EXPOSING THE LIMITS OFNEUROPSYCHOLOGICAL

ASSESSMENTS

James L. Vigmond & Karen N. Vigmond

• What is neuropsychology?• How does it work?• When might I consider using it?• Do I want to expose the limits?• What are the limits?• What are the challenges to presenting the

evidence?

• The study of the relationship between brain (injury vs function) and behaviour

WHAT IS NEUROPSYCHOLOGY?

• The study of the relationship between brain (injury vs function) and behaviour

• Effects on cognition, emotions and executive function

WHAT IS NEUROPSYCHOLOGY?

• Interview the plaintiff/insured• Review records and documents• Administer tests• Score tests• Interpret tests• Formulate opinion

HOW DOES IT WORK

• Whenever I want to demonstrate brain-related impairment

WHEN MIGHT I CONSIDER USING IT?

• Is there an opposing neuropsych report?• Is there a neuropsych report that differs

from mine?

DO I WANT TO EXPOSE THE LIMITS?

• Failed validity testing• Failure to establish an appropriate baseline• Repeat testing• Errors of interpretation• Lack of test sensitivity to executive functioning• Use and quality of collateral information• The test environment (the “profound paradox”)

EXPOSING THE LIMITS(undermining the opinion)

• Failed validity testing• Failure to establish an appropriate baseline• Repeat testing• Errors of interpretation• Lack of test sensitivity to executive functioning• Use and quality of collateral information• The test environment (the “profound paradox”)• Giving appropriate consideration to assessment

difficulties

EXPOSING THE LIMITS(undermining the opinion)

• Recognition of attention deficits• Effects of pain• Effects of fatigue• Effects of medication• Effects of sleep disorders, anxiety and

depression

COMMON ASSESSMENT DIFFICULTIESAMOUNT THE BRAIN DISORDERED

• Tedious, technical and tiresome

PRESENTATION OF THE EXPERT EVIDENCE

• Neuropsychological evaluation provides an objective measure of impairment but requires subjective evaluation by the neuropsychologist.

• You can assist by providing collateral information.

• Be strategic in using it.

CONCLUSION