Monthly Archives: February 2015

A number of my clients are people in their 50s, 60s and 70s referred to me by their neurologist to help find out why they are having memory difficulties.

Are the difficulties related to advancing age?

Or secondary to a neurological condition (such as Alzheimer’s Disease)? Or due to depression?

Neuropsychological assessment will help find out the reasons behind a person’s memory problems. Standardized, normed tests are used to assess cognitive, memory, adaptive and emotional functioning. The scores from the different tests will give a good picture of how the client is doing compared to other persons of the same age range.

I have had a number of clients complaining of memory difficulties who, upon neuropsychological assessment, exhibited normal or average memory functioning. Although they have noticed their capacity to retain information was no longer as good as they used to, they are not any worse off than their peers. I had one client who was so immensely relieved of such assessment finding because she had been afraid of the big “A” (Alzheimer’s Desease). Instead of a memory impairment, testing uncovered a mild depression, a condition that often looks much like memory impairment.

Memory difficulties could be due to any one or a combination of the following:

1. Age related memory decline— with advancing age, the brain is less able to retain as much information as it used to. Neuropsychological assessment will help determine if memory functioning is still “normal” compared to peers.

2. Memory decline secondary to a neurocognitive disorder— Memory decline also happens when the brain suffers an injury during a traumatic event (e.g. vehicular accident) or neurological insult (e.g. a stroke), or a degenerative disease (Alzheimer’s Disease). In this case, neuropsychological testing will assess and document the nature and depth of the memory difficulty.

3. Depression— Memory difficulties also happen during a depression. I have seen this in some of my clients. Retirees, formerly busy executives or entrepreneurs, who find themselves with nothing to do and with limited social contact. Neuropsychological assessment will help determine if the difficulties are due to depression and recommend strategies to help manage them.

The following are red flags of LD in older children, adolescents and adults:

Grade School

-Reverses letter sequences (soiled/solid, left/felt)
-Slow to learn prefixes, suffixes, root words, and other spelling strategies
-Avoids reading aloud
-Trouble with word problems
-Difficulty with handwriting
-Awkward, fist-like, or tight pencil grip
-Avoids writing assignments
-Slow or poor recall of facts
-Difficulty making friends
-Trouble understanding body language and facial expressions

High School Students and Adults

-Continues to spell incorrectly, frequently spells the same word differently in a single piece of writing
-Avoids reading and writing tasks
-Trouble summarizing
-Trouble with open-ended questions on tests
-Weak memory skills
-Difficulty adjusting to new settings
-Works slowly
-Poor grasp of abstract concepts
-Either pays too little attention to details or focuses on them too much
-Misreads information

Children and adolescents who exhibit a combination of these behaviors have a good chance of having a learning disability. When this happens it is best to consult your child’s pediatrician or a developmental pediatrician or a child psychologist. It is difficult to get an appointment especially with a developmental pediatrician, so as soon as you suspect LD, make an appointment with one already. In the meantime, you can also talk to your child’s teacher(s) regarding their own observations and recommendations.

Children with learning problems are often referred to a psychologist for a psychoeducational or neuropsychological assessment. The referrals usually come from developmental pediatricians or teachers/schools. What the assessment does is to determine the level of cognitive functioning (IQ) and achievement levels in reading, math, spelling and writing. A learning disability is identified when the achievement level in a specific area of learning is significantly lower than the IQ (which, at the very least, would be in the average range).