Neuropysch Assessment Results
 

So I went and met with the neuropsychologist last week and she gave me the results and a report. Overall, I guess I wasn't surprised by the results, but maybe disappointed. Part of me was hoping that the results would come back saying nothing was wrong with me and all the problems I thought I was having were just being imagined and if I just tried harder... and all that. You know the rest.

I don't know what the next steps are yet, if there will be any or not, I've not met with my physiatrist yet and he's the one that will be directing that. So right now, I'm just sort of left with this 4 page report. I won't type out the whole thing, just the parts that I think might be interesting or relevant?

The really good part of the whole NPA is that in talking to the neuropsych, nothing that was discovered during testing will trigger any issues with my drivers license, so I can keep on driving, which is a big deal to me. So I'm happy about that.

Not sure what the rest of the NPA means for me and my future.

(Just a bit of reminder history, this is my first NPA and my accident was February 2012, so just over a year ago. The only meds I take is topamax. I'm 41, college grad, used to work in high tech, left high tech a few years back to hobby farm)

The tests that were administered, WAIS-IV, Trail Making Test, Hooper Visual Organization Test, Boston Naming Test, Verbal Fluency Tests, Wisconsin Card Sorting Test, California Verbal Learning Test-II, Rey-Osterreith Complex Figure Test, Brief Visualspatial Memory Test-Revised, partial MWS-III (selected sub tests), Auditory Consonant Trigrams Test.

Full scale IQ ended up in the low average range. This was because all the tests were averaged and while many were average, some were far below average and brought the overall score way down.

Semantic and phonemic fluency task were in the impaired range and may reflect executive difficulties in strategic search and self initiation.

Impaired performance was seen on a task of visual search (searching among several similar stimuli for as specific target) whereas low average performance was noted on a measure involving clerical coding skills.

"Starr" also demonstrated impoverished working memory. Specifically, WAIS-IV Working Memory Index fell in the impaired range (2nd percentile) with poor performance on tasks requiring mental arithmetic problem solving or measuring auditory attention span.

On the latter, particular difficulty was noted on working memory (longest backwards span was 2 digits, below 1st percentile) whereas forward span of 6 digits placed her registration space at the borderline range.

When asked to hold letter triplets in mind while simultaneously counting backwards for varying intervals of time, her abilities fell at the borderline to impaired range. This indicated further vulnerability to distraction and interference when working memory in required.

Visual planning as measured by solution of paper and pencil mazes was impaired. "Starr" indicated that she had difficulty coping with the multiple dark lines contained in each maze. This again suggests difficulty dealing with visual interference.

Her ability to learn a list of 16 unrelated words was low average across 5 trials. Performance on the initial learning trial indicated reduced single trial learning and although she did benefit from repetition of the information, her learning curve was somewhat shallow. In addition, there was evidence of mild retroactive interference from an interposed list when short term recall of this original material was assessed.

Generally speaking, "Starr" demonstrated impoverished performance on a more complex verbal learning task, with poor encoding of information if not repeated, shallow acquisition despite repeated exposure and susceptibility to retroactive interference effects when required to acquire additional information prior to an extended consolidation period for the original information.

Conclusion:
The results indicate a number of relatively well preserved skills. Fundamental verbal abilities were generally intact, as were visual spatial skills, strategic thinking and memory for contextualized verbal and visual information. Visual learning was intact as well.

She demonstrated some subtle executive difficulties. Impaired semantic and phonemic fluency possibly reflect executive difficulties such as strategic search and self initiation. Higher order attention, speed of information processing and working memory skills were variable.

In terms of learning ability, her difficulties in this assessment were noted particularly with more complex verbal information. Results indicate that encoding may be poor when she does not have opportunity for rehearsal of information and it is mildly limited despite repetition. Furthermore, learning was affected by retroactive interference by new material during consolidation stages.

These results are certainly consistent with typical sequalae of post concussive syndrome. Given that the difficulties appear under the relatively well controlled conditions of a testing environment, it is likely that they are more pronounced in a more complex day to day environment where multi tasking, rapid information processing and greater reliance on single trial learning is required.

In order to improve function, "Starr" could consider implementing a variety of compensatory strategies that could include:

1. Taking extra time to process information when conditions require multi tasking or selective attention (conditions of distraction or interference).

2. Removing distraction from the environment when performing mentally challenging tasks.

3. Performing mental activities in shorter sessions, with ample time in between tasks to rest and consolidate information.

4. Writing information required for problem solving down.

5. Working at a self regulated pace and avoiding excessive time limited conditions.

6. Performing tasks one at a time.

7. Using a multi modal approach (visual, oral repetition, written, etc) when learning new information

8. Creating ample opportunity for repetition of new material

9. Using energy conservation techniques effectively to maximize her cognitive performance.

Starr

Don't get too discouraged. You are still you! It is good to be able to pinpoint some of the issues you are struggling with...it is not imagined! And it gives you a roadmap for healing. And from that report, it looks like you are in a good position to improve in these areas.
I know I am much better now that when I was tested 12 months post injury....i don't have to be tested to know that. So remember the power of neuroplasticity! You can regain so many things with therapy, rest and using your brain in new ways.
Hang in there!!!!

Starr,

As disappointing your report may be compared to your hopes, the recommendations at the bottom would apply to me exactly. My only change would be, Do not try to multi-task. It just sets me up for failure. Probably the same for you.

That comment "1. Taking extra time to process information when conditions require multi tasking or selective attention (conditions of distraction or interference)." basically means to learn to Stop to Think. This is a fabulous skill to learn and make a habit.

I need to use this Stop to Think frequently. If I do not use it proactively, I get myself into trouble. The normal or hurried pace of mental processing means I tend to crash and forget all of the information. If I slow down and Stop to Think, I can keep the thought in my mind so I can complete the mental processing. Sometimes, this requires that I write down the second step or have someone remind me of the next step.

You should try to feel encouraged by this report because it says you are not a faker and have been trying your best. Now, you can put that best in context with your brain's ability.

I have learned a new Work-around. I usually have my laptop in front of me when I am on the phone. I open a Word or WordPad document and take notes about my phone conversation. I can type faster than I can write legibly. There is a Word Notes or Post It notes application for many computer platforms.

Your intact functions means you have a good foundation to use to develop work-arounds and other coping skills.

Hopefully, this will lead to some help in planning your activities and endeavors. As you set a new set of living environment standards, you have great opportunities to pursue a full and calm, sort of back to nature life. I have found that the natural world has far more to offer those of us with these brain limitations.

If I can ever find a few acres of country land with limited zoning/use limitations, I will be able to set up such a lifestyle.

My best to you.

Starr,
Glad to see you received your results from the neuropsychological testing. I still have not received my report. It has been a month since I had my last session. I am getting really nervous about why I don't have a report yet. I have called the place twice and left messages but I get no call back. If I went through all that for nothing I am going to be really upset. Did anyone else have to wait this long to get their report? I need it for my disability claim. The lady knows this!
I wish you the best in your recovery Starr. I think it is easier to have the areas identified that you need to work on. Don't let this report get you down. I think you can learn ways to work around the problems. Mark and some others on here seem to have learned how to run this marathon and still have an enjoyable life. I am going to try and look to their example.
Brain :hug:

I Can Relate
 

Starr~I can relate!Your test results sounds very similar to mine. I did my test at a year and half (when I got diagnosis).Except my visual is ok as well so I can still drive.That is a huge plus.My percentile range was in the zero to 10 range.I am needing cognitive rehab for 4 impairments.Keep your head up and now you have some direction to aid with dealing with the impairments and to build skills around the impairments.:hug:

Thanks everyone for your kind word and support.

I'm trying not to let it get me down and just focus on the good parts, like it not triggering an issue with my driver's license... I was very worried about that.

I guess just seeing it in black and white was a bit ouchie. A bit like bringing home a bad report card or something!

Not sure when I'll be called back to the brain injury clinic to meet with the physiatrist, but I'm sure it'll be topic for discussion at that appointment and I wonder if he'll suggest a new referral then or not? Not knowing where this will lead is a bit unnerving also.

Tomorrow I meet with my rehab psych (different from my neuro psych) and she may well have insight into the next step as well... she seems to have a pretty good handle on what the general path(s) often are. At $210/ 50 min hour, she better!! LOL!!!

Starr

Similar
 

I should receive my test results beck in the next week. It was very helpful to read your post. I think my results will be very similar to yours. It was also very helpful to read other people's posts on work arounds.

When reading the recommendations at the bottom I couldn't imagine how I can modify my job. I work in a very noisy, hectic, busy, multi-tasking situation. But, i love my job.

Working in nature sounds heavenly. I wish you luck..

Keep us posted. I am interested to hear what the further recommendations are going to be.

Su seb

Thanks For This
 

I think that knowing 'where you are' is half the battle. I'll be seeing a neurologist soon and your post gives me hope. :)
Thank you.