Forensic Neuropsychological Evaluation involves the application of neuropsychological assessment methods to the evaluation of criminal or civil litigants.

Assessment of collateral sources of information, response bias, malingering, and norm-based psychological testing are essential components of the forensic clinical neuropsychological evaluation.

The examiner should be well qualified in both forensic psychology and clinical neuropsychology. The approach and batteries used should be capable of meeting legal standards.

In most states the examiner should at a minimum be licensed in psychology in order to perform psychological testing. Further training involving formal graduate level training is recommended as a standard by organizations such as Div. 40 of the APA and the National Academy of Neuropsychologists.

ABBP or ABPN Board Certification are normally recognized as high standards of proficiency. On the other hand many individuals "Board Certified" in neuropsychology by the American Board of Forensic Examiners have qualified solely on the basis of points and an application fee, and would not meet the criteria of requiring formal Graduate School education or supervision in neuropsychology.

Few states (Lousiana is one) have licensing laws governing neuropsychology, and regulation is subsumed by laws governing the practice of psychology and generally APA ethical standards which require psychologists to practice within the range of their competence.

The neuropsychological evaluation should contain the following elements:

1. Detailed review of medical and developmental history
2. Review of academic history and records when available
3. Review of current medication and past psychoactive meds
4. Review of trauma, exposure to toxins, and other potential neurological events
5. Review of social and occupational adjustment
6. Examination of current stressors
7. Detailed mental status examination
8. Formal neuropsychological testing

Neuropsychological testing should be thorough and can take up to two (or sometimes three) days to complete. Multiple measures of a particular cognitive function to examine for consistency is usually indicated in forensic settings. In forensic settings formal testing for malingering or reduced effort with tests designed for this purpose is suggested. While test patters are also helpful, little research has been conducted concerning the potential error rate of utilizing a virtually unlimited number of test pattern indicators.

A thorough neuropsychological evaluation should generally provide for evaluation of the following:

1. General Cognitive abilities
2. Academic Achievement
3. Sensory Perceptual Skills
4. Motor speed, coordination, and planning
5. Attention, Concentration and mental processing speed in visual and auditory modalities
6. Comparison of right and left hand performance
7. Assessment of language functions such as fluency and naming
8. Assessment of nonverbal skills such as construction
9. Assessment of verbal and nonverbal memory including retention and learning rates
10. Assessment of executive functions and cognitive flexibility
11. Assessment of personality and emotional adjustment.
A FORENSIC NEUROPSYCHOLOGY EXPERT presents quantifiable, data driven information about the relationship between brain damage or injury, and the behavioral or cognitive consequences that are related to the legal proceeding. Scientific tests assess the status of cognitive functions such as memory, intellectual ability, attention, concentration, information processing abilities, executive functions, and skill level. Useful in personal injury, competency, criminal, and disability cases.

Neuropsychology is the study of the relationship between the brain and function including reasoning, behaviors, learning, memory, reading, writing, emotions, and various cognitive and behavioral functions. Neuropsychological testing and evaluations provide a method of measuring neuropsychological function and its interplay with behavior.

Results of neuropsychological tests are organized by into cognitive domains that are generally accepted by the scientific community, providing a useful and functional way to consider a person's cognitive abilities. While different neuropsychologists will "carve up" these domains in various ways, most evaluations include the following factors:
     * Attention and concentration.
     * Perceptual and spatial abilities.
     * Memory and learning.
     * Motor skills.
     * Language and communication.
     * Reasoning, problem-solving, and judgment.
     * Emotion and personality.
     * Executive abilities such as planning, organizing, executing.
This provides to the professionals in the legal setting a straightforward objective way to discuss problems caused by head injury, brain injury, toxic exposure, medical malpractice, or other factors.

WHY A NEUROPSYCHOLOGIST rather than an MD Psychiatrist or Neurologist?  Neurospychologists use tests such as the Wechsler Memory Scales, Luria-Nebraska Neuropsychological Battery, and many other standardized tests.  Most MD's just do not work with these tests because they were not trained in these methods.  Which would stand up better in Court?  From an MD: "The patient was able to recall 1 words of a 3 words after a 15 minute delay".   From a Neuropsychologist: "The patient achieved a score of 54 on the Visual Memory Scale, indicating memory function in the 10th percentile, meaning that 90% of  people in the United States Normative base have a better visual memory".
© 1999