ARC believes in the value of utilizing a therapeutic testing approach. While all neuropsychological testing is standardized in administration, Dr. Gayoso and the team at ARC believe that every child responds in their own way to the process, and building rapport and taking care of client needs is more important for valid and reliable results. 

Neuropsychology is a specialty field that joins the medical fields of neurology, psychology and psychiatry. Neuropsychology involves determining how well the brain is working when it is disrupted by a brain injury or psychological disorder. A neuropsychological assessment is a comprehensive test of a wide range of mental functions including behavior. 

Through neuropsychological testing, we are able to determine a diagnosis, understand the progression and severity of the diagnosis, and provide treatment plan to help the patient and their family make appropriate adaptations and develop ways to cope with the diagnosis. 

A neuropsychological evaluation is an evaluation of the brain-behavior relationship. It is the unique integration of genetic, developmental, and environmental history with formal test data to create a narrative report that tells the story of the patient and gives highly specialized treatment plan.

Formal testing assesses cognitive, personality, and functional areas through intellectual and executive functioning; memory – attention, short-and-long-term memory, visual & auditory memory; language  – receptive, expressive, figurative, semantic, syntactical, and phonology; gross motor development – balance, hemispheric dominance, fine motor control & speed, and left-right discrimination.

Executive skills assessment includes problem-solving, planning, organization, inhibition, attention, and spatial relations. In addition, because personal efficiency and effectiveness are dramatically affected by emotional states, we also evaluate psychological and personality functioning to understand how the patient feels about themselves and interacts with the world around them.

Collateral information and behavioral assessment is sought from parents, educators, doctors, and therapists when appropriate. Direct assessment time is typically between 6 and 8 hours.  

These Are The Assessments That May Be Used By Domain Within A Neuropsychological Evaluation: 

Intelligence Tests 

• Wechsler Adult Intelligence Scale 

• Wechsler Intelligence Scale for Children 

• Stanford Binet Intelligence Scale 

• Woodcock John Tests of Cogniton 

• Test of Nonverbal Intelligence 

• Shipley Intelligence Scale 

Achievement Tests 

Achievement tests measure what one has learned already. Typically this relates to reading, writing and math, and gives a baseline for intelligence and how a person may function. 

• Woodcock Johnson Tests of Achievement 

• Wechsler Individual Achievement Test 

• Wide Range Achievement Test   

• Attention – CCPT, WCST, Vanderbilt, NEPSY 

• Language – GORT, Boston Naming, HRB-Aphasia 

• Memory and Learning – WMS, WRAML, CVLT, RAVLT, ROCF, NEPSY 

• Motor Control – Grooved Pegoard, Finger Tapping, Grip Strength, Lateral Dominance 

• Visual-Spatial – ROCFT, Bender-Gestalt, HVOT 

• Autism – ADOS, ASDS, ADI, GAR 

• Executive Functioning – WCST, BRIEF, EFSD, D-KEFS, HRB   

• Behavioral – BASC, Achenbach, Vanderbilt 

Commonly seen disorders

Neurodevelopmental Disorders

• Attention Deficit Disorder / ADHD / ADD

• Autism spectrum / Asperger’s

• Pervasive Developmental Disorders

• Dyslexia

• Learning Disabilities

• Visual Processing Disorders

• Auditory Processing Disorder / APD / CAPD

• Developmental Delay

• Non Verbal Learning Disabilities

• Sensory Integration Disorders

• Social Skills Development Concerns

• Brain Injury / Concussion 

• Mild head injury

• Post-Concussive Problems

• Seizure Disorders / Epilespy

• Congenital Brain Disorders

• Chronic Pain

• Functional Pain

• Psychiatric Disorders

• Behavioral Disorders (conduct, oppositionality, impulsivity)

• Mood Disorders including Depression or Bipolar

• Anxiety Disorders

• Alcohol and Substance Abuse Issues

When there is a disturbance in the normal pattern of the brain-behavior relationship, this will cause deficits in learning, behavior, mood, and development. These disturbances may be related to injury, illness, or genetic coding. Neuropsychological assessment provides the road map to understand these problems.

Some cognitive abilities tend to be very stable despite neurologic illnesses or injuries. Those abilities often provide an estimate of the level of your other cognitive abilities if no injury or illness had occurred. Your results will be compared to the pattern of results associated with various illnesses or injuries to help determine if changes have occurred. 

See your healthcare professional for a referral for a neuropsychological assessment if you or a loved one show any of the following signs: 

• Changes in short-term memory or asks the same question repeatedly 

• Frequently loses items, gets lost easily 

• Confusion 

• Poor attention and concentration; doesn’t appear to listen; gets confused in conversation 

• Language difficulty: has trouble speaking or finding words or cannot understand what others say 

• Difficulty recognizing common items

• Visuospatial difficulties including difficulty drawing or using a map 

• Poor judgment/decision-making 

• An unexplained change in personality, increase in anxiety or depression, development of delusions or hallucinations 

• New difficulty with understanding or managing bills or finances 

• Trouble recognizing familiar people 

If you are undergoing a neuropsychological assessment, the mental functions tested include:

• General intellect

• Language usage and understanding of what others say

• Attention/concentration

• Processing speed

• Learning and memory

• Reasoning

• Executive functions, which are higher-level skills you use to organize and plan, manage your time, problem solve, multi-task, make judgments and maintain self-control

• Visuospatial skills

• Motor speed and dexterity

• Mood and personality

A neuropsychological assessment can be requested for a number of reasons including:

• To help with diagnosis: Test results are sometimes used to help understand the cause of problems with your thinking and understanding. For example, test results might be used to determine if your cognitive (mental) changes are due to normal aging, a neurological illness, depression, anxiety or other causes. Your healthcare provider can then use the results of your neuropsychological examination along with the results of other tests, such as brain scans, EEGs, and blood tests, to arrive at a diagnosis that will help to guide your healthcare.

• To determine cognitive strengths and weaknesses: In some cases, a healthcare provider may order tests if you’ve had a known neurological event or injury, such as a stroke or traumatic brain injury, to find which cognitive functions have changed and how much they have changed.

• To establish a baseline: In some instances, an exam is performed before and after a medical or surgical treatment to determine if cognitive abilities were affected by the intervention. Re-examination at some point after the baseline can also demonstrate how well you’re recovering from a stroke or traumatic brain injury and whether or not you’re ready to return to work, resume driving or take on other duties.

• To help plan a treatment or other intervention: Test results can be used to identify which cognitive abilities should be the focus of rehabilitation if you’ve had a brain injury. Results also help therapists determine which strengths might be able to compensate for weaknesses. The evaluation can provide the basis for making decisions and/or adjustments to school or work schedules and determine the skills that are most important for you to work on.

Many neurologic conditions can result in changes in cognitive function. Some include:

• Alzheimer’s disease

• Transient ischemic attack and stroke

• Traumatic brain injury

• Epilepsy

• Parkinson’s disease and other movement disorders

• Multiple sclerosis

• Brain tumors

• Infections of the brain and spinal cord

Many non-neurologic conditions and their treatments can also affect cognitive function, particularly when they are advanced or severe. Some include diseases of the liver, kidneys, heart, lungs, digestive system, and endocrine systems, as well as some cancers.

Insurance coverage varies greatly, depending on individual insurance plans. Some portion of the assessment is usually covered. If you have any concerns about insurance coverage, please check with your insurance company. If you want to check with your insurance company before the evaluation, you will need to let them know the following CPT (procedure) codes:

90791: Interview

96132, 96133: analysis and interpretation by a neuropsychologist

96136, 96137: Test administration

Our experience has been that most psychological problems have a neurocognitive substrate. A standard psychological or psycho-educational evaluation evaluates basic intellectual, academic, and personality functioning. A neuropsychological assessment goes into greater depth with executive functioning, attention, memory, visual-spatial, and language functioning. A neuropsychologist is specifically trained to evaluate the brain-behavior relationship and has a strong background in neurodevelopment. By using more data points with a more intensive look at genetic, developmental, and environmental facts, we believe that neuropsychological evaluations are more accurate. In a standard evaluation, subtle learning disabilities may be missed because the greater specialization of neuropsychology was not used.  

With a neurodevelopmental perspective, we evaluate students for signs and symptoms of learning disorders. Each brain has unique strengths and weaknesses, and a diagnosis is never black and white – strengths and weaknesses are on a continuum. Assessment and treatment of subtle signs and symptoms is very important for overall success. We believe that many psychiatric and behavioral disorders are driven by mild neurocognitive disorders which affect how a person learns to deal with their environment. Most people are never made aware of these peculiarities in their learning style which eventually cause problems. For example, if a child has a visual-spatial neglect, they will likely miss visual cues in their environment. Missing these cues will mean that they may not pick up on subtle nonverbal language in social relationships. This could cause them to be rejected by others, feel frustrated and depressed, and may cause them to choose other methods of acceptance or satiation such as drugs. In adult life, this person may continue feeling isolated because they never learned the tools to remediate such a problem. In fact, they never even knew there was a problem. 

Assessment is the key to understanding the highly complex functioning of the brain. Without a full comprehensive assessment, therapies may be stumbling around in the dark on how to make a difference. In providing these very thorough neuropsychological evaluations, we are seeing the brain as a unique set of strengths and weaknesses. At ARC, we explain these complexities and lay out the road map for diagnosis, treatment, and accommodations so that this complex picture can be understood.  This will allow treatment providers to have all the facts and oversight to accurately help clients with their neuro needs in an efficient and effective manner.  

In the document download section of this website, there are forms that should be completed prior to the evaluation. These include the Patient Questionnaire.pdf that includes these things:

(1) Disclosure and Authorization for Services,

(2) Patient billing information,

(3) Patient Questionnaire,

(4) Privacy Policy.

On the day of your appointment, you should bring the completed Patient Questionnaire. Please double check the location that you will be meeting the psychologist. Please do not be late or miss your appointment. Call us at 469-908-7585 if there are any problems.

As you begin the testing session, the psychologist will want to get to know you better and establish a working rapport. The session will most likely begin with an interview and a review of information. The testing portion will take between 4 to 6 hours, so at least one break will be necessary. Please bring a light snack for this break.

Most people find the activities stimulating and enjoyable. Each task will likely be novel and will test your abilities by becoming increasingly challenging. It is important to do your best but do not feel bad if you are unable to get all the answers correct. You will be asked to complete a variety of questionnaires and rating scales, and other observers (parents, teachers) may be asked to complete rating scales as well.

Upon completion of the neuropsychological evaluation, a mental health professional at ARC will engage in a detailed analysis of the results. This involves a meticulous process of scoring, grounded in extensive mental health research and aligned with the criteria of the DSM-V. Our focus is on ensuring accuracy and reliability in interpreting these results.

Following this, we integrate the data to form a holistic view of the patient's cognitive, emotional, and behavioral profile. This comprehensive approach allows us to identify not only areas that may require support but also to highlight the patient's strengths. The outcome of this analysis includes the formulation of any relevant diagnoses, if applicable, and the preparation of a detailed report. This report will encapsulate the findings and propose a personalized treatment plan, tailored to address the specific needs and goals of the patient.

We understand that this process is thorough and may require some time to complete, reflecting our commitment to precision and care. Once finalized, a feedback session will be scheduled with you and your family. During this session, our psychologist will discuss the evaluation findings in depth and provide an overview of the suggested treatment plan. This meeting is a vital part of our collaborative approach, offering an opportunity for discussion, clarification, and to ensure a shared understanding of the path forward.

Additionally, at your request, we can furnish the written report and pertinent information to other treatment providers. This facilitates a coordinated and integrated approach to care, ensuring that all parties involved in the patient's well-being are informed and aligned.

At ARC, we understand that the decision to pursue a neuropsychological evaluation is significant for you and your family. The total investment for this comprehensive assessment is tailored to meet the unique needs of each individual. This cost varies depending on several factors, including the specific objectives of the evaluation and the setting in which it is conducted (such as in our office or at a treatment center).

Our evaluation encompasses a thorough process, which includes:

1. Intake Interviews: Initial discussions to understand the patient's history and current concerns.

2. Test Administration: Utilization of a range of tools to assess cognitive, emotional, and behavioral functioning.

3. Scoring and Analysis: Detailed examination of test results.

4. Interpretation: Insightful understanding of the individual's neuropsychological profile.

5. Report Generation: A comprehensive, narrative report outlining the findings and including a tailored treatment plan.

6. Follow-Up Visit: A session dedicated to discussing the results, providing feedback, and ensuring a clear understanding of the next steps.

We strive to deliver these results in a timely manner and schedule an in-person feedback session at the earliest convenience for both the family and the neuropsychologist.

At ARC, we recognize that navigating the realm of health insurance can be intricate and sometimes overwhelming. To ensure you have a comprehensive understanding of your coverage, we advise initiating a conversation with your insurance provider. This step is crucial for gaining insight into the specifics of your policy, especially as it pertains to neuropsychological evaluations.

Our skilled administrative team is at your service to provide assistance with any billing and insurance-related queries. We acknowledge that reimbursement policies can vary and are subject to change, depending on the carrier and the specific plan. In light of this, while we do require payment at the time of service, we are dedicated to supporting you in the reimbursement process. Our team will assist by providing necessary documentation and offering guidance to help you navigate your claim with your insurance provider.

Our commitment at ARC is to offer clarity and support throughout this process. We aim to alleviate any administrative burdens, allowing you and your family to focus on what is most essential – the mental health and developmental growth of you or your loved one. Rest assured, we are here to guide and support you every step of the way, in alignment with our core values of compassion, integrity, and a growth mindset.

Therapy, behavioral consultation, and specialty treatment is also fee-for-service, and this can be discussed at the appropriate time. 

Our medical partners (pediatricians, psychiatrists, and neurologists) do accept some insurance carriers, and this can be discussed when appropriate. 

Travel and on-site assessment or treatment can be provided at additional cost.  

We are in-network with and accept the following insurance providers and plans: Aetna, Cigna, & BCBS - PPO plans only for all (no HMO plans).

Please email your questions to: support@thearcfrisco.com