Welcome to the December edition of Ask Dr. Emily!

We often receive questions that we want to share with all our readers. To help with this, Dr. Emily Neuhaus, a clinical psychologist at Seattle Children’s Autism Center, will share insights in a question and answer format.

We welcome you to send us your questions and Dr. Neuhaus will do her best to answer them each month. Send your questions to [email protected].

Question: What is neuropsych testing, and how do I know if my child needs it?

Answer: A neuropsychological evaluation is a special type of evaluation that measures skills and behaviors in areas like problem-solving, memory, learning, communication, and attention/concentration, along with others. Because this a lot to measure, evaluations often take several visits. It might start with a visit where caregivers share information about their concerns and describe how their child or teen is doing in everyday life, and medical and school records might be reviewed. At other visits, children or teens might participate in structured testing – working at a table to do different activities targeting those areas of skill. Once those visits are complete, families typically have a feedback visit where they learn the results of the evaluation, and then receive a written report with results and recommendations.

There are several reasons families might pursue this type of evaluation. Sometimes, there’s a question about how a medical condition (for example, a seizure disorder, brain injury, or genetic syndrome) is affecting a child’s skills, and whether any skills are changing over time as part of that medical condition or its treatment. Other times, the goal of the evaluation is to get a really good picture of someone’s unique combination of strengths and weaknesses, and the results can help determine what types of treatments and supports will be helpful for them. Neuropsychology evaluation can also be helpful in figuring out whether diagnoses such as learning disorders, intellectual disability, or ADHD might be appropriate for someone.

As you can imagine from all this, neuropsychology evaluations take significant time and energy for families. They can also be quite expensive, especially if insurance coverage is limited. Fortunately, most kids won’t need a neuropsychological evaluation. If you suspect your child or teen might, your best approach would be talking with their pediatrician or with other providers they might have (e.g., neurologist) to consider whether it’s appropriate and how to get a referral.

Question: How can I find a mental health therapist in the community?

Answer: This is a great question – it’s helpful to have a sense of the process for finding a therapist so that you’re ready with the information if and when you need one. In general, there are a few things to consider when you’re looking for a therapist.

First, how do you figure out who you can see for therapy?
This can depend on how you want to pay for therapy. If you’re using state insurance (e.g., Apple Health, Molina), you will need to call the “behavioral health organization” or BHO for your area. They’ll tell you how their intake process works, and help you get connected with a therapist who can help. You can find your area’s BHO at this link.  If you’re using private insurance, call your insurance company to find out who’s covered under your plan, and what limits you might have on who you see or how many sessions you have. If you’re not using insurance, you can sometimes find clinics with lower fees or sliding scale fees to help reduce the cost.

Second, if you have choices about what therapist you see, how do you choose a therapist?
One strategy is to talk with the people you already know and trust (such as your primary care provider, teachers, parent groups, etc.) for therapists they might know of and recommend. You can also check out our Resource Guide for the names and contact information for therapists in the community. Whichever you do, keep in mind that therapists often vary in what types of therapy they provide (e.g., individual, family, groups), what ages of individuals they see (e.g., children, teens, adults), what types of issues they most commonly help with (e.g., challenging behaviors, anxiety, family stress), and what approaches they use (e.g., parent-training, cognitive-behavioral therapy). Check out therapists’ websites or call them to learn more about them so you can figure out a good fit for your needs.

Finally, sometimes it takes some effort to find the right therapist for your family. Families will occasionally meet a therapist where the fit between them isn’t right, and so they may think therapy isn’t for them. If this happens to you, I’d encourage you not to give up and to try working with someone else if you can – once you find a good fit, therapy can be so helpful!