What is a neuropsychological evaluation?

A neuropsychological evaluation is a comprehensive assessment of a child’s functioning in many domains, including communication, visual-spatial ability, problem solving, memory, attention, social skills, and emotional status. The assessment of these functions is based upon information obtained from the child’s history, clinical observations, and testing results. One of the most important aspects of the neuropsychological evaluation is the integration of all the information about a child into a meaningful profile of functioning that describes “The Whole Child”.

What’s involved in a neuropsychological evaluation?

A neuropsychological evaluation at NESCA generally consists of four appointments, two for the parents and two for the child. The first appointment is an intake, or diagnostic interview, with the parents and the doctor, which lasts for 45 minutes – one hour. The next two appointments are testing sessions for the child; those are 2.5 hours each, with a break in the middle. Finally there is a feedback session with the parents and the doctor which lasts for an hour and a half.

We may also schedule an additional, 30 – 45 minute feedback for adolescents and young adults, apart from their parents, if this is of interest to them and their family.

To client families coming to NESCA from abroad, or from considerable distances within the U.S., for whom scheduling may be an issue, we can offer “compressed” but nonetheless comprehensive evaluations conducted by a clinical team, including a psychometrician (test scoring technician). These may be completed in as little as a single day or two. They are appropriate for adolescents and young adults with the motivation and stamina to participate in two full testing sessions in a single day.

Why does an evaluation at NESCA always address educational issues?

At NESCA, we consider testing for both diagnostic and educational purposes to be essential and inseparable elements of an effective evaluation. Because your child’s disability will inevitably affect his or her major life activity, which is school, it is important to understand the nature and extent of that impact. Conversely, much of any necessary remediation may well happen in school, and we need to be able to write well-reasoned, detailed recommendations about how the school should address your child’s special needs.

These recommendations need to be made persuasively, in a way that maximizes the likelihood that the school will recognize the recommended services as integral parts of the “free and appropriate public education (FAPE)” that public schools are required to provide to children with special needs. In addition, your child may need, and be legally entitled to, accommodations for his or her disability in the academic setting, and this also needs to be documented.

What will a neuropsychological evaluation tell me about my child?

The purpose of neuropsychological evaluation is to gain deeper knowledge of a child’s inherent strengths and weaknesses, in order to better understand the challenges that a child may experience in meeting developmental demands, and the strengths that child can call upon to compensate. Once the child’s learning profile is understood, recommendations can be made for direct interventions and supports at home and school to assist the child in functioning to full potential.

Results of the neuropsychological profile are often used to make specific diagnoses and to provide parents with information about a child’s level of functioning relative to same-age peers.

What does an evaluation cost, and how may I pay for it?

The cost of a comprehensive neuropsychological evaluation at NESCA is $5800-$6800. We collect a $500 deposit at the time of scheduling. We require a 50% payment three business days before your child’s initial  testing appointment and the remaining balance three business days prior to your child’s final testing session. We accept personal checks and all major credit and debit cards.

NESCA currently accepts Blue Cross Blue Shield for the following providers: Drs. Asher, Burns, Creedon, Currie, Dautoff, Folsom, Gibbons, Halladay, Hess, Milana, Rodriguez, and Talamo. NESCA can submit claims for some of their services directly to Blue Cross Blue Shield.

None of our other clinicians is a provider to Blue Cross or any other insurance company. If you wish to seek reimbursement from one of them yourself, we will provide to them whatever documentation they require, and that you authorize us to release. We cannot bill them directly on your behalf.

If you intend to try to access health insurance coverage, in advance of your intake appointment, please contact your carrier directly to discuss the specific requirements of the plan in which you are enrolled.

Please be aware that neuropsychological testing now generally requires prior authorization from insurance carriers. Understand also that requests for neuropsychological testing must satisfy “medical necessity” criteria, and that health insurance companies will not authorize testing they consider to be primarily for educational purposes. ADHD and executive function deficits, while neurologically-based, are no longer considered by insurers to be covered medical conditions.

Ancillary services including consultation and document review, transitional services, classroom observations, participation in TEAM meetings and expert testimony are not covered by insurance.

Does insurance cover the total cost of an evaluation?

Insurance does not typically cover the total cost of evaluation and it is expected that there will be out-of-pocket expenses for families seeking comprehensive neuropsychological and/or psychological evaluation.

NESCA currently accepts Blue Cross Blue Shield for the following providers: Drs. Asher, Burns, Creedon, Currie, Dautoff, Folsom, Gibbons, Halladay, Hess, Milana, Rodriguez, and Talamo. None of our other clinicians is a provider to Blue Cross or any other insurance company and we cannot directly submit insurance claims for any other providers or for any services outside of neuropsychological evaluation and psychological evaluation services.

Insurance covers only the neuropsychological and psychological services deemed “medically necessary” for a student. Health insurance companies will not authorize testing they consider to be primarily for educational purposes. ADHD and executive function deficits, while neurologically-based, are not covered medical conditions. Academic testing – which is necessary for educational processes – is not covered by insurance. School consultation services, classroom observations, program observations, team meeting participation, document review, and many other important neuropsychological services are also not covered by insurance.

What is included in the cost of the evaluation?

Included in this fee are: the initial intake session with parents, two testing sessions with the child, a feedback meeting with parents and the preparation of a detailed report with comprehensive recommendations. There are flat fees, payable in advance, for participation in team meetings and school observations; these are not included in the cost of the basic evaluation. Consultations with other professionals and other related services are billed at each clinician’s hourly rate, ranging from $300 to $500 per hour.

Does NESCA ever offer pro-bono (free) or reduced-price evaluations?

NESCA is committed to making quality care available to those most in need and least able to afford it. To that end, we do offer free or subsidized evaluations and other services, but only through a number of charitable organizations with which we have had longstanding relationships. These include Mass. Advocates for Children,the EdLaw Project, Epiphany School in Boston and the South Sudanese Enrichment for Families. We have found that this is the best way for us to leverage our limited resources.

Who will test my child?

All of the neuropsychologists at NESCA are licensed clinical psychologists who have completed specific post-doctoral training in pediatric neuropsychology. Most of the neuropsychologists at NESCA spent at least six months working directly with Dr. Helmus before seeing patients independently, in order to insure uniformity in the assessments done through NESCA. All professionals at NESCA consistently demonstrate an exceptionally strong commitment to meeting the needs of the children and families who we serve.

Dr. Helmus is assisted by post-doctoral fellows in all of her evaluations. The other clinicians are assisted with some of their evaluations by a post-doctoral fellow. The post-doctoral fellows have completed their doctorates in psychology, and are receiving through NESCA the additional supervised training in pediatric neuropsychology that is required for professional licensure. The post-doctoral fellows observe the intake and feedback sessions, and perform part of the testing under direct observation by their supervisor. Please be assured that the senior clinicians remain actively involved in the assessment of your child, even when they are not personally administering the tests.

What will happen at the intake session?

The intake session, or diagnostic interview, is an opportunity for parents to meet with their child’s clinician alone to discuss their concerns, ask questions, and get to know the clinician. Intakes generally last about an hour, and typically involve a complete review of the child’s developmental history, various questionnaires we provide in advance and discussion about parental observations of the child.

What can I expect at the feedback meeting?

The feedback is the final appointment in the evaluation process, and is designed for the clinician to present the findings to the parents/guardians, respond to the referral question(s), and fully explain recommendations. This meeting is scheduled as a 1 ½ hour block, some of which may be used for initiating phone contacts requested by the family and other aspects of case management.

When will I receive a written report?

At NESCA, our goal is to deliver written reports six weeks after the feedback meeting. For various reasons, reports may sometimes take longer than this to be completed. If you have a specific date (i.e. upcoming TEAM meeting, school conference) when you will need a written document, please let us know when making your appointment or at the intake session, so we can determine if that deadline can be met. Please plan accordingly by scheduling those meetings eight to nine weeks after the feedback session. This will allow you to get the report to the schools at least 10 days prior to your meeting, which most schools require.

How should I prepare my child for the evaluation?

For school-age children, we recommend telling the child that you would like to have more information about how they learn, so that you can make sure that their teachers “know the best ways of teaching” them. You can let your child know that they will be spending about two hours working with a doctor who wants to understand how they learn and solve problems. The doctor will be asking questions, telling stories, showing pictures and asking them to draw.

For younger children, you may downplay the label “doctor” if this is a frightening term, and feel free to refer to your clinician by their first name. Reassure the child that this is an office with lots of toys and games in the waiting room as well as in the clinician’s office. Parents of pre-school age children may remain in the office throughout the testing.

Please try to ensure that your child has adequate sleep the night before, and a good breakfast on the day of testing. It is important that you convey to your child a positive and confident attitude about the evaluation experience.

Do NESCA administrators ever reschedule appointments?

We do recognize the difficulties that may be involved in making arrangements to bring your child to our scheduled appointments, and we make every effort not to change appointment times. Occasionally, however, we must make scheduling changes because of bad weather, or in order to accommodate the medical, legal or educational needs of the families whom we serve. We will alert you to any changes as soon as possible. In the event of a schedule change, your child will be seen in the same general time frame as initially scheduled. We appreciate your patience and understanding under these unusual circumstances.

We are committed to keeping our appointments running on time throughout the day, and ask that you arrive at the scheduled time.

What will I do while my child is being tested?

We invite you to make yourself comfortable in our large waiting area, where your child will join you for a ten- minute break in the middle of the testing session. Feel free to bring your lap top and use our high-speed wireless internet service. If you would like to run errands in the area, we do request that you please leave a cell phone number with the administrator at our front desk.

There are times that we may request parents of preschoolers and other children to remain in the waiting room. We request that you limit cell phone calls to the lobby outside our office suite.

What about privacy and confidentiality?

At NESCA, we take our responsibility for your privacy very seriously! In designing our facilities and information systems, we went to great lengths to comply fully with the privacy provisions of the federal HIPAA statute. Our hard-wired office computer network is secured by unbreakable 128-bit encryption. When clinicians use laptops in our office, they access our network through a secure wireless connection separate from a second, open wireless network (called “Red”) we provide for your convenience.

When they use their laptops remotely to communicate with our server, where some essential information may be stored, they do so through secure VPN (virtual private network) connections, rather than over the internet. Similarly, clinicians off site may access and transmit email through a secure connection for which an SSL Certificate has been issued. We are equally careful in our handling of files and other documents.

Our clinicians’ offices are private, substantially soundproof and locked overnight, as are our file storage areas, both on- and off-site. We will not share any of your information with anyone, by any means, without your express written consent.

How can I learn more about NESCA or request an appointment?

On this website, you will find much more information about our practice. To request an appointment, complete the brief, time-saving intake form, which will be sent to us securely. One of our administrators will quickly contact you.

We also encourage you to read and subscribe to our new, award-winning blog, NESCA Notes, which updated weekly. Delivering updates on significant developments in science, education and the law as they affect families of children with special needs, along with practical parenting advice and links to carefully-screened and reliable sources of additional information.

Does NESCA have more than one location?

NESCA proudly offers three office locations.

55 Chapel St., Suite 202, Newton, MA 02458
Tel 617 658.9800 | Fax 617 658.9801

Get Directions to Newton office

99 Derby Street, Suite 200, Hingham, MA 02043
Tel 617 568.9800 | Fax 617 658.9801

Get Directions to Hingham office

74 Taunton Street, Unit G01, Plainville, MA 02762
Tel 617 568.9800 | Fax 617 658.9801

Get Directions to Plainville office

75 Gilcreast Road, Suite 305, Londonderry, NH 03053
Tel 603 818.8526 | Fax 603 965.4330

Get Directions to Londonderry office

Appointments may also be arranged using our secure online intake form