I only have one data point (myself) with two NPAs conducted 3 months apart, but in retrospect they were spot on.

The first one (two months post-accident and just before I was discharged from in-patient neuro rehab) stated: “patient does show significant difficulties with visuospatial learning and recall, as well as mental flexibility and multitasking. He displays weaknesses in aspects of executive system functioning (retrieval of learned information, mental flexibility, abstract reasoning, problem solving, and verbal fluency)”. I recognized this to be true; I frequently forgot things, I’d repeat myself often, I had problems finding my way around the hospital rehab center though I’d been there four weeks, I had a hard time processing and retaining written material and couldn’t do simple math problems.

Three months later the follow up exam stated “On examination, the patient demonstrated intact cognition in all domains assessed including learning and memory, attention, processing speed, language skills and executive functions. He has shown an excellent recovery from his severe injury only five months ago. From a cognitive standpoint there are no concerns with respect to the patient returning to work full time or returning to driving”. By this time I was able to do some analytical work part time from home, I comprehended written materials (newspapers, books) fine, my wife didn’t observe me repeating myself or forgetting things, and I passed my driving test with no problems.

So to directly answer your question, I believe they are accurate for the time they are taken. Since yours was two years ago you have most likely have made improvement since then. The other dynamic is the tests administered. If you have copies of the report it should say what the tests are. For example the WAIS-IV and trail marking are tests for processing speed/attention; Rey Auditory Verbal Learning is a test for learning and memory, etc.

Regarding your next move, what do you wish to accomplish through the testing? A new test could show where you have improved and if there are remaining deficits that need attention. An NPA is expensive, but if it’s to return to the workforce and you are covered by health insurance this may be covered.