I will apologise at first if this post may come across as elitist or class orientated it isn’t intended to be.

Over the many months I have been visiting the board, I have noticed that even with the limitations of our injuries the majority of the posts are articulate, well reasoned and informative. However, one of the common themes is that the NeuroPsychological and even Psychological assessment falls short of our expectations.

One thing that I have been wondering more and more is it the generic nature of the NeuroPsychological assessment and that the “system” is not tailored to deal with those whom previously had a high capability for logical thought, speech or even artistic ability. Looking at some of assessment test they seem to be based on the “average man in the street” and do not take into account the different perspectives that academic or business achievement would bring. One of the popular tests has questions on whether you would like to work in a library or would be prepared to sneak into a movie if you knew you could get away with it. If you were someone whom loves working outdoors a library might be your version of hell but heaven to an academic. Likewise sneaking into a cinema would be abhorrent to a business or person with strong religious or moral beliefs. Obviously, depending on how these (and others) were answered determines you evaluation.

I think the problems really occur when articulate people describe their symptoms to clinicians because all they see is someone whom is articulate, logical and can present a good account of their injuries therefore – there can’t be anything wrong with them and it must be psychological than physical. They seem to disregard that allthouhg there is a relatively high capacity this is much reduced than before, mental effort it took to give the explanation or how easy it would have been pre injury. Similarly I have tried some of the NP tests on 3 non injured friends who dropped out of school early and work in the service industry, all of which scored just below the level I did.

For example I described a problem I encountered to my GP – I had to work out the number of hours between 17:00 and 07:00. My mind first suggested 10 hours but something in my mind told me it was wrong and it should be 12. My mind kept on telling me that it is still wrong – so I broke it into 17:00 to 24:00 and 00:00 to 07:00 to get the right answer of 14. My GP’s view was most people would have got that wrong so what the problem? Pre accident, I would have worked out the answer without thought.

So my question is do Academic or Artistic people miss out on the diagnostic processes ?