NEUROPSYCHOLOGIST [ back to Glossary Index ]
A neuropsychologist is a psychologist who has taken required courses in  neuroanatomy, neurophysiology and neuropathology and who understands the complex interrelationships between brain function, personality and behavior. Currently only a small number of neuropsychologists are certified by either the American Board of Clinical Neuropsychology or the American Board of Professional Neuropsychology, and very few are certified by both.  Some practitioners assess but do not treat patients. Such practitioners are consulted by physicians (and occasionally by attorneys) and asked for a report commenting upon the presence, type and extent of cognitive dysfunction, and its likely cause(s). Others counsel patients with neurologic disorders (such as TBI or stroke) to understand and accept their limitations and learn compensatory techniques to improve daily functioning, such as using daily planners, memory aids and avoiding situations which cause an overload of stress or fatigue. Some are pure clinicians who will not work with attorneys. Some only do forensic work for attorneys in the legal arena. Many do both.

Neuropsychology has developed rapidly over the past 20 years. It is a commonplace today for a neurologist who suspects TBI to refer a patient for testing by a trusted neuropsychologist. Prior the advent of CT and MRI, neuropsychologists focused on locating the lesion in the brain by interview and written testing of cognitive capacities. Today they focus much more on the functional impact of brain damage on a patient's life activities including work, family, recreation and leisure. The one exception is "mild" TBI which remains invisible on CT and MRI. Two figures who had enormous influence on neuropsychology were Norman Geschwind, MD of Boston Hospital and Ralph Reitan, Phd of Arizona. Dr. Geschwind founded the field of "behavioral neurology" premised upon the observation that structural damage to neural circuitry in the brain from injury or illness had profound effects on the behavior of patients. Dr. Reitan (first student, then collaborator, then successor to Ward Halstead of the University of Chicago) developed a fixed battery of neuropsychologic tests which were sensitive to and specific to brain injury. Although modern neuropsychology tends much more to utilize the flexible rather than the fixed test battery, Dr. Reitan was an important pioneer in the field.