Developmental Psychology. Contemporary Educational Psychology. Human Communication Research. Journal of Positive Behavior Interventions. Behaviour Research and Therapy. Reading Research Quarterly. Clinical Child and Family Psychology Review. Journal of Abnormal Child Psychology.
Journal of Experimental Child Psychology. Psychosomatic Medicine. Applied Psychology. Early Childhood Research Quarterly. Exceptional Children. Journal of School Psychology.
Neuropsychological assessment of children and adults with traumatic brain injury
Educational and Psychological Measurement. Development and Psychopathology. Journal of Autism and Developmental Disorders. Youth Violence and Juvenile Justice. Psychology of Women Quarterly. European Child and Adolescent Psychiatry. Decision Support Systems. Journal of Youth and Adolescence. Neuropsychological assessments for LTCSS participants may be used to inform eligibility determinations as well as to inform treatment, rehabilitation and care programs. This section of the Guidelines establishes the procedures for arranging assessments and the mandatory sharing of reports. With effective communication and adherence with these Guidelines, neuropsychological assessments can be scheduled at appropriate intervals to provide the necessary information required for rehabilitation, CTP claims management, LTCSS participant planning and settlement purposes.
This is important for injured people, particularly children and those who will require multiple assessments through the course of their development and recovery, to ensure all measures are taken to limit the number of assessments undertaken. Neuropsychological assessments conducted for rehabilitation planning and treatment purposes take priority over medico-legal assessments.
Neuropsychological assessment of children and adults with traumatic brain injury - SIRA
Provision of supplementary information may negate the need for additional and unnecessary neuropsychological assessments. In the event that an assessment is required for management or settlement of a CTP claim, or to inform eligibility of a LTCSS participant, the following should be considered before arranging a medico-legal assessment:. At least 12 months, and ideally 2 years should pass between assessments. Assessments arranged more frequently than the schedule recommended in the Guidelines may impact the validity of results, place an unnecessary burden on the injured person and impose an avoidable cost.
Whenever possible, rehabilitation needs should direct the timing for neuropsychological assessments. A clinical report has a different use and purpose to a medico-legal report. However, much of the information typically required for medico-legal purposes may be available in the report, or from the assessing psychologist, particularly when the assessment has been conducted within the preceding 12—24 months.
The CTP insurer, solicitor or other party seeking additional information should contact the psychologist who most recently conducted a neuropsychological assessment to determine whether medico-legal or other appropriate information required can be provided to supplement the report. This could include information required for pre-settlement or opinion on an individual's capacity to manage their affairs. The specific issues to be addressed, questions to be answered and cost for providing any additional information should be negotiated prior to the provision of any supplementary documentation.
The psychologist will be able to provide advice regarding the appropriateness and usefulness of any supplementary information on a case by case basis as well as advice regarding the timing of subsequent assessments for clinical purposes. The CTP insurer, solicitor or other party seeking additional information should contact all other parties advising that supplementary information is being sought from the psychologist and outlining the nature of the request.
The Neuropsychological assessment notification NAN form can be used for this purpose. The response from the psychologist should be shared with all parties. The roles and responsibilities for parties with an interest in neuropsychological assessments of CTP claimants and LTCSS participants include but are not limited to the following. The BIRP should be contacted to nominate the psychologist to conduct the neuropsychological assessment if the injured person is a current BIRP patient.
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In other situations, such as claimants with mild TBI who may not be a patient of the BIRP, all parties including both plaintiff and defendant representatives should agree on the psychologist. The psychologist must be registered with the Psychology Board of Australia PsyBA and be competent to conduct neuropsychological assessments. Competence can be determined by endorsement for approved areas of practice which specifies advanced qualifications or supervised experience according to the Guidelines on area of practice endorsements 3 issued under section 39 of the Health Practitioner Regulation National Law.
Parties arranging assessments are responsible for ensuring the psychologist is appropriately registered, endorsed and competent to conduct the assessment. Registered psychologists endorsed in Clinical Neuropsychology as an approved area of practice by the PsyBA are qualified and competent to conduct neuropsychological assessments. Costs should also be agreed while arranging the assessment.
The party initiating the assessment should inform all other parties and provide information about the assessment and the nominated psychologist by completing the NAN form. Any dispute regarding the psychologist nominated to conduct an assessment must be raised with the party initiating the assessment within 10 working days after advice has been provided and the following process applied. A number of issues should be considered when determining whether a neuropsychological assessment is required, including but not limited to the following:. The timing and number of assessments should be guided by injury severity and clinical need.
The timing of assessments for clinical purposes will vary depending on clinical indicators.
It is important that medico-legal assessments do not take place at the same time as clinical reviews unless the assessment report can be shared by all parties including the treating team. A medico-legal assessment coinciding with clinical reviews at critical times during treatment and recovery can interfere with the rehabilitation process. Communication and collaboration between the parties will ensure multiple assessments are not required. Neuropsychological assessments are sometimes repeated to measure the change attributable to spontaneous recovery, treatment effects or deterioration in brain function.
However, neuropsychological tests are unlike other medical tests such as blood tests or MRI brain scans. Such medical tests can be done at repeated intervals without one assessment influencing the other. In contrast, one occasion of neuropsychological testing can have a significant impact on the results of the subsequent occasion of testing. To reduce these effects and maximise reliability, the assessments need to be carefully timed and only tests with known errors of measurement should be used.
Interpretation of test scores on a second occasion of testing presents considerable challenges. The complexity of interpretation is exponentially compounded the more times a person undergoes assessment on a particular test. For this reason the number of occasions of testing should be kept to a minimum. A minimum period of 12—24 months between assessments is recommended. Before arranging a medico-legal assessment every effort should be made to acquire the required information in what is available or could be obtained through liaison with the assessing psychologist.
In order to provide an informed and valid interpretation, it is imperative that the psychologist is provided with the names of the tests used and the raw scores obtained on previous assessment for comparison with current test scores. This will allow for appropriate statistical analysis of the change in results and for the selection of tests to be included to minimise practice effects.
Cognitive fatigue commonly occurs following TBI and may result in impaired concentration and sub-optimal performance on neuropsychological testing. The impact of fatigue on test performance should be taken into account. When fatigue is an obvious problem appropriate rest breaks should be provided.
For people with moderate to extremely severe TBI, rest breaks during a single session may be appropriate, or testing over several days may be required. All parties have responsibility to communicate and share information before and after a neuropsychological assessment as outlined in the roles and responsibilities section.
A series of fact sheets, available in Part Three of the Guidelines, provide information about neuropsychological assessment for individuals undergoing assessment, their families, significant others and other parties with an interest in the information provided in reports. To ensure that effective communication and sharing of information occurs for each neuropsychological assessment, the party arranging the assessment should facilitate the following:. Adherence with the Guidelines by all parties will ensure that neuropsychological assessment reports will meet clinical, CTP claims management and LTCSA planning needs as well as providing important information to the injured person, their family and service providers involved in treatment, rehabilitation and care.
This includes satisfying the need for information in the early recovery period that provides:. Neuropsychological assessment reports may be used up to and during the process of settling a CTP claim. Reports prepared according to the Guidelines should include test raw scores and sources of normative data such that a qualified psychologist with access to the manuals and reference material would be able to provide an independent interpretation. There are significant differences in the assessment of neuropsychological function in children and adults, and in the assessment of mild or moderate-severe TBI.
This section recommends tests that are sensitive and useful for the neuropsychological assessment of all TBI. The selection of specific tests and normative data recommended in the Guidelines are examples of appropriate measures. These can be supplemented or substituted with other tests at the discretion of the psychologist depending on the circumstances of each case.
The assessment of TBI and classification of the severity of an injury is reflected both by the depth of disturbance in consciousness coma , as well as the duration of post-traumatic amnesia PTA. Clinical assessment is used to determine the duration of PTA of children under seven years and may also be used to determine the duration of PTA for older children and adults with TBI. Due care is required when interpreting PTA test scores as failure on PTA scales can occur for reasons other than amnesia. Operational criteria for clinical identification include:.