ABSTRACT
Neuropsychological assessment is differentiated from more generic psychological evaluation, not so much by the test measures employed, but by the interpretation of the data resulting from those measures, in terms of knowledge of brain structure and function. The discipline is founded in the dual theoretical domains of the neurosciences and cognitive sciences. The practice of neuropsychology requires the integration of information across these disciplines, in as much as current knowledge allows. A sound theoretical basis, both with respect to neurological disorders and cognitive processes, is essential for a full neuropsychological evaluation and interpretation. Consider the situation where a child is referred for neuropsychological assessment of memory difficulties. To investigate these problems, the neuropsychologist might administer some memory tasks, for example, a word list learning test or a spatial learning measure. Results might demonstrate an impaired performance on the verbal memory task, with intact spatial memory. Without knowledge of brain-behaviour relationships, the neuropsychologist can make limited conclusions, and would possibly diagnose a verbal-specific memory deficit. However, if additional background history is available, indicating that the child suffers from intractable epilepsy, due to left-sided hippocampal sclerosis, then interpretation is based on behavioural findings plus an understanding that aspects of memory and learning are subsumed by the hippocampus and related cerebral structures. The resulting formulation may then
conclude that the child is exhibiting verbal memory deficits consistent with documented cerebral pathology. More importantly, if there is a question of surgical treatment, as discussed in Chapter 9, it may be possible to relate verbal-specific memory deficits to radiological and neurological evidence of left-sided pathology, and intact right hippocampal function, and even to comment on likely prognosis.
