Carole J. Symer, Ph.D.

A neuropsychological evaluation can be immensely helpful in clarifying the difficulties your child is encountering. You may already be suspecting there is a specific learning or attention deficit disorder emerging or that a brain injury or illness has slowed down development. These evaluations may also be pursued when social or emotional difficulties are getting in the way of your child’s success at school or with relationships with peers. For many reasons, parents may wish to delay pursuing an evaluation, hoping their child will eventually ‘grow out of it’. Sometimes this is true. But most professionals agree that early intervention plays a vital part in the outcome and progress of a child’s developmental growth. More information about the various strengths and weaknesses help parents and teachers hone the supports they are giving and teach to the child’s motivation. Generally speaking, it is recommended that evaluations are best done as early as possible. Undiagnosed learning and attentional disorders are a primary complicating feature of development, affecting a child’s school performance, emerging sense of self, attainment of success later on in college and work, and capacity to form and sustain meaningful personal relationships. An evaluation may be helpful in clarifying a diagnosis, understanding cognitive strengths and weaknesses, and obtaining insight about coping styles. Additional reasons when an evaluation might be sought include:  You child is struggling in school, on standardized tests, or in completing homework.  You child has problems retaining information and requires frequent redirection.  Your child continues to struggle academically despite school-based support and/or tutoring at home.  You are unclear why there is gap between your child’s potential and your child’s school performance.  You think your child may be gifted.  You are wondering if your child has a reading disorder like dyslexia.  You want to know if your child’s struggle in math is due to a learning issue, ADHD, or both.  Your child has a history of neurological difficulty or developmental delay (e.g., delayed language or sensory-motor activity).  Your child has suffered a concussion or traumatic brain injury. You want information to chart the recovery.  Your child has suffered exposure to a toxic substance (e.g., lead poisoning, alcohol, or drugs).  You want to do an updated evaluation in order to document changes in your child’s abilities or achievement due to development or remediation efforts pursued.

The process of the evaluation consists of three parts: Initial Intake Session, Evaluation, Feedback Sessions. Each of these phases are held in face-to-face meetings with me. Initial Intake Session: A comprehensive history of the concerns is discussed during a sixty-minutesession. Evaluation: If an evaluation is determined to be in your (or your child’s) best interests, evaluation sessions are scheduled. Those sessions generally take several hours and may be spread across several sessions. The assessment is interactive, involving hands-on activities, answering questions, and paper-and-pencil tasks. You and your child’s questions, reactions to the sessions, insights about the process are very much sought and valuable to the process. During the assessment, the following areas are usually assessed:  Intelligence / Cognitive Skills  Attention and Concentration  Learning and Memory  Language and Social Communication Skills  Visual/Perceptual Spatial Skills  Motor Skills  Academic Skills  Social Interaction Skills  Social-Emotional Areas  Behavior and Coping Skills Feedback Sessions: These are scheduled approximately two to three weeks after the last testing session, at which time the results are explained and diagnostic formulations are discussed. Most importantly, the reasoning for each recommendation is detailed and a plan of treatment is discussed in collaboration with parents and keeping the life of the child or adult I am evaluating in mind. Report: A comprehensive written report follows the feedback session, detailing the test results and diagnostic findings, along with a set of recommendations for home and school to enhance learning and life. Parents sometimes request additional letters to testing programs like College Boards and ACTs. I offer those services as well.

The purpose of these evaluations is to provide a comprehensive profile of how your child learns best and what may be interfering with their potential, academically, socially, emotionally, or behaviorally. Recommendations are made for therapeutic or educational interventions and various support services for home and at school to assist your child in optimizing their development. The knowledge that comes from the neuropsychological evaluation is useful in designing interventions and remediation strategies geared to your child’s specific learning and educational needs. The written report is a valuable roadmap to support the developmental progress of your child in the years ahead.

 Obtaining a detailed understanding of your child’s learning style.  Understanding why your child is having difficulties in school. For example, a child may have difficulty reading or doing math because of an attention problem, a language disorder, an auditory processing problem, or an actual reading or math disorder. An evaluation can tease out the factors impacting your child.  Finding out what else you can do to help your child learn to compensate for difficulties.  Determining whether your child needs extra time on standardized tests or other supportive services at school.  Evaluating current treatments and interventions, and determining whether academic or motivational difficulties are due to cognitive problems, a learning disability, or psychological challenges.  Determining the impact of developmental, neurological and/or medical problems on cognitive and emotional functioning (e.g., traumatic brain injury, autistic spectrum disorder, ADHD, dyslexia or a genetic disorder).  Obtaining a baseline to assess treatment outcomes, recovery rates, or your child’s development over time.

Some reasons for pursuing these kinds of evaluations as an adult are as follows:  Gaining insight as to what underlying cognitive or learning challenges, if any, may be interfering with the therapeutic interventions you are pursuing (e.g., psychotherapy, pharmacological interventions, physical therapy or rehabilitation, personal fitness goals, etc.).  Understanding why recent changes in jobs, schools, or relationships have left you struggling more than you anticipated and without the skills needed to tackle the new demands.  Detailing how the changes in your health or following an accident/head injury have compromised your usual routines, emotional experiencing, overall stress level, and required more time to heal than expected.  Wondering how to best handle a return to school, changes in jobs, and determining what supports you may need.  Gaining more information about the changes in your cognition/memory; determining whether these are due to normal aging or a dementia in the making, and learning how to optimize you’re your health and ongoing development across the lifespan.

I am an out-of-network provider with insurance companies and do not accept direct payment from insurance. Many health insurance companies will reimburse for a portion of consultations or neuropsychological evaluations. Toward that, if you ask, I am happy to provide you with information in advance that you may forward to your insurance company that may help you determine the insurance benefits to which you may be entitled. But because I do not bill insurance companies directly, payment is expected from clients at the time of service. With regard to specific fees, each evaluation situation is unique and I tailor my services accordingly to offer the most appropriate services to meet each client’s needs.