Accessing a neuropsychological evaluation (neuropsych), can be difficult, especially as a college-aged adult. The process can be time-consuming and expensive, and many locations only evaluate those under 18. Those that do evaluate adults can have several weeks to several months long waitlists or don’t accept any insurance. As someone who got a neuropsych as an adult during the pandemic, this guide is meant to help you navigate the process.
What is a Neuropsych?
A neuropsych is “an in-depth assessment of skills and abilities linked to brain function. The evaluation measures such areas as attention, problem-solving, memory, language, I.Q., visual-spatial skills, academic skills, and social-emotional functioning.” Depending on what you’re being assessed for you’ll do different activities, such as reading a picture book, talking with your assessor, or filling out questionnaires. In some cases, there might be an interview with your parent or guardian (even if you’re over 18) to discuss what you were like as a child. These evaluations usually take place over the course of three sessions.
Should I prepare for a Neuropsych? How?
I personally prepared for my neuropsych by working with my therapist to read through the DSM criteria (this is the book of diagnostic criteria that’s used by psychologists in the U.S.) and wrote down my traits for each of the diagnostic criteria. For me, I appreciated having this written down in advance so I didn’t feel like I was forgetting things, and I also had a written copy that I gave to my provider for reference. You can also prepare by finding any past evaluations or diagnoses you have for the evaluator's reference. If your neuropsych includes a conversation with your parents, you can consider talking with them about what to expect, and clear up any misconceptions they have, or remind them of things they might have forgotten.
What I wouldn’t recommend doing is trying to practice any of the activities, or trying to do it at a point of low stress. Neuropsychs ideally happen in periods that represent what your life is like, so don’t try to make your life easier by skipping work, class, or other activities the day before. On that note, if possible I would recommend taking the rest of the day of your neuropsych off if possible since they can be emotionally draining.
What should I do if I'm worried about evaluator bias?
Unfortunately, there are some neuropsych evaluators who will have outdated or limited ideas about what neurodivergency can look like. They might assume (explicitly or implicitly) that only men can have ADHD or autism or primarily work with young children and not know what neurodivergency looks like in adults or college students. If you have the ability to do so, I would encourage trying to find someone who works with other people who share identities that are important to you. For example, you have the ability to schedule your neuropsych with someone who mostly works with adults, or specifically with women or nonbinary people with ADHD. You can also research if an organization’s or individual’s website has any information acknowledging that biases exist within diagnoses.
What can ADR do for you?
ADR may be able to approve temporary accommodations while you wait for a neuropsych. ADR also provides a list of neuropsych providers in the Boston area, some of which provide low-cost or sliding-scale services to college students. This list provided by ADR also includes what options take Wellesley College insurance specifically. If you see a therapist or doctor, or have other diagnoses, you can talk to ADR about what documentation you need.
What should I start looking?
If you have insurance, a good place to start is looking on your insurance’s website to find places that are in your network. Psychology Today is also a helpful resource that allows you to search for neuropsychiatrists based on insurance, age, and specialty. You can also read a bio about each provider. Larger providers tend to take more kinds of insurance. Psychology Today also provides information about different kinds of therapists and psychologists.
What advice do you have?
If you’re an out-of-state student and visit home during breaks, consider researching providers near your permanent address. This gives you twice as many options.
Sign up for as many waitlists as possible. While this step is time-consuming, it will give you more chances that there’s a sudden opening you’re able to fill.
Call your insurance to ask about coverage if you're unsure. It’s better to have a long phone call than end up having your evaluation not be covered. Alternatively, you can ask the evaluator to run your insurance before your appointment and inquire about any out-of-pocket expenses.
What if I'm still in high school?
If you’re still in high school in the United States and have an education plan, make sure you receive an up-to-date evaluation before you graduate. If you have never been evaluated before, ask your school about your options. In K-12 public education, schools are required to provide appropriate evaluations and cover the cost. If you have the ability to receive an evaluation before you graduate, this will likely be easier than getting one in college. High school is also a good time to gather information about any previous documentation you have.