  

This increase in demand follows a national pattern: There has been an increase in ADHD diagnoses as well as prescriptions for stimulants such as Adderall, which are commonly used to treat ADHD.  

 
Why has there been an increase in people diagnosed with ADHD? 

Trampush says the general interpretation is that once classes and work went remote, people had a harder time focusing.  

“All of a sudden things were very different for a lot of people, and they weren’t learning,” Trampush says. “They got really stressed and became anxious.” 

As a neuropsychologist, he helps to determine whether the symptoms a person is experiencing are a normal response or a measurable problem in cognitive function and various forms of memory, such as short-term, long-term and visual memory.  

“Sometimes people do have ADHD, but sometimes, it’s something else,” Trampush says. “Our job is to tease apart nuanced differences in behavior to determine whether someone has ADHD, generalized anxiety disorder, personality difficulties, undiagnosed learning disorders or even substance abuse disorder.” 

 
What should you do if you think you need neuropsychological support services? 

If you have mental health concerns, Trampush recommends talking to a mental health professional and getting an evaluation rather than jumping to conclusions or trying to self-diagnose online.  

“The value of neuropsychological testing is that it can help us fully understand your condition so that we can start treatment early. The earlier someone receives treatment, the better the outcome can be long term,” he says. 

Trampush adds that as awareness of conditions like ADHD and autism continues to grow, there may also be a rise in the need for psychiatric and mental health services, such as neuropsychological evaluations.  

“I don’t see this uptick in the need for psychiatric and mental health services going away,” he says. “There’s still a stigma around mental health, but the more people are becoming okay with talking about it and seeking evaluation and treatment from professionals, the more it will help.” 

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