This is the first article in a two-part series on evaluations for children with learning differences. Part One looks at neuropsychological evaluations: what they are, what parents can expect, and when they may be useful. Part Two will focus on school-based evaluations and the different role they play in identifying a child’s educational needs.

Some children seem to struggle in ways that are different from their peers. Maybe schoolwork takes longer than expected. Perhaps a child has difficulty staying focused or organized, or seems overwhelmed by situations that other children manage more easily. Parents may notice these patterns without knowing exactly what they mean.

Sometimes these challenges are simply part of growing up; however, they may also reflect a particular learning difference or be related to a condition such as ADHD, autism, or a learning disability. When parents want to better understand what is happening, one option is a neuropsychological evaluation.

A neuropsychological evaluation can help move a family from a general sense that something is getting in the way of social or academic development toward a clearer picture of how a child thinks, learns, and approaches the world.

Dr. Laura Rubin, a neuropsychologist from the Portsmouth Neuropsychology Center in Portsmouth, New Hampshire, defines a neuropsychological evaluation as “a comprehensive analysis of a child’s strengths and potential challenges.”

As Rubin explains, a psychological evaluation examines a number of areas that can affect how a child functions. These may include cognitive and academic functioning, language, memory, attention, executive functioning, mood, and behavior.

According to Rubin, neuropsychologists are a little like detectives. Rather than looking at one test score or one area of difficulty, they work to piece information from different domains together to understand a child’s unique profile.

That means there is not one standard set of tests given to every child. Neuropsychologists have large “test libraries,” according to Rubin, and an evaluation can be tailored to the questions and concerns that brought a family in. A child experiencing academic difficulties, for example, may complete a different group of tests than a child whose parents are primarily concerned about attention, behavior, or emotional regulation.

This history provides important context. It helps the neuropsychologist understand what the child has experienced over time and decide which areas should be explored more closely during testing.

The child then typically meets individually with the neuropsychologist for testing. Depending on the child’s age, the questions being explored, and the practice conducting the evaluation, testing may take place across several appointments lasting a few hours at a time.

After testing is complete, parents generally meet with the neuropsychologist for a feedback session. The neuropsychologist explains the results, discusses the child’s areas of strength and challenge, and may offer recommendations for school, home, treatment, or other supports.

An important thing to know about the neuropsychological process is that booking an appointment often takes time. Families have reported anywhere from one month to six months wait time for an initial appointment. Once the evaluation process begins, it will take place over numerous weeks and even months because the evaluation process is thorough and consists of a number of appointments.

Parents are sometimes unsure whether they should pursue a neuropsychological evaluation or ask their child’s school for an evaluation. The two can overlap, but they have different primary purposes.

A school-based evaluation generally focuses on a student’s educational functioning with the aim of determining whether the child qualifies for specialized instruction, accommodations, or other school-based services. If a parent’s main concern is getting appropriate support in place at school, a school evaluation may be an important first step—and in some cases may provide all the information the family needs.

A neuropsychological evaluation has a broader clinical focus. Its goal is to understand patterns in a child’s learning, memory, attention, executive functioning, behavior, and emotional functioning. When appropriate, this type of evaluation may also help determine whether a child meets criteria for a diagnosis such as ADHD, autism, or a learning disorder that could impact not only academic functioning but also social-emotional functioning and inform both school and treatment interventions..

This broader perspective can be particularly helpful when several factors may be contributing to a child’s difficulties. Rubin gives the example of a child who has a history of attention problems as well as a history of trauma. Both can affect concentration and learning, so understanding what is contributing to the child’s struggles may require specialized assessment and a careful look across several areas of functioning.

The distinction does not mean that neuropsychologists and school evaluation teams are working at odds with one another. Quite the opposite. Rubin notes that neuropsychologists may participate in school meetings, conduct school observations, share recommendations, or work with school teams to help translate evaluation findings into useful supports for a student.

For parents, the important thing is to understand the different questions each evaluation is designed to answer. A school evaluation focuses primarily on what a child needs to access and make progress in their education. A neuropsychological evaluation aims to develop a broader picture of why a child may be experiencing particular challenges, the basis of a child’s strengths and relative challenges, and provide a roadmap for academic and social-emotional success.

Rubin explains that families arrive with many different questions. Parents may be wondering about ADHD, autism, learning disabilities, mood concerns, or a combination of issues. In some cases, they may not have a particular diagnosis in mind at all. They simply know that their child is struggling and want to better understand why.

“Its really a broad range of concerns that we might be seeing and helping families with.”

For many families, that may be the most useful way to think about a neuropsychological evaluation. It is not simply a search for a diagnosis. It is a process for developing a more complete understanding of a child—the tasks and activities that come easily to the child, the tasks and activities that require more effort, and the kinds of support that may help them thrive and reach their goals.