FAQs

Clinical neuropsychology is a specialized field (within psychology) that focuses on the relationship between the brain and behavior. The goal of clinical neuropsychology is to understand how brain dysfunction contributes to changes in behavior and cognition, identify useful recommendations and develop interventions to help individuals cope with and improve their cognitive functioning.

Neuropsychological assessments include pencil-and-paper and some computerized tests. Evaluations are commonly used to assess cognitive function, support diagnostic impressions, determine decision-making capacity, aid in treatment planning, and track changes over time.

These evaluations are comprehensive and typically include a review of medical and psychological history; interviews with the patient and a spouse, loved one or close friend; a neurobehavioral examination and all-inclusive cognitive testing. Testing involves a variety of standardized measures that assess detailed aspects of general intellectual functioning, attention, processing speed, learning and memory, language, visuospatial skills, executive functioning, motor and sensory abilities, motivation, and emotional or personality functioning. Evaluations can last several hours, but may vary depending on the presenting concerns as well as the patient’s needs and abilities.

Testing is usually recommended when there are changes in thinking abilities, such as symptoms or complaints involving memory or attention. This may be signaled by a change in concentration, organization, reasoning, memory, language, perception, coordination, or personality. These changes may be due to a number of medical, neurological, psychological, or genetic causes. Testing will be helpful in understanding your specific situation.

Some individuals pursue baseline testing to know how they are currently performing. Others have concerns about future decline and want a record of their current abilities for comparison.

Dr. Glusman provides a complimentary over the phone consultation to any prospective patients.

Your test scores will be compared to scores from people who are like you in important ways. By using a database of scores from a large group of demographically similar peers for comparison, the neuropsychologist can judge whether or not your scores are normal for your age and educational background. The pattern of your own test scores will also be reviewed to estimate whether or not there have been changes in certain abilities. How you go about solving the various problems and answering questions during the examination will also be noted. Using these methods, your strengths and weaknesses can be identified.

Testing can identify weaknesses in specific areas. Neuropsychological assessments are very sensitive to mild memory and thinking problems that might not be obvious in other ways. When problems are very mild, testing may be the only way to detect them. For example, testing can help determine whether memory changes are consistent with normal aging or are caused by a neurological disorder. Testing might also be used to identify problems related to medical conditions that can affect memory and thinking, such as diabetes, metabolic or infectious diseases, or alcoholism.

Test results can also be used to help differentiate among illnesses, which is important because appropriate treatment depends on an accurate diagnosis. Different illnesses result in different patterns of strengths and weaknesses on testing. Therefore, the results can be helpful in determining which areas of the brain might be involved and what illness might be operating. For instance, testing can help to differentiate between Alzheimer’s disease, stroke, and depression.

Sometimes testing is used to establish a “baseline,” or document a person’s skills before there is any problem. By doing this, changes that occur later can be detected by comparing their performances.

Test results can be used to plan treatments that utilize strengths to compensate for weaknesses. The results help identify what target problems to work on and which strategies to use. For example, the results can help plan and monitor rehabilitation or follow the recovery of skills after a stroke or traumatic brain injury.

Studies have shown how scores on specific tests relate to everyday functional skills, such as managing money, driving, or readiness to return to work. Your results will help you and your doctors understand what problems you may have in everyday life. This will help in planning for assistance or treatment.

A neurological evaluation generally involves examination of basic motor and sensory functions (strength, reflexes, sensitivity to touch, and coordination), and basic thinking skills, including functional communication (speech and language), orientation to person, place, time and circumstances, simple memory functions, and an ability to follow basic commands. The most sensitive indicators of head injury, learning disabilities, early dementia, etc., are often deficits in subtle and complex cognitive and behavioral functions. These functions are assessed in a neuropsychological evaluation. Areas commonly assessed include general intellectual functioning, attention and concentration, processing speed, learning and memory, language, visuospatial skills, executive functioning, motor and sensory abilities, motivation, and emotional or personality functioning. Unlike a neurological evaluation, a neuropsychological assessment measures subtle and detailed aspects of the domains (listed above) using standardized, objective tests. Performance is then analyzed using both normative and individual comparison standards for measuring the relative strengths and weaknesses of cognitive and social-emotional systems.

Each evaluation is tailored to the individual. Specific tests are administered based on the problems or concerns voiced by the patient, their family, or the referring provider. Tests can also be adjusted during the evaluation based on the patient’s performance. Neuropsychological evaluations are time intensive, but can provide invaluable information for the patient and their family in order to maximize quality of life. Evaluations can range from four to six hours, or longer depending on the patient’s concerns and abilities. Dr. Glusman reserves a full workday for each patient to ensure that her patient’s receive the level of care and attention they deserve.

Glusman Neuropsychology Specialists LLC is a self-pay, concierge private practice where patients receive enhanced access to care without requiring a referral, or limitations imposed by insurance companies. All of Dr. Glusman’s patients receive highly specialized, one-on-one care, with the option of neuropsychological testing in our office or in your own home. Evaluations usually begin by interviewing the patient and a collateral source (spouse, family member, or close friend), if available. Interviews can be conducted together or separately. Collateral interviews can also be conducted over-the-phone. The patient interview includes questions about symptoms, educational background, work and medical histories, medications, as well as other important factors. Once the interviews are complete, testing will begin. Dr. Glusman and the patient are the only individuals permitted during testing. The time required for testing depends on the presenting problem and the patient’s abilities. Breaks are provided as needed. In general, several hours are needed to assess the various skills being evaluated.

Some tests will be easy while others will be more complex. The most important thing is that patients try their best. Most individuals find testing interesting, and the detailed information that is gathered will contribute to improving quality of life.

Once the evaluation is complete, Dr. Glusman will score the tests and write a comprehensive report. She will provide feedback on the results at a follow-up appointment. The feedback appointment will include detailed information regarding your current and projected cognitive functioning, comprehensive education about a diagnosis (if applicable), a written report specifying each aspect of your evaluation, and personalized recommendations aimed at improving quality of life. Dr. Glusman prefers to conduct feedback appointments in-person, but will accommodate you and your family as needed. Family members are encouraged to participate in the feedback session. Following your feedback appointment, Dr. Glusman offers an optional consultation period, that includes up to three, 30-minute phone sessions, within eight weeks of your feedback appointment.

Once your appointment is scheduled, Glusman Neuropsychology Specialists will mail or email a packet of forms (based on your preference), including the Consent Form, Payment Agreement, Patient History Questionnaire, and In-Home Evaluation Agreement (if applicable). Relevant medical records and any previous neuropsychological assessments should be faxed to Dr. Glusman (fax (843)379-9545) prior to your scheduled appointment.

On the day of the evaluation, you should maintain your normal routine. For instance, if you normally have coffee and eat breakfast, please do that as you normally would prior to the evaluation. Continue to take all medications as prescribed, and be sure to bring your glasses and hearing aids (if applicable) to the appointment. Patients should wear comfortable clothes, and have snacks and lunch available. Breaks are provided as needed, including a lunch break.

Neuropsychological evaluations are time intensive. Due to ongoing and unpredictable changes in insurance coverage, including preauthorization that does not ensure later payment for services, and frequent denial of payment despite written appeals, Glusman Neuropsychology Specialists does not bill insurance directly, but instead participates in a private pay arrangement.

Benefits to private pay:

Patients/families are able to self-refer for an evaluation. Health insurances commonly require a referral from a medical doctor as well as a qualifying medical condition to be referred for a neuropsychological evaluation. Additionally, patients do not have to wait for medical referrals or insurance preauthorization’s in order to schedule an evaluation.

Our services are transparent. There are no hidden costs, or unexpected bills. Patients/families know the exact cost of the evaluation, and the specific services they will receive.

· All of Dr. Glusman’s patients receive highly specialized, one-on-one care, with the option of neuropsychological testing in our office or in your own home.

The patient and provider are in control of the evaluation. Insurance cannot stipulate how services are offered, what services are covered, or the amount of time spent on the services provided.

· You and your family are our priority. No other patients are scheduled on the day of your appointment. We want to ensure enough time is dedicated to you and your family through every step of this evaluative process.

· We do not use technicians or students/trainees for our services. Every aspect of the evaluation, including medical record review, interview(s), testing, scoring, report writing, and feedback is conducted by Dr. Glusman.

Privacy. Our evaluations are not subject to insurance review or accessed by any other outside entity for billing or qualifying coverage.