Introducing Neuropsychology: A Conversation with Dr. Sherrie All

Introducing Neuropsychology: A Conversation with Dr. Sherrie All

by Linsey Knerl

For this article, we’ve invited Dr. Sherrie All, a leading neuropsychologist and author, to introduce our readers to the field of neuropsychology. In our interview with Sherrie, she sheds light on this lesser-known yet essential profession, and including how neuropsychology fits within a broader evaluation and treatment of neurocognitive disorders.

Renewal: Thank you so much for taking the time to speak with us, Dr. All. Let’s start at the beginning: what exactly does a neuropsychologist do?

Dr. All: My pleasure.  Simply put, the fundamental job of a neuropsychologist is to measure your thinking abilities through objective testing. Through these tests, we aim to get a quantification of cognitive skills. These skills include memory, attention, executive function, language, and visual processing. 

Broadly speaking, anything that answers the question, "how does your brain handle the input that's coming in through the senses” could be considered the work of a neuropsychologist. They monitor and assess what’s behaviorally happening with the brain.

Renewal: When does someone typically see a neuropsychologist?

Dr. All: Typically, people will see a neuropsychologist when they are experiencing symptoms of some sort of cognitive irregularity.  Examples may include memory problems, difficulty concentrating or thinking, impaired executive functioning, unexplained changes in mood and personality, and challenges expressing or processing language, among other symptoms.

These symptoms may be related to an acute event, such as a stroke or traumatic brain injury (TBI); or in other circumstances, these symptoms may develop slowly over time, as they commonly do with Alzheimer’s disease, lewy body dementia, frontotemporal dementia, Parkinson’s-related dementia, and other neurocognitive disorders.

Renewal: What is the typical age or age group of a neuropsychology patient?

Dr. All: We see patients of all ages for various reasons. For example, we evaluate children who are experiencing difficulty focusing - possibly as the result of ADHD, as well as younger adults living with a neurodevelopmental disorder such as autism spectrum disorder. Through diagnosis, we can help children receive the support they need, both at school and at home.  

Tragically, traumatic brain injuries befall people of all ages, and our work can help measure the extent to which someone is functionally disabled.  

On the older side of the age spectrum, we most commonly see people who are experiencing memory problems. While most of the people we see are in their 70’s and above, it’s not uncommon for us to evaluate people in their 50’s and 60’s.  Some of our younger patients experiencing memory loss are very vigilant about their health and may come to us when they are noticing the initial signs of memory loss, also known as mild cognitive impairment (MCI). I encourage this proactive approach; the sooner someone is diagnosed, the sooner we can develop interventions that may slow or halt further cognitive decline. 

Renewal: How is a neuropsychologist different from a neurologist?

Dr. All: A neurologist is a medical doctor, and a neuropsychologist is a specialized psychologist. Both are evaluating the brain, but they are doing so through different lenses.  A neurologist is looking at the brain through a biological lens, whereas the neuropsychologist is evaluating the brain through a behavioral lens. 

A neurologist, for instance, may order MRIs and bloodwork to determine how the body and brain are functioning on a biological level. A neurologist may also perform different sensory and motor functioning tests, such as asking a patient to touch their finger to their nose, rub their fingers by their ears, and walk up and down the hallway to test different senses. 

A neuropsychologist administers detailed testing of cognitive skills, such as memory, attention, and language. Feedback from these tests can lend incredible insight into what's going on in the brain. As neuropsychologists, we also assess what is happening on an emotional level.  This is especially important, given that depression and anxiety can have a direct effect on cognitive functioning. 

In addition to differences in focus between a neurologist and neuropsychologist, there are also differences in training. While a neurologist goes to medical school to get an MD; a neuropsychologist goes to graduate school to get a PhD. or a PsyD.

Renewal: Do neurologists and neuropsychologists work together? If so, how? 

Dr. All: As a best practice, Alzheimer’s Disease Research Centers have professionals from both disciplines on their team. Neuropsychologists work hand in hand with neurologists. For a holistic assessment of brain health, input from both professionals is key. Both professionals can separately diagnose, but it's best when they work together. This is especially true for dementia because it's not a disease per se, but rather a syndrome, or a collection of symptoms such as memory and cognitive skill loss. 

Renewal: What is the neuropsychologist’s role in providing ongoing care?

Dr. All: For many patients, a visit to a neuropsychologist is a one-time occurrence - for example, a single visit for a specific test. Some patients may come back every year or every few years for follow-up and to see how the condition has progressed. If stable, there may be no need to return for a long time.

Renewal: Is neuropsychology covered by insurance?

Dr. All: Your appointment with a neuropsychologist is considered a covered medical procedure. It would cost the same as if you went for a brain scan. Medicare will pay for a neuropsychological assessment annually. Patients do need a doctor's referral, but getting one should be simple if you let them know of your concerns, such as having memory issues.

Patients can save more if they have a good supplemental Medicare plan and have already met the annual deductible. However, even those with Medicare Part B only will pay just 20% out of pocket.

Renewal: How can patients prepare for a neuropsychologist appointment?

Dr. All: Understandably, many are afraid or anxious about the visit that may reveal potential neurological problems. In fact, many seem as distressed about these appointments as they would be about major surgery. While the tests are rigorous, they are not invasive, and they can provide valuable insight into what’s going on with the brain and how to best treat it. 

If you miss a problem on the test, take a breath and move on. Stay on task with the next question, and do your best to complete the tests as best as possible. They are made to be challenging, and you won't get every answer correct.

Renewal: On a personal note, what do you do to support your brain health? 

Dr. All: I give hugs! They trigger the release of oxytocin, also known as “the cuddle hormone.” The chemical is linked to many benefits, including stress reduction and emotional well-being. It’s one of the reasons social connections are essential for a long and healthy life.

About the Expert

Sherrie All, PhD is a neuropsychologist, brain health expert, and author. She is the founder of the Centers for Cognitive Wellness, a neuropsychology practice with offices in Chicago, IL, and Chevy Chase, MD. You can read more about neuroscience and its role in keeping you healthy in Sherrie’s book The Neuroscience of Memory: Seven Skills to Optimize Your Brain Power, Improve Memory, and Stay Sharp at Any Age.