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Cognitive Testing

Cognitive Testing

Alternate Names

  • neuropsychological testing

Definition

Cognitive testing can detect changes in the way the brain functions. It can also determine whether the changes have occurred as a result of brain injury, illness or disease. Cognitive testing looks at a person's thinking skills. It also explores whether emotional or physical problems are interfering with those thinking skills. Specific areas examined during cognitive testing include:
  • attention
  • concentration
  • memory
  • abstract thinking
  • problem solving
  • judgment
  • language skills
  • ability to interpret information from senses (such as hearing, vision, touch)
  • ability to control fine motor skills in the hands
  • intelligence
  • academic skills
  • emotional functioning
  • Who is a candidate for the test?

    Anyone who is suspected of having a change in brain function may need cognitive testing. This testing is done for the following reasons:
    • diagnosis of cognitive problems or symptoms
    • as a baseline where the test may be repeated at a later date to monitor change in cognition
    • to determine the needs of someone suspected of having cognitive problems

    How is the test performed?

    Many tests are needed to give a complete picture of a person's cognitive skills. For example, to test attention and concentration, a person is asked to perform a simple task when there is a distraction nearby. Memory testing involves having a person memorize simple words and recite them later. Other tests ask the person to copy drawings, locate objects, name pictures, or explain the meaning of proverbs.
    The tests chosen for each person depend upon the problems the person is showing. Some of the tests can be given by a speech/language pathologist, also called a speech therapist (ST). They can also be administered by an occupational therapist (OT). Some of these tests are used to screen for problems. They can also be used to determine if a particular therapy is bringing about improvement.
    For example, someone who had a stroke may have some problems with understanding words. The ST may give tests that measure whether speech therapy is helping the person recover. When the ST or OT discovers cognitive problems, the therapist may recommend a full battery of tests. These are used to sort out causes of the problems and determine the best treatment plan.
    In this case, person should also be seen by a psychologist. A psychologist is qualified to give the full array of cognitive tests and to interpret the results. A psychologist who has received advanced training in the relationship between neurological and psychological problems is called a neuropsychologist. This professional often administers this type of testing.

    What is involved in preparation for the test?

    There is no advanced preparation for cognitive testing. It is not possible to learn things just to take the tests. The full array of tests can take several hours to complete. The most accurate results are obtained if the person is well rested. If the person becomes overly fatigued, the psychologist may recommend that the tests be given during several short appointments instead of one long session.

    What do the test results mean?

    The test results can reveal problems with brain function. Problems may be from physical damage, such as a head injury, or psychological problem, such as depression. Careful interpretation is important because the cause of the problems determines the treatment. Some conditions such as a disease that destroys brain cells cause permanent damage.
    Other sources of impairment are temporary. An example of this would be a reaction to a medication. The tests can sort out the causes. This allows the healthcare professional to set the direction for care and treatment. Test results can also show whether treatment is helping. Repeating certain tests over time, can give an indication of whether or not a person is improving.
    Many cognitive problems can be improved with treatment. This is true even if the impairment cannot be reversed. People can be retrained to compensate for some problems. For example, techniques such as using a notepad or an alarm watch can help compensate for memory problems. A speech/language pathologist, occupational therapist, rehabilitation nurse, primary healthcare professional and/or a psychologist are typically involved in treatment.

    Sources

    Horn, L.&Zasler, N. (1996). Medical rehabilitation of traumatic brain injury. St. Louis, MO: Mosby.

    Rosenthal, M, et al. (1999). Rehabilitation of the adult and child with traumatic brain injury. Philadelphia, PA: F.A. Davis Company.

    Sbordone, R. (1994). Neuropsychology for the attorney. Delray Beach, FL: GR/St. Lucie Press.

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