How do I set up an evaluation for my child?
The best way is to call the office and speak with Dr. Brefach or a member of the staff.  If you reach the answering service, please leave a message with your name (with spelling) and numbers where you can be reached.  Please indicate whether there is a preferred time and number to contact you.  Dr. Brefach generally returns phone calls within 1-2 days, depending on her schedule.  You may also send an email to [email protected] with your contact information, and you will receive a response within 1-2 days.

What does a neuropsychological evaluation include?
An evaluation at Neurodevelopment Associates is comprehensive.  It includes testing in the three major areas that describe a child’s performance—cognitive skills in verbal and non-verbal areas, as well as memory and processing speed; neuropsychological functioning including expressive and receptive language skills, auditory and visual memory, fine motor skills, attention and executive functioning, planning and organizational skills, and sequencing; and in-depth academic testing that includes oral and silent reading, decoding and phonemic skills, spelling, written language, arithmetic processes and math problem solving.  It also includes a psychological screening for issues such as self confidence, self esteem, and peer relations.

Who is the best person to evaluate my child?

At NAI, we believe that evaluations need to be performed by fully qualified and experienced professionals, who will be able to obtain the necessary data from testing and integrate it into the most useful, accurate report to meet a client’s needs.  The people who work with you and your child at NAI, and any outside professionals who might conduct additional evaluations, will always be fully trained, highly experienced, and able to provide the highest level of service.  No evaluations will be performed by trainees or interns.

Why does NAI offer full neuropsychological evaluations rather than partial ones?

In most cases, parents who come to NAI with questions about their child will want to understand the full scope of their child’s functioning.  This includes their cognitive abilities, areas of strength and weakness, academic skills, and general emotional functioning.  For school-age children and adolescents, it is important to have a complete diagnostic picture in order to make the most effective recommendations.  Depending on the age of the client, tests will be chosen to provide the most relevant, complete data to aid in diagnosis and treatment.
With only a partial evaluation, it is much more difficult for the clinician to answer questions about the client’s needs, or to make accurate recommendations.  Any type of advocacy is limited when the clinician does not have a complete diagnostic picture.  There may be times when a partial re-evaluation is needed, for example at the end of a school year, or after a certain therapy has been provided for the client.  This can be discussed when the evaluation is scheduled.
In some cases, there are significant concerns about emotional functioning.  If in-depth projective testing is needed, this will be done during a second evaluation session, and a separate report will be written.  The need for this testing, and the specifics of scheduling and cost, can be addressed during the conversation to set up the neuropsychological evaluation.

Why is the educational part of the testing so important?

Most of the clients we work with are having difficulty with one or more aspects of academic performance.  Even the adults we test are often hoping to obtain accommodations for standardized testing.  For this reason, we evaluate performance levels in all academic areas in depth, and integrate this data with the cognitive and neuropsychological data to provide a comprehensive picture.  In cases where parents have concerns about their child’s skills, it is critical to obtain objective data to compare with other testing that might have been done.  This helps parents understand whether their child’s needs are being met by current school interventions.
Depending on the age of the client, different academic tests will be chosen.  For example, for children in kindergarten through third grade, there will be emphasis on phonemic awareness, decoding skills and strategies, phonological memory, and auditory analysis skills, while tests for older children would generally place more emphasis on critical thinking and levels of comprehension.

Why is the evaluation done in a single session?

School-age children are in class for approximately 6 ½ hours each day, and are expected to remain focused on work for many of those hours, with breaks for recess, lunch, and non-academic classes.  It is important for the evaluator to observe a child’s “work muscles”, attention span, persistence, and mood during a similar amount of time.  A few children are only able to work for shorter periods, which means they will have difficulty “getting through” a full school day.  The evaluator will need to address this issue in the recommendations.  Breaks in testing are scheduled every 45-60 minutes, or more often if needed, depending on a child’s ability to work effectively.  This is one of many important behavioral observations that are part of the final report.

Why aren’t previous reports or IEPs reviewed before the testing is done?

One of the significant ways in which evaluations at NAI are different from those done at other clinics is the fact that each child is evaluated “cold”, with the clinician knowing as little as possible about the child ahead of time.  This sets the stage for a fully objective evaluation, which is greatly appreciated by parents, advocates, and other professionals working with children.  The evaluator is a skilled professional who provides accurate data from testing, and then the synthesis of that data, as part of a comprehensive picture of each individual child.  Parents are seeking an objective expert opinion, and this is provided without influence from previous reports.  These reports are read after testing is completed, and are summarized in the background section of the report.

How else are our evaluations different from those at other clinics?

At Neurodevelopment Associates, accuracy and completeness are just the first step.  The next, crucial step is more of an art—the ability to weave these facts into your child’s story and provide a clear, understandable picture of your child and his or her needs.  You will understand the entire report, no matter what your background.  Many professionals can administer tests, but few have the skills to produce the type of report that captures your child as a unique individual, along with the essential recommendations for the help he or she requires. 

The other key difference is the ongoing support available to parents.  The best report is a means to an end.  It must be used effectively in order to be of help to a child.  We don’t expect parents to do this on their own.  We work with parents until school is “working for” their child, and the instruction and accommodations provided by the school are sufficient to allow success and mastery of skills.  Then, we monitor the progress over time.  In many cases, we need to gather additional facts from school observations and program assessments.  We will advocate for more appropriate services.  We attend Team Meetings, mediations, settlement conferences, and BSEA hearings.  We provide expert testimony and stand behind our diagnoses and recommendations.  We are committed to making school work for your child.