A neuropsychological evaluation answers questions.

What’s holding my child back? What can move my child forward?

More specifically, parents who come to Dr. Petrosky for a neuropsychological assessment have questions such as:

• Why is my son or daughter having trouble in school? What’s getting in the way?
• How can I challenge my child without overwhelming him or her?
• How can I promote my child’s development?
• What’s the diagnosis?
• Why is my child such an enigma?
• Is this just a normal part of growing up or does my child need some help?

A neuropsychological evaluation is the type of assessment to get in order to find out if your child has a learning disability, such as dyslexia, dyscalculia, or a Disorder of Written Expression, ADD / ADHD, executive functioning or memory impairments, or another type of learning challenge.

Neuropsychological assessments can play a crucial role in differential diagnosis. Making a “differential diagnosis” is when a clinician determines which of several possible diagnoses the person has. This is particularly important because different conditions can look very similar on the surface. For example, poor attention and concentration can be caused by ADD / ADHD, anxiety, depression, all of the above, or something else. A differential diagnosis helps answer questions such as: Is my child not learning because s/he is not paying attention or is my child not paying attention because s/he is not learning?

In short, a neuropsychological evaluation helps get to the bottom of things and pinpoint what the problem is and what can be done to help. It also identifies the child’s strengths and learning styles and how to leverage them.

A neuropsychological evaluation provides clarity and guidance. A neuropsychological evaluation helps you, teachers, tutors, and others who work with your child understand him or her and – just as importantly – not misunderstand your child.

A neuropsychological evaluation (a.k.a. neuropsychological assessment, neuropsychological testing) is a way of objectively measuring how the brain processes information or how the brain is performing. It looks at areas such as attention, executive functioning, planning, organization, problem solving, memory, language, nonverbal abilities, intelligence, reading, writing, math, fine motor skills, and other areas. Neuropsychological testing provides clients with tasks to perform, such as answering questions, memorizing information, and solving puzzles. Some of the tasks seem like “brain teasers.” Other tasks seem like the types of things a child does in school, like reading, writing, and math exercises.

Dr. Petrosky then performs a thorough analysis of the neuropsychological test data. This includes objective scores, but much more than that, Dr. Petrosky goes “past the scores” and looks at why the scores are high or low, why certain tasks were challenging and why others were easy for the child. Neuropsychological testing analysis also includes looking at patterns of scores, strengths, and weaknesses.

Dr. Petrosky uses this information to answer the questions that brought the child in for a neuropsychological evaluation, like the questions above. Most importantly, he uses this information to generate practical, actionable recommendations.

To simplify, neurological tests generally look at what is physically happening in the brain. For example, neurological tests such as a CT Scan or MRI can detect if there are lesions (cuts) or malformations in the brain. An EEG can detect if there is abnormal brain wave activity. Most children with learning challenges, however, have brain dysfunction that is not picked up by existing neurological tests. Neuropsychological tests, by having the individual perform certain tasks (e.g. solving problems), look at how the brain is performing. For individuals who do produce positive findings on neurological tests (e.g. agenesis of the corpus callosum), neuropsychological testing is also very helpful for identifying exactly how the neurological condition is affecting their school or job performance, behavior, and relationships.

A neuropsychological assessment with Dr. Petrosky generally involves 5 sessions and a comprehensive and detailed neuropsychological evaluation report:

• Session 1: The Parent Interview. This is a diagnostic interview with the child’s parents or legal guardian and generally lasts about 45 minutes. This session may be done in person or virtually. Dr. Petrosky finds out what questions about the child the parent needs answered and what the parent wants to get out of the evaluation. Dr. Petrosky also collects information about the child’s developmental, medical, family, social, and educational history.
• Sessions 2, 3, and 4: Testing Sessions with the Child. Usually three testing sessions are enough for Dr. Petrosky to collect all the information he needs, although sometimes he needs an additional session with the child. Each of these sessions are about 2 hours long.
  Most children, even those with attention difficulty, can sit for the full time, although an increased number of shorter sessions can be arranged if necessary. The testing is one on one and designed to be engaging, so most children, including those with special needs, can sit for the 2 hours. If needed, however, Dr. Petrosky modifies the above format to accommodate the child, such as by doing more testing sessions shorter in duration. Dr. Petrosky also can combine the parent interview and the first testing session into one visit (provided the parent interview is in person), if the child is old enough to wait in the waiting room while Dr. Petrosky first speaks with the parent and then meets with the child. All of the child’s testing sessions are in person.
• Session 5: The Parent Feedback session. The neuropsychological assessment culminates in an in-depth feedback session with the parents in which Dr. Petrosky explains all the results, findings, and recommendations and answers parent questions. This session is like an in depth consultation session. The feedback session lasts 1 – 2 hours, depending on how many questions the parents have. It can be done in person or virtually.

  For older clients (e.g. high school age), if Dr. Petrosky and the parents feel it would be helpful, Dr. Petrosky also conducts a separate feedback session for the student. These sessions are shorter than the parent feedback session. Dr. Petrosky does not want the student to feel “under a microscope” or like s/he is being lectured. So, these sessions are “short and sweet.” Dr. Petrosky goes over the main bullet points. Dr. Petrosky wants this to be a validating experience for the student. He goes over the student’s strengths and presents the main areas of challenge in a proactive, constructive manner (e.g. “In order to have an easier time with x, you might want to try…”).

• The neuropsychological evaluation report is several things. Firstly, it explains all the results and findings. You shouldn’t have to be a psychologist to understand your child’s neuropsychological report. For this reason, Dr. Petrosky places great emphasis on explaining the results and “buzz words” in easy to understand, everyday language. Secondly, the neuropsychological assessment report contains Dr. Petrosky’s diagnosis, if there is one. Thirdly, the report serves as documentation to try to get the child the proper services, modifications, and accommodations from the school district. Finally, the report is a reference guide for helping, as Dr. Petrosky provides many practical recommendations about what parents, teachers, therapists, the child him/herself, and others can do to promote the child’s development.

All the neuropsychological testing sessions with the child and Dr. Petrosky are done in person. The initial diagnostic interview and final feedback session with the parents can be done virtually or in-person, depending on parent preference.

Because Dr. Petrosky takes such a detailed and comprehensive approach, his neuropsychological evaluations are extremely time intensive and this is reflected in the fee. Please contact Dr. Petrosky to get the exact fee for a neuropsychological evaluation.

Dr. Petrosky does not accept payments from school districts, organizations, or other third parties. All parents pay Dr. Petrosky directly. Parents can ask their district if the district would reimburse them after the fact for what they pay for the evaluation, however, this would be strictly a matter between the parent and school district.

Part of Dr. Petrosky’s feedback session includes practical advice on what “next steps” to take, including how and with whom to share the report. He is also available for follow up questions. In addition, down the road from the evaluation, parents may wish to come in for a consultation session to discuss and assess the child’s progress since the evaluation and determine if there are any new or different actions the parents should take. There is no additional charge for parents to ask several follow up questions soon after the feedback session, although there is an additional charge for any lengthy follow-up sessions after the feedback session as well as for consultation sessions.

Not necessarily. Dr. Petrosky tries to be as comprehensive as possible in order to help guide the parents moving forward.

In short, neuropsychological evaluations answer questions. So, if in the future new and different questions about your child arise, this could be an indication for another neuropsychological evaluation. This could include if the child is at a different stage of development than when s/he had the first evaluation and is facing new and different demands and challenges. An example would be a child who was assessed in the 1st grade because of decoding difficulty, but now is in or approaching middle school and is struggling with comprehension and executive functioning. This also could include situations in which the child has begun to struggle in ways that you or teachers do not understand. On the other hand, if your child is progressing nicely and neither you nor the child’s teachers and/or therapists have any questions as to what the child needs and how to best help the child, then there most likely would not be a reason for another evaluation.

Another potential reason for having another neuropsychological evaluation is if the last evaluation was a relatively long time ago and a school, agency, or institution is requiring a more recent evaluation, such as when considering a current appropriate educational placement or when applying for accommodations on standardized tests or in college.

A clarification to the above is that Dr. Petrosky does conduct follow up educational testing for children he has tested previously. This consists of testing specifically for reading, writing, and math (as opposed to doing a full neuropsychological evaluation) in order to assess a student’s academic progress since the last evaluation, to see how much the student’s skills have “moved the needle,” and to determine what the student’s current needs are. Dr. Petrosky only conducts this type of evaluation for students with whom he has previously conducted a full neuropsychological evaluation.

Children with a severe or profound intellectual disability, children who are nonverbal, and children with severe Autism have needs that fall outside of the typical types of assessments Dr. Petrosky performs.

In addition, Dr. Petrosky now focuses exclusively on the types of learning challenges discussed here. He no longer does evaluations to determine if a child has Autism Spectrum Disorder, Social (Pragmatic) Communication Disorder, Nonverbal Learning Disability, or behavioral disturbances (e.g. Oppositional Defiant Disorder).

Finally, Dr. Petrosky does not do evaluations to determine if a child has a Central Auditory Processing Disorder (CAPD), as this is done by a Speech – Language Pathologist.

*Please note that, as internet search engines sometimes retrieve old, incorrect addresses, Dr. Petrosky’s above Syosset office is his one and only current office.