Adult Neuropsychological Evaluations
When difficulties with attention, memory, organization, or mental stamina begin to interfere with daily life, or long-standing challenges become harder to manage, an evaluation can help clarify what is happening and what supports are most likely to help. The process starts with a detailed intake and review of relevant medical, academic, or workplace information when available, followed by individualized testing based on your goals and concerns. You’ll receive a feedback session that connects the findings to real-world functioning and outlines clear next steps, along with a comprehensive written report.
Conditions We Evaluate
Adults seek neuropsychological evaluations for a wide range of concerns. Whether you are navigating cognitive changes for the first time, looking for clarity around a long-standing challenge, or need documentation for workplace or academic accommodations, we tailor the evaluation to your specific questions at our Southeast Michigan practice. Below are some of the most common reasons adults are referred for evaluation. Even if your concern is not listed, please reach out by calling us or through our contact page to discuss how we can help you take next steps.
Adult Evaluations
- ADHD and Executive Dysfunction
- Anxiety and Avoidance
- Cancer-Related Cognitive Changes
- Capacity
- Concussion and TBI
- Depression
- Dyscalculia
- Dysgraphia
- Dyslexia
- Epilepsy and Seizure Disorders
- High-Stakes Testing Accommodations
- IQ and Cognitive Assessment
- Long COVID
- Multiple Sclerosis (MS)
- Obsessive-Compulsive Disorder (OCD)
- PTSD and Trauma
ADHD and Executive Dysfunction
What is ADHD?
Attention-Deficit/Hyperactivity Disorder (ADHD), also previously referred to as ADD, is a neurodevelopmental condition that affects attention regulation, impulse control, and executive functioning skills such as planning, organization, task initiation, and time management. ADHD can present differently across the lifespan. In children, it may show up as restlessness, difficulty following directions, and inconsistent academic performance. In teens and adults, it often looks like chronic disorganization, missed deadlines, difficulty sustaining effort on routine tasks, and mental overload.
Common signs and symptoms
- Distractibility or difficulty sustaining focus
- Disorganization, losing items, forgetting tasks or deadlines
- Trouble starting tasks, procrastination, difficulty estimating time
- Executive dysfunction
- Impulsivity in conversation or decision-making
- Restlessness or difficulty staying still
- Strong ability with inconsistent output
Common look-alikes and co-occurring concerns
Inattention is not specific to ADHD. Anxiety, depression, sleep problems, learning disorders, concussion history, medication effects, and chronic stress can mimic or worsen ADHD-like symptoms. Many individuals also have overlapping learning differences or emotional concerns that affect daily functioning.
How a neuropsychological evaluation helps
A neuropsychological evaluation clarifies whether ADHD is the best explanation for ongoing difficulties using more than just questionnaires. Evaluation identifies the specific mechanisms contributing to symptoms (for example, working memory limits, slowed processing speed, weak inhibition, or reduced sustained attention). Formal evaluation is often required to receive necessary accommodations, guide treatment, and results can support school planning, workplace accommodations, and a practical strategy plan.
What an ADHD evaluation typically includes
A typical evaluation includes a detailed interview and history review, record review when available, and standardized testing across attention, executive functioning, processing speed, learning and memory, and other domains as needed, along with thorough questionnaires.
Anxiety and Avoidance
Why anxiety is evaluated in neuropsychology
Anxiety can significantly affect cognitive efficiency. When the brain is in a heightened threat state, attention becomes harder to sustain, working memory becomes overloaded, processing speed slows, and test performance becomes less consistent. Anxiety can also lead to avoidance, which reduces learning opportunities and increases stress over time.
Common signs and concerns
- Persistent worry, perfectionism, or fear of making mistakes
- Avoidance of school, assignments, or social situations
- Physical complaints such as headaches or stomachaches
- Panic symptoms or shutdown under pressure
- Difficulty speaking in certain settings (selective mutism)
- Inconsistent performance that worsens with evaluation demands
- Restlessness or difficulty relaxing
Common look-alikes and overlaps
Anxiety can mimic ADHD or amplify learning problems. It can also co-occur with ADHD, learning disorders, and depression. A neuropsychological evaluation helps clarify whether cognitive concerns are primarily skill-based, attention-based, anxiety-driven, or a combination.
How testing helps
Evaluation identifies how anxiety affects cognition and access to learning. Results can inform school recommendations that reduce impairment, improve predictability, and support performance without reinforcing avoidance. It also helps guide next-step referrals and provides a clear explanation of why the individual is struggling.
Cancer-Related Cognitive Changes
Why cancer and treatment can affect cognition
Cognitive changes can occur during or after cancer treatment due to chemotherapy, radiation, surgery, fatigue, sleep disruption, stress, mood symptoms, and medication effects. Many people describe “brain fog,” reduced stamina, or difficulty returning to prior levels of efficiency at work or school.
Common concerns
- Slowed processing speed and reduced mental stamina
- Difficulty concentrating and multitasking
- Word-finding inefficiency
- Memory inefficiency, especially under fatigue or stress
- Increased effort required for routine cognitive tasks
How neuropsychological testing helps
A neuropsychological evaluation characterizes cognitive strengths and weaknesses and clarifies contributing factors such as sleep, fatigue, stress, and mood. Results support practical strategies and accommodations when needed, including return-to-work planning, workload modification recommendations, and compensatory approaches. Baseline testing can also help monitor change over time.
Capacity
What is a capacity evaluation?
A capacity evaluation assesses whether an individual has the cognitive ability to make a specific decision or perform a specific function at a particular point in time. Capacity is not all-or-nothing and is not a global label. A person may have capacity for some decisions and not others, depending on the complexity of the task, cognitive status, and available supports.
Common referral questions
- Ability to understand and make medical decisions
- Ability to manage medications safely
- Ability to handle financial tasks and budgeting demands
- Ability to live independently with or without supports
- Ability to continue driving
- Decision-making abilities during cognitive decline or medical illness
How neuropsychological testing helps
A comprehensive evaluation measures cognitive abilities directly relevant to the capacity question (memory, attention, reasoning, executive functioning, language), assesses functional skills and practical judgment, identifies supports that may enhance functioning, and provides clear documentation describing findings, reasoning, and recommendations.
Concussion and TBI
What is a concussion or traumatic brain injury (TBI)?
A traumatic brain injury (TBI) is an injury to the brain caused by an external force, such as a fall, motor vehicle accident, sports injury, or other force to the head. Mild TBI, or concussion, can temporarily affect attention, processing speed, memory efficiency, sleep, and emotional regulation. The impact of any TBI can vary widely depending on injury severity, medical complications, and factors such as sleep, pain, stress, and mental health.
How neuropsychological testing helps
Neuropsychological testing clarifies which cognitive systems are affected and which remain strengths, identifies factors that may be amplifying symptoms (such as sleep disruption, pain, anxiety, or depression), and translates findings into practical recommendations including return-to-learn and return-to-work planning, pacing strategies, and rehabilitation planning when recovery is more complex.
Depression
How mood affects thinking
Depression can reduce energy, motivation, initiation, and cognitive efficiency. People may notice slowed thinking, difficulty concentrating, indecision, reduced mental stamina, and memory complaints. These experiences are real, and they can impact performance even when underlying cognitive abilities remain strong.
Common concerns
- Low mood or irritability, loss of interest, reduced drive
- Fatigue, low initiation, difficulty sustaining effort
- Slowed processing speed or feeling mentally “foggy”
- Concentration problems and inconsistent performance
- Sleep disruption that worsens cognitive functioning
Why neuropsychological evaluation can be helpful
Cognitive complaints can be caused by many factors. Sometimes they reflect mood, stress, sleep disruption, or burnout. Other times there is an underlying learning, attention, medical, or neurologic contributor. Neuropsychological evaluation helps clarify the most accurate explanation, identifies which cognitive systems remain strengths, and provides practical recommendations for school, work, and home.
Dyscalculia
What is dyscalculia?
Dyscalculia is a learning disorder that affects number sense, calculation, math fact fluency, and/or math reasoning. Some individuals struggle with foundational quantity concepts and math facts. Others can do math but lose accuracy or efficiency when tasks become multi-step, time-pressured, or language-heavy. Math difficulties often lead to anxiety and avoidance.
Common signs and concerns
- Weak number sense (estimating, comparing quantities, understanding place value)
- Slow or inaccurate math facts; heavy reliance on counting strategies
- Difficulty learning procedures and keeping steps in mind
- Trouble with word problems, translating language into math
- High math anxiety, avoidance, or shutdown during math tasks
How neuropsychological testing helps
Evaluation clarifies whether a dyscalculia pattern is present, separates fact fluency issues from reasoning and language-based math demands, identifies cognitive contributors (working memory, attention, processing speed), and provides practical recommendations for instruction targets and accommodations.
Dysgraphia
What is dysgraphia?
Dysgraphia refers to persistent difficulty with written expression. For some individuals, the challenge is producing written output efficiently (handwriting speed, legibility, fatigue). For others, the challenge is language-based (spelling, grammar) or executive-based (planning, organizing ideas, revising). Many people with dysgraphia have strong ideas and verbal reasoning, yet writing is slow, effortful, and does not reflect what they know.
Common signs and concerns
- Slow writing, short answers, or incomplete written work
- Hand fatigue, discomfort, or significant effort to keep up
- Poor spelling, grammar, or sentence structure
- Difficulty organizing ideas, starting writing tasks, or revising
- Avoidance of writing-heavy classes or assignments
- Written work that seems “below” verbal ability
How neuropsychological testing helps
Evaluation clarifies the roles of processing speed, working memory, and attention, identifies strengths that can support compensatory strategy use, and provides school-ready recommendations including assistive technology, reduced copying, alternative response formats, extended time, and writing scaffolds.
Dyslexia
What is dyslexia?
Dyslexia is a language-based learning disorder that affects accurate and fluent word reading and often spelling. Dyslexia is not caused by low intelligence or lack of effort. Many individuals with dyslexia understand material well when it is presented verbally, yet reading is slow, effortful, and fatiguing.
Common signs and concerns
- Slow, effortful reading; avoids reading aloud
- Difficulty sounding out unfamiliar words
- Persistent spelling challenges and inconsistent spelling patterns
- Reading fatigue, headaches, or reduced stamina with longer assignments
- Strong listening comprehension but weaker reading comprehension
- Family history of reading difficulties
How neuropsychological testing helps
A comprehensive evaluation determines whether the pattern is consistent with dyslexia, clarifies the specific mechanisms involved (phonological processing, rapid naming, decoding, fluency, orthographic processing), identifies strengths that support learning and compensation, and provides practical recommendations for intervention targets and accommodations.
Epilepsy and Seizure Disorders
Why seizures can affect cognition
Epilepsy and seizure disorders can affect thinking in ways that vary by seizure type, seizure frequency, sleep disruption, medications, and the brain systems involved. Some people notice consistent changes; others experience fluctuations tied to fatigue, stress, or seizure activity.
Common concerns
- Memory inefficiency or inconsistent recall
- Attention lapses and reduced cognitive stamina
- Word-finding difficulty or slowed language efficiency
- Slowed processing speed
- Academic or work performance changes
How neuropsychological testing helps
Neuropsychological evaluation provides a detailed profile of cognitive strengths and weaknesses, clarifies functional implications, and helps identify contributors such as sleep, mood, and medication effects. It can support school and workplace recommendations and provide objective baseline data for monitoring change over time.
High-Stakes Testing Accommodations
Why capable adults can struggle on major exams
Graduate and professional exams place heavy demands on speed, sustained attention, reading efficiency, working memory, and emotional regulation. There may be long-standing ADHD or learning difficulties that were never formally evaluated. Many individuals experience test anxiety and performance disruption that is out of proportion to preparation. It is also extremely common for updated neuropsychological testing results to be required in order to apply for testing accommodations.
Common concerns
- Consistently running out of time despite strong knowledge base
- Slow reading, difficulty processing dense passages under time pressure
- Attention drift during long sections; difficulty sustaining effort
- Working memory overload in multi-step reasoning tasks
- Severe test anxiety, panic symptoms, or cognitive “blanking”
- Multiple exam attempts with minimal score change
- Need for clear documentation to support accommodation requests
How neuropsychological testing helps
A neuropsychological evaluation identifies cognitive strengths and bottlenecks that affect exam performance, clarifies whether ADHD, learning disorders, processing speed limitations, anxiety, or other concerns are primary drivers, provides individualized recommendations for study structure and test-day strategies, and produces objective documentation describing functional impact and rationale for supports. Testing agencies vary in their documentation criteria, and it is crucial to work with a professional who has extensive experience providing documentation for a wide range of universities and testing agencies.
IQ and Cognitive Assessment
What is an IQ assessment?
An IQ assessment is a standardized measure of cognitive abilities compared to others of the same age. It helps answer questions about how a person reasons, solves problems, learns new information, and processes language and visual information. IQ testing is often used as part of educational planning, admissions testing, diagnostic clarification, and identifying learning strengths and vulnerabilities.
Common reasons people request IQ testing
- School admissions or program placement decisions
- Gifted identification or clarification of uneven learning profiles
- Learning concerns where a cognitive baseline is needed
- Clarifying how cognitive strengths and weaknesses affect performance
- Establishing documentation for educational planning and supports
What IQ testing can and cannot tell you
A high-quality IQ assessment provides valuable information, but it does not directly measure many important human capacities such as creativity, kinesthetic learning, musical ability, interpersonal skills, or emotional insight. For some referral questions, pairing IQ testing with additional assessment gives a more complete picture.
Long COVID
Why post-viral syndromes can affect cognition
Some individuals experience persistent cognitive symptoms after viral illness, often described as brain fog. Common domains include attention, processing speed, working memory, and stamina. Symptoms are frequently influenced by fatigue, sleep disruption, autonomic symptoms, pain, mood, and other medical factors.
Common concerns
- Mental fatigue and reduced cognitive endurance
- Slowed processing speed and difficulty multitasking
- Concentration problems later in the day
- Working memory strain, losing track mid-task
- Word-finding inefficiency or slowed retrieval
How neuropsychological testing helps
Evaluation provides objective data about cognitive functioning and real-world impact. It helps determine whether the pattern reflects reduced stamina and efficiency versus a primary memory disorder, clarifies contributing factors, and generates practical strategies for work, school, and daily routines. Baseline testing can also be useful for tracking improvement over time.
Multiple Sclerosis (MS)
Why MS can affect thinking
Multiple sclerosis can affect cognition directly and indirectly. Cognitive symptoms may arise from changes in brain networks as well as fatigue, sleep disruption, pain, medication effects, and mood symptoms. Processing speed, attention, working memory, and executive functioning are common areas of concern.
Common concerns
- Slowed thinking, especially under fatigue
- Reduced concentration and difficulty multitasking
- Working memory strain, losing track mid-task
- Word-finding inefficiency
- Fluctuating performance from day to day
How neuropsychological testing helps
Evaluation clarifies the cognitive profile and distinguishes MS-related cognitive patterns from sleep and mood contributors. Results support practical recommendations for daily functioning, workplace accommodations when appropriate, pacing strategies, and a baseline to monitor cognitive change over time.
Obsessive-Compulsive Disorder (OCD)
What is OCD?
Obsessive-Compulsive Disorder involves intrusive thoughts and repetitive behaviors or mental rituals intended to reduce distress. OCD can consume time, narrow attention, and disrupt daily routines. Symptoms may present as reassurance-seeking, checking, repeating, fear of mistakes, or rigid routines. It also often leads to slowed efficiency, avoidance, and significant interference with work and daily life.
Common signs and concerns
- Excessive checking or repeating
- Rigid routines, fear of mistakes, “stuck” thinking
- Slow completion due to compulsions or perfectionism
- Avoidance of triggers and distress when interrupted
- Difficulty shifting attention away from intrusive thoughts
Why neuropsychological testing can help
OCD-related difficulties can resemble processing speed weakness or ADHD. Evaluation clarifies which mechanisms are driving functional difficulty and identifies strengths that can support intervention planning and day-to-day strategies.
PTSD and Trauma
Why these concerns show up in neuropsychology
Trauma exposure and chronic stress can shift the brain into a heightened threat state, affecting attention, working memory, sleep, and emotional regulation. Eating disorders can be associated with cognitive rigidity, perfectionism, reduced flexibility, impaired concentration, and slowed thinking, particularly when sleep, nutrition, and medical stability are affected.
Common concerns
- Difficulty concentrating or staying mentally organized
- Memory inefficiency under stress or during emotional activation
- Hypervigilance, shutdown, avoidance, or irritability
- Reduced stamina and worsening performance over the day
- Cognitive rigidity and trouble shifting strategies
How neuropsychological testing helps
Neuropsychological evaluation clarifies whether cognitive symptoms are primarily related to stress and regulation, medical factors, attention and executive functioning constraints, or another neurologic contributor. It identifies strengths and vulnerabilities and links results to real-world recommendations for school or workplace functioning.
- ADHD and Executive Dysfunction
- Anxiety and Avoidance
- Cancer-Related Cognitive Changes
- Capacity
- Concussion and TBI
- Depression
- Dyscalculia
- Dysgraphia
- Dyslexia
- Epilepsy and Seizure Disorders
- High-Stakes Testing Accommodations
- IQ and Cognitive Assessment
- Long COVID
- Multiple Sclerosis (MS)
- Obsessive-Compulsive Disorder (OCD)
- PTSD and Trauma