Psychiatry

Neuropsychological Services for Children, Adolescents, and Young Adults

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At Mount Sinai, we provide comprehensive neuropsychological assessments, treatments, and support for children struggling with learning disabilities such as Attention Deficit Hyperactivity Disorder (ADHD), academic delays, developmental delays, autism spectrum disorders, mild disruption behavior disorder, and school-based anxieties. Our staff combines research advances with clinical experience to provide the most effective and compassionate care for each patient.

Our pediatric neuropsychologists—licensed psychologists with expertise in learning and behavior as they relate to brain structures and systems—are skilled in the evaluation and treatment of learning and developmental disabilities. Starting with the initial assessment through the entire course of treatment, we work with our patients, their families, and school personnel to conduct and implement evaluations and treatments.

The First Step: A Comprehensive Assessment

The process of treating a new patient starts with a thorough assessment in order to make the correct diagnosis and develop the most effective treatment plan. Because everyone learns in different ways, these assessments help us choose the strategies and services personalized to each patient’s individual needs.

The assessment includes the following elements:

  • Analysis of the child's medical, family, and neurodevelopment history
  • Child and parent interviews
  • Psychological testing
  • Neuropsychological evaluation
  • Parent and school feedback
  • Collaboration with schools, therapists, tutors, and educational advocates

Neuropsychological Evaluation
The core of the assessment is the neuropsychological evaluation, which measures areas such as intellectual ability, executive functioning (which includes attention, planning, organization, initiation, and self-monitoring), visual and auditory perception, language, memory, motor skills, social perception, and emotional functioning. A neuropsychological evaluation differs from other psychological evaluations in that it gauges the functioning of the patient’s central nervous system to help the clinician discover the specific cognitive processes that may be impaired in each patient.

These evaluations typically consist of an interview with the parents about the child’s history; an interview with the child; individual testing (which involves having the child perform paper-and-pencil and hands-on activities, answer questions, and sometimes use a computer); and a questionnaire to be completed by the parents about their child's development and behavior.

A neuropsychological evaluation assesses the following areas:

  • Attention and concentration
  • Full scale IQ
  • Speech and language
  • Phonological and audiological functioning
  • Verbal and visual memory
  • Visual motor integration
  • Executive functioning skills (such as planning, attention, and inhibition)
  • Fine motor functioning
  • Intellectual ability
  • Academic skills
  • Social perception
  • Audiological processing
  • Emotional functioning
  • Interpersonal functioning

Typically, parents are not in the room during the testing portion but may be present with very young children. The time required depends on the child's age and the nature of the issue(s) at hand. Because we are a teaching hospital, there is opportunity to have your child assessed by one of the externs or fellows for a reduced fee. The externs and fellows are closely supervised by a licensed pediatric neuropsychologist.

What to Tell your Child
What you tell your child about the evaluation depends on how much he or she can understand. In general, it is best to indicate that these assessments will shed light on how to educate them at home and at school. Some tips for preparing for your child’s evaluation include the following:

  • If your child wears glasses or a hearing aid, make sure to bring them.
  • If your child has special language needs, please alert the neuropsychologist in advance.
  • If your child is taking psychotropic medication, please inform the neuropsychologist beforehand to ask whether the medication should be taken on the day(s) of the assessment.
  • If your child has had previous school testing, an individual education plan, or has related medical records, please bring those records with you to your appointment.

Collaborating with Schools
To augment information obtained during the neuropsychological evaluation, our staff conducts classroom observations to evaluate the fit between a child’s cognitive, behavioral, and social-emotional skills and his or her learning environment. During this time, we will assess the child’s peer group and social interactions as well as consult with teachers and school-based support teams. Pediatric neuropsychologists may work closely with a physician to manage difficulties and frequently consult with schools to provide appropriate educational programming.

Integrated Learning and Development Treatments

Each assessment culminates in a comprehensive report that integrates the findings of our multidisciplinary team in a detailed, easy-to-understand summary. Our staff then meets with each patient and/or parent to review the results and share our recommendations.

Together, we create a remedial plan that will address the needs of the entire family. This plan may include:

  • An integrated way of thinking about the individual’s strengths and needs
  • Targeted recommendations to correct or accommodate cognitive and/or behavioral challenges
  • Concrete recommendations on how to advocate for your child
  • Recommendations and support for obtaining needed services
  • Attending all Individualized Education Program (IEP) and Committees on Special Education (CSE) meetings
  • Meeting with teachers and administrators to help explain report results
  • Working with educational advocates, if necessary, to devise a free and appropriate education plan

We provide a network of psychological and remedial treatment services to meet each child's cognitive, social, and behavioral needs, which may include psychotherapy or play therapy, cognitive remediation, parent management training, and school-based or social anxiety support. When appropriate, our staff will be in communication with schools and other professionals involved with the child. If requested by the parents, we can coordinate our treatment plan with the school, provide consultation to the school, and attend CSE meetings.

Our specialized staff are skilled in personalizing these services to best meet the needs of each child or adult coming to us for treatment. We hope to partner with our patients to provide the coordinated care they need to attain their highest level of function.