Learning disabilities represent neurodevelopmental disorders that affect cognitive (thinking) processes. Individuals that suffer possess normal intellectual ability and preserved skills in other cognitive domains. The observed weaknesses make sense based on scientific evidence regarding maladaptive brain development and functioning that can affect written and spoken language, attention, problem-solving skills, executive functions, learning and memory, visuo-spatial abilities, and mathematics. Learning disabilities can have a negative impact on a person’s ability to demonstrate their knowledge and skills at school, work, social life, and home activities. In some cases, the learning disability is highly visible to teachers, parents, loved-ones, friends, and colleagues, but often the weaknesses are hidden and not directly observable. In many cases, sufferers have learned to compensate for their weaknesses, but may be working extremely hard to “keep up appearances”. A learning disability is not better explained by other factors such as an acquired physical or neurological disorder, either in childhood or later life, generally low cognitive functioning across the board, cultural factors, mental health problems, or lack of educational opportunity/exposure (Robert Mapou, 2002; NAN position paper, 2006).
Academic problems are some of the most frequent reasons that individuals are referred to the clinic. Traditional psychoeducational evaluation is available at the clinic and is often sufficient for the determination of eligibility for additional services or accommodations in a school or other learning environments. However, this type of evaluation can miss a large portion of cognitive difficulties, or other factors, that may be affecting an individual’s ability to learn or function. The comprehensive neuropsychological evaluation provides a more in-depth understanding of the learner, is more precise in clarifying a person’s strengths and weaknesses and is useful in determining such things as appropriate educational placement and programming, behaviour management techniques, avenues for self-help, accommodations, career, and vocational planning. Often referrals are received because an individual’s academic or work performance is not meeting expectations.
WHY INVEST IN A NEUROPSYCHOLOGICAL EVALUATION?
While many individuals have undergone a school based psychological or educational evaluation, it is possible that specific strengths and weaknesses have been overlooked or that a deficit has been missed. In other cases, some, but not all, of the deficits have been identified, leading to the implementation of rehabilitation programs that do not produce academic improvement. Moreover, although evaluators have traditionally relied on discrepancies between intellectual skills and academic function to determine the presence of a learning disorder, this method fails to identify approximately 50% of individuals with bona-fide learning disorders, or cognitive or emotional/behaviour difficulties that affect learning. The neuropsychological evaluation includes both measures of intellectual and academic functioning, but then goes beyond to employ methods that evaluate those brain functions involved in reading, math, and writing as well as the subtler components involved in each of those academic domains. This entails detailed knowledge of the brain, the role that different brain areas serve, and how functions are affected by various conditions like learning disabilities, Down Syndrome, ADHD, among others. A neuropsychological evaluation draws on multiple sources of data and is comprehensive. In some cases, it allows for a more fine-tuned diagnosis of the problem and may uncover factors that are contributing to the problem(s), with the goal of leading to the development and implementation of more effective accommodations and treatment recommendations. Like a psychoeducational evaluation it includes an academic component but also involves intellectual skills, cognitive abilities, brain behaviour relationships and mental health screening (when applicable).