lyndianne,

I had a neuro-psych assessment by Kaiser in Sacramento a few years ago. The NP was doing his neuro-psych internship/residency. He was an idiot. He chose to not include the scores that went against his diagnosis. He said I was faking it. He blamed my symptoms on depression. But when I got a copy of my scores, I scored 48 and 49 on the validity/malingering tests. 50 is a perfect score and means that I was absolutely not faking anything. The scores that show malingering or faking are in the 30's or lower.

He attempted to do a PASAT, Paced Audio Serial Addition Test verbally with a 'close enough ' stop watch technique. Dr Gronwall developed the PASAT back in the 1970's as one of the first tests for diagnosing Post Concussion Syndrome and her protocol calls for using a tape recording of the audio.

Even the MMPI-II (Minnesota Multiphasic Personality Inventory II) is misused when administered to the probable Post Concussion subject. I have had that used to mis-diagnose me.

One of the problems with neuro-psych assessments is very simple. If you score well on the WAIS (Wechsler Adult Intelligence Scales) scales but do poorly on the other tests, they blame your low scores on faking or malingering. I have had two different NP's disregard the validity scores that conflicted with their diagnoses.

On the Trail making test, it is common for the NP to improperly score them. If the A test is in the lower normal times but the B test is in the higher normal times, this discrepancy points to a cognitive problem with switching. I had to look back to determine what number or letter I was looking for. My tester tried to hurry me up too. The test protocols call for the tester to prompt the subject about errors or such but not to discount the effort. If they could just see what our eyes are doing as we search back and forth for the next target....

It is amazing that some NP's have the boldness to state in their report, "Contrary to the scores in the ..... test that show low indicators of depression... the subject's primary problem is depression. This is due to the subject's purposeful lack of effort, despite his strong showing on the scales for effort. " My first NP assessment in 2002 was supposed to last two days. It was finished by 2:30 the first day. The NP still charged the employer for the full two day battery claiming he spend two days testing me. He billed the employer almost $4600 including an approved extra fee for extra pages in his report. He mistakenly included his letter that mentioned being authorized for his extra fees beyond those authorized by Work Comp fee schedules. Do these NP's think we are dummies?

The non-neuro-psych psychologist who assessed me for Social Security Disability in two hours did a better job. He actually understood concussions. But he could not write a decent report.

So, be very careful about who you let assess you. It is difficult to overcome a biased or poorly presented assessment.

Glad to hear you found a Chiro who understood concussion. A friend with a moderate concussion had a mental melt down in her chiro's office. Her vital signs went haywire. He did not have a clue what to do. Unfortunately, he was her primary physician in a Work Comp case. He controlled who could examine her. He refused to let her see an MD.