School Neuropsychologists....wait, what?

[Therapist4Chnge]

I recently learned about "school neuropsychologists" from a recent discussion on a listserv I frequent. I had never heard of the title, though it's creation and proliferation is concerning on multiple levels. Has anyone encountered someone who uses this title?

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[aagman01]

http://www.absnp.com/index.php

I recently learned about "school neuropsychologists" from a recent discussion on a listserv I frequent. I had never heard of the title, though it's creation and proliferation is concerning on multiple levels. Has anyone encountered someone who uses this title?

 

[Therapist4Chnge]

I know they have a board, I was asking about people's experiences in practice.

 

[PerhapsMaybeOk]

I recently learned about "school neuropsychologists" from a recent discussion on a listserv I frequent. I had never heard of the title, though it's creation and proliferation is concerning on multiple levels. Has anyone encountered someone who uses this title?

wow did you see that website, whats with the model talking lol

 

[FadedC]

My only exerience with them was a presentation in which some people who I believe defined themselves as school neuropsychologists showed how a neuropsychological perspective could be useful in developing interventions for school children with specific problems. I know very little about the discipline beyond that.

 

[SNB1111]

I've perused these forums since I first began applying to psychology doctoral programs.
I'm currently in a doctoral school psychology program that offers a school neuropsychology specialization. It requires multiple neuropsychological assessment courses, a neurodevelopmental class, a 50 hour neuropsychology supervised practicum as well as other course offerings. The department head is ABSNP and literally helped "write the books" on the specialization. School neuropsychologists specialize in assessing for traumatic brain injuries and other neurodevelopmental disorders in children. This is an essential specialty when it comes to determining special education disabilities in the school system. To summarize, school neuropsychology focuses on children and issues that interfere with school and development. It's an up and coming area that is considered to be the future of school psychology. For this reason it is not well-known or understood. Can you please explain why the existence of this specialty is of concern?

 

[Therapist4Chnge]

Can you please explain why the existence of this specialty is of concern?

The lack of adequate training to do anything remotely related to neuropsychology assessment. You wrote....

It requires multiple neuropsychological assessment courses, a neurodevelopmental class, a 50 hour neuropsychology supervised practicum as well as other course offerings.

So, the entire training is equal to a semester worth of classes and a week or two of practica training? How is this possibly enough? I've spent 50+ hours just in the wet lab/morgue in the past year reviewing and teaching the associated pathophysiology and neuroanatomy, which is just a small part of what we need to know in regard to the "neuro" side of neuropsychology. Congenital defects, acquired trauma, and related factors are all fair game in neuropsychology, regardless if the assessment is done within the context of school problems or a hospital stay.

I'm on the adult side of things, but pediatric neuropsychologists also start their training during their doctoral program (classes, research, and practica), and then they continue it through a one year internship and then a two year fellowship. Those experiences provide thousands of hours of additional training, hundreds of hours of additional mentorship, and hundreds of hours of didactic training.

Houston Guidelines include a more detailed description of the training, though I think it is important to highlight requirement #3:

Foundations for the study of brain-behavior relationships
A. Functional neuroanatomy
B. Neurological and related disorders including their etiology, pathology, course and treatment
C. Non-neurologic conditions affecting CNS functioning
D. Neuroimaging and other neurodiagnostic techniques
E. Neurochemistry of behavior (e.g., psychopharmacology)
F. Neuropsychology of behavior

How are these areas addressed in your training? The neuro in neuropsychology is a very important aspect of the training. The practice of neuropsychology is more than just administering some assessments and interpreting some data.

 

[SNB1111]

The lack of adequate training to do anything remotely related to neuropsychology assessment. You wrote....



So, the entire training is equal to a semester worth of classes and a week or two of practica training? How is this possibly enough? Pediatric neuropsychologists start their training during their doctoral program, and then they continue it through a one year internship and then a two year fellowship. They get literally thousands of hours of additional training and hundreds of hours of additional mentorship.

Houston Guidelines include a more detailed description of the training, though I think it is important to highlight requirement #3:

Foundations for the study of brain-behavior relationships
A. Functional neuroanatomy
B. Neurological and related disorders including their etiology, pathology, course and treatment
C. Non-neurologic conditions affecting CNS functioning
D. Neuroimaging and other neurodiagnostic techniques
E. Neurochemistry of behavior (e.g., psychopharmacology)
F. Neuropsychology of behavior

How are these areas addressed in your training? The neuro in neuropsychology is a very important aspect of the training, as the assessment data are only one part of the clinical picture.

Thank you for the clarification. I can see how this would certainly worry you given how extensive your neuropsychological training has been. We certainly do not gain that much experience, however I would also like to clarify what we are trained in. Yes, it is true that we are not trained nearly as extensively as the traditional neuropsychologist. In each of our assessment courses we also must complete three 50 hour prepracticums and cannot continue in the program until we reach mastery in each neuropsychological assessment tool. Assessment is very important in school psychology, which is why there is such a heavy emphasis on that area. We have an entire year devoted solely to neuropsychology that adds to our foundational school and child psychology coursework, which includes child psychopharmacology and behavioral neuroscience courses. Although they are not solely neuropsychological in nature, we do gain some understanding of these areas. The major research team at my school also focuses on school neuropsychology and many students have multiple publications in the area upon graduation and therefore thousands of hours involved in independent neuropsychological study guided by experts in the field. We also receive supervision and mentorship during our pre-practicum and practicum hours, as well as our internship if we match with a location that allows for school neuropsychological supervision. Many of the graduates from our program have obtained such internships.

I'm sorry again if I implied that school neuropsychologists are as extensively trained as traditional neuropsychologists. I merely meant to demonstrate that it can be a legitimate specialization and is greatly needed in the school system, which functions quite differently from the traditional clinical setting and therefore requires different training. It is also important to make the distinction that the program trains school psychologists with a specialty in school neuropsychology, not neuropsychologists. I would never use the title neuropsychologist as that would not be my specialty area. School psychology has a much different focus - it is vital that we have a thorough understanding of special education, consultation, intervention, and assessment, which does take up most of our coursework. It would be unethical to practice as a school psychologist without understanding in those areas. Lastly, we are always reminded to always practice within the limits of our knowledge. We are encouraged to frequently continue our education and consult with others and to always refer out when we are not competent in an area. Our neuropsychological competence is limited compared to traditional neuropsychology and therefore, we must practice with caution and only within the boundaries of our understanding. This cautious practice should hold true across all fields of psychology.

Please feel free to PM and I can send you some information on the specialty if you're interested in learning about it. I certainly respect your opinions as well as your expertise and am happy to discuss any concerns you might have with my career path. I hope it doesn't seem like we are encroaching on your area of expertise because that is in no way what is occurring. The specialty is needed in the school system with the prevalence of TBI and other neurodevelomental/genetic disorders. In fact, neuropsychologists and school neuropsychologists will often work together to monitor the functioning of children with such issues in the school system. I think we're all here to live up to the ethical goal of beneficence. We're here to help our clients, not harm them, and the goal of helping children is certainly what those being trained in school neuropsychology are hoping to do. Incompentence can harm others and I would never practice outside of my own competence.

 

[SNB1111]

Thank you for the clarification. I can see how this would certainly worry you given how extensive your neuropsychological training has been. We certainly do not gain that much experience, however I would also like to clarify what we are trained in. Yes, it is true that we are not trained nearly as extensively as the traditional neuropsychologist. However, I should have also mentioned that in each of our assessment courses we also must complete three 50 hour prepracticums and cannot continue in the program until we reach mastery in each neuropsychological assessment tool (students typically end up with over 100 prepracticum hours for each in order to obtain mastery). Assessment is very important in school psychology, which is why there is such a heavy emphasis on that area. Evaluation and reevaluation is essential when it comes to special education placement and services. We have an entire year devoted solely to neuropsychology that adds to our foundational school and child psychology coursework, which includes child psychopharmacology and behavioral neuroscience courses. Although the neuroscience and psychopharm courses are not solely neuropsychological in nature, we do gain some understanding in those areas. The major research team at my school also focuses on school neuropsychology and many students have multiple publications in the area upon graduation and therefore thousands of hours involved in independent neuropsychological study guided by experts in the field. We also receive supervision and mentorship during our pre-practicum and practicum hours, as well as our internship if we match with a location that allows for school neuropsychological supervision. Many of the graduates from our program have obtained such internships. We are trained to always refer out to a neuropsychologist in the areas that are not covered in our training, particularly concerning neuroimaging. In fact, the school neuropsychologist often serves as a liaison between the school and the neuropsychologist who works with a child clinically. This helps the family, clinician, and school to stay on the same page.

I'm sorry again if I implied that school neuropsychologists are as extensively trained as traditional neuropsychologists. I merely meant to demonstrate that it can be a legitimate specialization and is greatly needed in the school system, which functions quite differently from the traditional clinical setting and therefore requires different training. It is also important to make the distinction that the program trains school psychologists with a specialty in school neuropsychology, not neuropsychologists. I would never use the title neuropsychologist as that would not be my specialty area. School psychology has a much different focus - it is vital that we have a thorough understanding of special education, consultation, intervention, and assessment, which does take up most of our coursework. It would be unethical to practice as a school psychologist without understanding in those areas. Lastly, we are always reminded to always practice within the limits of our knowledge. We are encouraged to frequently continue our education and consult with others and as I mentioned previously, to always refer out when we are not competent in an area. Our neuropsychological competence is limited compared to traditional neuropsychology and therefore, we must practice with caution and only within the boundaries of our understanding. This cautious practice should hold true across all fields of psychology.

Please feel free to PM and I can send you some information on the specialty if you're interested in learning about it. I certainly respect your opinions as well as your expertise and am happy to discuss any concerns you might have with my career path. I hope it doesn't seem like we are encroaching on your area of expertise because that is in no way what is occurring. The specialty is needed in the school system with the prevalence of TBI and other neurodevelomental/genetic disorders. In fact, neuropsychologists and school neuropsychologists will often work together to monitor the functioning of children with such issues in the school system. I think we're all here to live up to the ethical goal of beneficence. We're here to help our clients, not harm them, and the goal of helping children is certainly what those being trained in school neuropsychology are hoping to do. Incompentence can harm others and I would never practice outside of my own competence.

Edit: I'm so very sorry. I was reading through your response and was wondering why you mentioned the "one week" practicum. On my first post I should have said 500 (not 50) hour supervised neuropsychology practicum, typically under a neuropsychologist in the clinical setting in addition to the three 50 hour prepracticums, coursework, research team, and internship. I must have mistyped it. I know that still is nowhere near your training, but I felt that it was important to correct my mistake. Whoops

 

[Pragma]

Thank you for the clarification. I can see how this would certainly worry you given how extensive your neuropsychological training has been. We certainly do not gain that much experience, however I would also like to clarify what we are trained in. Yes, it is true that we are not trained nearly as extensively as the traditional neuropsychologist. However, I should have also mentioned that in each of our assessment courses we also must complete three 50 hour prepracticums and cannot continue in the program until we reach mastery in each neuropsychological assessment tool (students typically end up with over 100 prepracticum hours for each in order to obtain mastery). Assessment is very important in school psychology, which is why there is such a heavy emphasis on that area. Evaluation and reevaluation is essential when it comes to special education placement and services. We have an entire year devoted solely to neuropsychology that adds to our foundational school and child psychology coursework, which includes child psychopharmacology and behavioral neuroscience courses. Although the neuroscience and psychopharm courses are not solely neuropsychological in nature, we do gain some understanding in those areas. The major research team at my school also focuses on school neuropsychology and many students have multiple publications in the area upon graduation and therefore thousands of hours involved in independent neuropsychological study guided by experts in the field. We also receive supervision and mentorship during our pre-practicum and practicum hours, as well as our internship if we match with a location that allows for school neuropsychological supervision. Many of the graduates from our program have obtained such internships. We are trained to always refer out to a neuropsychologist in the areas that are not covered in our training, particularly concerning neuroimaging. In fact, the school neuropsychologist often serves as a liaison between the school and the neuropsychologist who works with a child clinically. This helps the family, clinician, and school to stay on the same page.

I'm sorry again if I implied that school neuropsychologists are as extensively trained as traditional neuropsychologists. I merely meant to demonstrate that it can be a legitimate specialization and is greatly needed in the school system, which functions quite differently from the traditional clinical setting and therefore requires different training. It is also important to make the distinction that the program trains school psychologists with a specialty in school neuropsychology, not neuropsychologists. I would never use the title neuropsychologist as that would not be my specialty area. School psychology has a much different focus - it is vital that we have a thorough understanding of special education, consultation, intervention, and assessment, which does take up most of our coursework. It would be unethical to practice as a school psychologist without understanding in those areas. Lastly, we are always reminded to always practice within the limits of our knowledge. We are encouraged to frequently continue our education and consult with others and as I mentioned previously, to always refer out when we are not competent in an area. Our neuropsychological competence is limited compared to traditional neuropsychology and therefore, we must practice with caution and only within the boundaries of our understanding. This cautious practice should hold true across all fields of psychology.

Please feel free to PM and I can send you some information on the specialty if you're interested in learning about it. I certainly respect your opinions as well as your expertise and am happy to discuss any concerns you might have with my career path. I hope it doesn't seem like we are encroaching on your area of expertise because that is in no way what is occurring. The specialty is needed in the school system with the prevalence of TBI and other neurodevelomental/genetic disorders. In fact, neuropsychologists and school neuropsychologists will often work together to monitor the functioning of children with such issues in the school system. I think we're all here to live up to the ethical goal of beneficence. We're here to help our clients, not harm them, and the goal of helping children is certainly what those being trained in school neuropsychology are hoping to do. Incompentence can harm others and I would never practice outside of my own competence.

Edit: I'm so very sorry. I was reading through your response and was wondering why you mentioned the "one week" practicum. On my first post I should have said 500 (not 50) hour supervised neuropsychology practicum, typically under a neuropsychologist in the clinical setting in addition to the three 50 hour prepracticums, coursework, research team, and internship. I must have mistyped it. I know that still is nowhere near your training, but I felt that it was important to correct my mistake. Whoops

I am on the adult side of things, but I wonder what many of the board-certified pediatric neuropsychologists who spent close to a decade training in the established ABPP specialty would think about this.

How long does it take, on average, to complete this program when students go full time?

Pediatric neuropsychologists are highly trained doctoral level psychologists. I am sure that they are happy to have folks working within the school system who seek some additional training in neuropsychology to better serve kids with neurocognitive issues through treatment and to be better consumers of neuropsychological assessment recommendations.

However, I can't fathom that they would be happy to hear that people use a "certificate" to suddenly give themselves a new title. It is very confusing to the public and really is a slap in the face to a discipline and Board that has been around for decades. My question is, why not just say "I have a Master's in School Psychology, and completed an additional training certificate with an emphasis on neuropsychology to help me consult with and implement interventions recommended by pediatric neuropsychologists" without lobbying to actually be called neuropsychologists? A follow-up question would be whether you consider an assessment completed by graduates of your program to be a "neuropsychological" assessment, given the extremely drastic difference in training between your program description and that of Board Certified Pediatric Neuropsychologists?

 

[Therapist4Chnge]

Edit: I'm so very sorry. I was reading through your response and was wondering why you mentioned the "one week" practicum. On my first post I should have said 500 (not 50) hour supervised neuropsychology practicum, typically under a neuropsychologist in the clinical setting in addition to the three 50 hour prepracticums, coursework, research team, and internship. I must have mistyped it. I know that still is nowhere near your training, but I felt that it was important to correct my mistake. Whoops

That makes more sense.

I'll try and respond to your post tomorrow, as I think it is important to talk about scope of practice and related issues. I appreciate your willingness to talk about the training, as this is definitely a controversial issue amongst neuropsychologists.

 

[PerhapsMaybeOk]

does this even require a phd? That website lists people with masters only.

 

[AcronymAllergy]

does this even require a phd? That website lists people with masters only.

No. The school neuropsychologist title and certification is master's-level, I believe.

 

[SNB1111]

How long does it take, on average, to complete this program when students go full time?

My question is, why not just say "I have a Master's in School Psychology, and completed an additional training certificate with an emphasis on neuropsychology to help me consult with and implement interventions recommended by pediatric neuropsychologists" without lobbying to actually be called neuropsychologists? A follow-up question would be whether you consider an assessment completed by graduates of your program to be a "neuropsychological" assessment, given the extremely drastic difference in training between your program description and that of Board Certified Pediatric Neuropsychologists?

Our program is a PhD program that takes on average 5 to 7 years to complete (inclusive of dissertation and internship). My school also offers a specialist program that takes 3 years to complete. The students in the subdoctoral program do not have any neuropsych coursework and therefore would not be able to specialize in school neuropsychology.

I'm unsure how it works elsewhere and whether there are programs that offer specialist/master's students certificates and additional experience to specialize in school neuropsychology. I noticed on the link that the OP posted that it mentioned that as one of the options but in my experience that is unheard of. It would be especially worrisome for a subdoctoral practitioner to use the title "school neuropsychologist." It's quite concerning that some states allow master's level practitioners to use the title school psychologist to begin with.

Can you please explain what you mean by your last question? It's a little unclear to me what you mean specifically. In our program we learn to administer, score, and interpret child neuropsychological assessment tools (e.g. NEPSY-II and others). Although we are not exposed to the depth and breadth of information that a neuropsych student would be exposed to, we obtain knowledge on the foundational information needed to interpret our findings and report them to outside sources, such as doctors and neuropsychologists.

I know of very few people who have obtained the ABSNP. These are the people who, as I mentioned earlier, "wrote the books" and have been practicing for decades. It is still a very difficult honor to receive and requires substantial work.

That makes more sense.

I'll try and respond to your post tomorrow, as I think it is important to talk about scope of practice and related issues. I appreciate your willingness to talk about the training, as this is definitely a controversial issue amongst neuropsychologists.

I also appreciate your introduction of this specialty into the forums. It's interesting because prior to reading your post I was never aware of the controversial nature of this area. I'm always happy to hear to about what others have to say as I believe it will allow me to become a better practitioner. I look forward to hearing back from you.

 

[Therapist4Chnge]

No. The school neuropsychologist title and certification is master's-level, I believe.

According to information posted on the ABSNP website and the training website...this is correct. This is yet another reason why title AND scope of practice matter. A child in a school system may see the following professionals for an assessment: school psychologist, clinical/counseling psychologist, "school neuropsychologist", or a neuropsychologist who works with school systems. Only one of those are truly qualified to administer, score, and interpret neuropsychological data.

From the FAQ section:

--------------------------------------------------------------------------------------------------------
When I finish this program will I be able to call myself a neuropsychologist?

No. A neuropsychologist typically has a doctorate in clinical psychology with a specialization in neuropsychology, an internship experience in neuropsychology, and is often board certified as a neuropsychologist by either the American Board of Clinical Neuropsychology, the American Board of Professional Neuropsychology, or the American Board of Pediatric Neuropsychology. This training program is for certified/licensed school psychologists and clinical psychologists who work with children to integrate neuropsychological theory and practice into their assessment and intervention techniques. The title "school neuropsychologist" is not regulated by national training standards at this time. Anyone graduating from this program should continue to use their current state certification title or licensure title. However, nothing precludes graduates of this training program to work within their added level of competency in providing school neuropsychological assessment.​

----------------------------------------------------------------------------------------------------

So this training will allow the person to practice as a neuropsychologist within the school setting, but without any of the formal training standards, title, or official acknowledgement from the state licensing board. I guess clinicians can practice at their own peril, but I wouldn't want to be a "school neuropsychologist" with the above training and have to defend it in a court of law. Frankly, I hope anyone practicing outside of their scope of practice is prosecuted to the fullest extend of their state's law because a handful of classes and a practica are not sufficient to be competently and ethically practice as a neuropsychologist. As the saying goes, "You don't know what you don't know", and that is a risk to the child/client.​

 

[Therapist4Chnge]

I support close collaboration between a school psychologist and a neuropsychologist because there are a host of issues that could pop up for either professional if they are not well informed about the nuances of assessment and the implications of the recommendations on the school setting.

We actually just talked about some of the challenges of accomodation earlier today in seminar, and it just reinforced why a school psychologist needs to be consulted to help guide/implement recommendations that come from an NP report. I will be the first person to admit that I don't feel comfortable trying to navigate and implement a 504 plan, IDEA/IEP, or similiar educational plans.

I spent a year working in a school system doing assessment and behavioral intervention, and I was included in aspects of the individual education plans for a number of students, but that doesn't mean I should be the one leading the way. I learned enough to realize I should defer to a professional who deal with these plans every day, just like non-neuropsychologists should defer neuropsychological assessment to professionals who have all of the proper training and experience in the area. There are just too many things that can go wrong, and it is not ethical to pretend otherwise.

 

[SNB1111]

I support close collaboration between a school psychologist and a neuropsychologist because there are a host of issues that could pop up for either professional if they are not well informed about the nuances of assessment and the implications of the recommendations on the school setting.

We actually just talked about some of the challenges of accomodation earlier today in seminar, and it just reinforced why a school psychologist needs to be consulted to help guide/implement recommendations that come from an NP report. I will be the first person to admit that I don't feel comfortable trying to navigate and implement a 504 plan, IDEA/IEP, or similiar educational plans.

I spent a year working in a school system doing assessment and behavioral intervention, and I was included in aspects of the individual education plans for a number of students, but that doesn't mean I should be the one leading the way. I learned enough to realize I should defer to a professional who deal with these plans every day, just like non-neuropsychologists should defer neuropsychological assessment to professionals who have all of the proper training and experience in the area. There are just too many things that can go wrong, and it is not ethical to pretend otherwise.

Thanks again, T4C for your contribution. I completely understand where your concern lies in regards to the use of the term "school neuropsychologist." As I mentioned earlier, I will always practice within the boundaries of my own knowledge and I can see the unethical nature of practicing neuropsychology within the school system without the proper extent of training. This worries me as I know some people who fully intend to use that title and to attempt to complete full neuropsychological assessments. I am only in the second year of my program and have not yet started the neuropsychological coursework but I feel somewhat mislead by what I was told at my initial interviews and throughout my experience in the program. However, I still feel that an understanding in basic neuropsychological constructs is vital for the school psychologist given the interplay between cognitive and neuropsychological functioning. Therefore, I will continue to research the area to allow me to become a better consultant and practitioner. To conclude, I value the inclusion of neuropsychology in my training but you've helped demonstrate that the term "school neuropsychologist" is misleading and unethical without the full training in neuropsychology. Therefore, I do not intend to use that title and plan to refer cases out when they require neuropsychological evaluation. It seems that some people in my program need a wake up call.

It's frightening to think that there are subdoctoral students out there who believe that they can become "school neuropsychologists." To be honest, the specialist level students in my program miss out on some of the essential school psychology courses to begin with (e.g. consultation, counseling, therapeutic interventions). They are already missing so much that I can't imagine them claiming to be a school neuropsychologist, let alone a school psychologist. If that makes sense...

 

[Therapist4Chnge]

...I know some people who fully intend to use that title and to attempt to complete full neuropsychological assessments.

That is what worries me. I know I tend to be very conservative when it comes to scope of practice issues. I was taught that every word I write in a report or progress note is subject to review, and I better be prepared to defend it in a court of law. I am ultimately responsible for the content and my participation in the intervention, and it is my license on the line if something goes wrong. It only takes one serious infraction to jeopardize your license/career.

However, I still feel that an understanding in basic neuropsychological constructs is vital for the school psychologist given the interplay between cognitive and neuropsychological functioning. Therefore, I will continue to research the area to allow me to become a better consultant and practitioner.

Educating yourself about related areas is a great thing to do, and it definitely can provide the opportunity to better inform your day to day work, though a prudent approach to extending your scope of practice is still needed. You sound very aware of some of the ethical issues involved, though I'd encourage you to seek further guidance and mentorship about the practice of neuropsychology before providing services under your own license.

 

[Pragma]

Our program is a PhD program that takes on average 5 to 7 years to complete (inclusive of dissertation and internship). My school also offers a specialist program that takes 3 years to complete. The students in the subdoctoral program do not have any neuropsych coursework and therefore would not be able to specialize in school neuropsychology.

I'm unsure how it works elsewhere and whether there are programs that offer specialist/master's students certificates and additional experience to specialize in school neuropsychology. I noticed on the link that the OP posted that it mentioned that as one of the options but in my experience that is unheard of. It would be especially worrisome for a subdoctoral practitioner to use the title "school neuropsychologist." It's quite concerning that some states allow master's level practitioners to use the title school psychologist to begin with.

Can you please explain what you mean by your last question? It's a little unclear to me what you mean specifically. In our program we learn to administer, score, and interpret child neuropsychological assessment tools (e.g. NEPSY-II and others). Although we are not exposed to the depth and breadth of information that a neuropsych student would be exposed to, we obtain knowledge on the foundational information needed to interpret our findings and report them to outside sources, such as doctors and neuropsychologists.

I know of very few people who have obtained the ABSNP. These are the people who, as I mentioned earlier, "wrote the books" and have been practicing for decades. It is still a very difficult honor to receive and requires substantial work.



I also appreciate your introduction of this specialty into the forums. It's interesting because prior to reading your post I was never aware of the controversial nature of this area. I'm always happy to hear to about what others have to say as I believe it will allow me to become a better practitioner. I look forward to hearing back from you.

I agree with you on the first part. Even among graduates of doctoral-level clinical psychology programs who have thier license, the norm is that you can't call yourself a neuropsychologist until you have completed a two year, full-time fellowship (or it's equivalent in some cases). Now, as the term is not legally regulated, there are clinical psychologists who call themselves neuropsychologists all the time and are misrepresenting themselves.

This leads to your inquiry about my second question - would you consider the testing you do "neuropsychological" testing? Psychologists (and non-psychologists) from all walks of life are capable of using tests that are marketed as "neuropsychological." Post-bachelor's level tech's are hired to train and then administer those tests all the time.

If you are going to call the testing that you do "neuropsychological" it had better be competent and appropriately interpreted. All the time, folks with standard clinical psychology training (and now even master's level training in the case of school psychologists) throw in a trailmaking test on top of a WAIS and call what they just did a "neuropsychological" evaluation, which is craziness. As T4C mentioned previously, there are numerous layers of competence involved in completing a comprehensive neuropsychological assessment. In order to develop this competence, one must have years of supervised experience. Board-certification within the field of neuropsychology helps to set a standard of competence.

So, I am saying that buying a "neuropsychological" test, reading the manual, administering it, and even taking a couple of classes about it does not make you competent to perform a full neuropsychological assessment. That would be like me reading a book about school psychology, doing a practicum at a school, and then calling myself a school psychologist after I did a classroom observation or attended an IEP meeting. Not nearly enough training.

 

[Therapist4Chnge]

If you are going to call the testing that you do "neuropsychological" it had better be competent and appropriately interpreted. All the time, folks with standard clinical psychology training (and now even master's level training in the case of school psychologists) throw in a trailmaking test on top of a WAIS and call what they just did a "neuropsychological" evaluation, which is craziness. As T4C mentioned previously, there are numerous layers of competence involved in completing a comprehensive neuropsychological assessment. In order to develop this competence, one must have years of supervised experience. Board-certification within the field of neuropsychology helps to set a standard of competence.

Excellent point. Test selection is paramount to a proper assessment. I also think an important aspect of neuropsychological assessment that is often overlooked is how the clinician incorporates the data from the assessment with other data in the medical record. I've seen proported neuropsychological reports that only report on the data, as if the purpose was to just list the results of the patient's performance on the measures in isolation. Some attempts may be made to speak to what that data means, but it is pretty much useless if you don't address other factors that may impact the patient's performance.

I think the real value of a neuropsychological report is to speak to what the data means in relation to everything else in the case, which can't be done without a strong foundation in the neuro side of things: neuroanatomy, neurophysiology, neurochemistry, etc. There are also non-neuro considerations like being aware of any organic processes that may have primary and/or secondary effects on neurological functioning.

A complete neuropsychological evaluation also incorporates information about existing neurological damage that was noted in the imaging as well as clinical observations like if dysarthria and/or an aphasia was present. Failure to account for any of these areas leaves a giant hole in your assessment. You can't be an expert on all things, but you need a working knowledge of many things across different domains. I think of neuropsychological assessment like pregnancy...you can't sort of do neuropsychological assessment, just like you can't sort of be pregnant.

ps. I know all of the above may not be possible in certain settings, but those caveats need to be clearly listed and accounted for in the report.

 

[psychtime101]

Granted I didnt go to the link but I think there is some discrepancy in general on what is considered neuropsychology. As Pragma said, people include a subtest form the D-KEFS and say its neuropsych. My impression is that it is what T4C says it is all about. However, there are neuropsych post docs in NYC that are just testing with didactic training in anatomy, neuropathy etc, but the bulk is testing with measures assessing for memory and learning. Do I think that that school psychs could be trained to administer the NEPSY, WRAML, DKEFS etc and understand more about learning style and memory yes, does this make this neuropsychologists absolutely not. In fact, having many friends do neuopsych externships in NYC i was surprised at how their reports were basic and disjointed, just summarizing several test measures assessing memory functioning.
Having worked in schools, it would be helpful if school psychologists were trained on measures that would provide insight into learning style and memory as this could certainly help to guide instruction and remediation activities.
Im not sure why a whole new area would need to be created to do this, nor should it be considered to be anything in comparison to what neuropsychologists do- they are on a league of their own.

 

[psychtime101]

I googled school neuropsych and this is what I found for the roles and functions off a website, though a different one than the one above.

• Provide neuropsychological assessment and interpretation services to schools for children with known or suspected neurological conditions.
• Assist in the interpretation of neuropsychological findings from outside consultants or medical records.
• Seek to integrate current brain research into educational practice.
• Provide educational interventions that have a basis in the neuropsychological or educational literature.
• Act as a liaison between the school and the medical community for transitional planning for TBI and other health impaired children and adolescents.
• Consult with curriculum specialists in designing approaches to instruction that more adequately reflect what is known about brain-behavior relationships.
• Conduct inservice training for educators and parents about the neuropsychological factors that relate to common childhood disorders.
• Engage in evidenced-based research to test for the efficacy of neuropsychologically- based interventions (Miller, 2007).

Reference

• Miller, D. C. (2007). Essentials of school neuropsychological assessment. Hoboken, NJ: Wiley and Sons.

 

[mkberry85]

We need to stop looking at this as a school psychologist trying to serve as a neuropsychologist inside of a school, but as a school psychologist that is gaining more competency is something that generally they are already doing. The board certification and training (be it through the board or academic) is meant to educate a school psychologist on the biological bases of behavior and how these factors can interfere with behavior and academics within a school. They are still completing the assessments, consulting, etc the same, but they are doing it with a more thorough understanding of neuropsychology. It is not meant for the school psychologist to replace a pediatric or clinical neuropsychologist, but doing their job "better."

 

[Jxz]

One of the early comments was "what do pediatric neuropsychologists think of school neuropsychologists." The easy answer is you could ask one if you can find one. There are 72 people in who have been certified by the AAPN board. A few of them might be in Canada and I can recognize the names of some who are entirely academics--they don't practice at all.

There are over 50 million children enrolled in the public schools.

A kid has a better chance of winning the lottery than having one of these guys administer, score or interpret neuropsychological data relating to their case.

 

[WisNeuro]

A kid has a better chance of winning the lottery than having one of these guys administer, score or interpret neuropsychological data relating to their case.

The Argosy's and Alliant's all started out small too...

 

[WisNeuro]

T4C, you should e-mail the link and a blurb to the npsych listservs. We may want to take a more active approach to this within the profession.

 

[Therapist4Chnge]

T4C, you should e-mail the link and a blurb to the npsych listservs. We may want to take a more active approach to this within the profession.

It's been mentioned on there at least once, as this started in TX and I think someone from down there posted about it.

 

[Therapist4Chnge]

We need to stop looking at this as a school psychologist trying to serve as a neuropsychologist inside of a school, but as a school psychologist that is gaining more competency is something that generally they are already doing.

If they are already doing it, then they are practicing outside of their scope, which can have some serious consequences for the kids. Misdiagnosing a child with an LD when it is actually an acute neurologic problem will delay/prevent that child from receive appropriate services. Another common example is the over diagnosis of ADHD. Putting a child on a psychostimulant at an early age can have a number of significant consequences for them down the road. There is also the issue of under coding, instead of accurately capturing and documenting cognitive problems the child is pushed into inadequate services and then will most likely struggle for the rest of their schooling.

The board certification and training (be it through the board or academic) is meant to educate a school psychologist on the biological bases of behavior and how these factors can interfere with behavior and academics within a school.

How?

Please see my prior post on the Houston Guidelines about this training area, as nothing I have seen remotely covers this area in enough breadth nor depth.

They are still completing the assessments, consulting, etc the same, but they are doing it with a more thorough understanding of neuropsychology. It is not meant for the school psychologist to replace a pediatric or clinical neuropsychologist, but doing their job "better."

That is patently false. One of the most common reasons given for this fly-by-night training is that there are not enough pediatric neuropsychologists around, so the school psychologists want to fill that niche….regardless if it is actually ethical or feasible.

 

[Therapist4Chnge]

One of the early comments was "what do pediatric neuropsychologists think of school neuropsychologists." The easy answer is you could ask one if you can find one. There are 72 people in who have been certified by the AAPN board. A few of them might be in Canada and I can recognize the names of some who are entirely academics--they don't practice at all.

Straw man. This figure ignores the 1000+ ABPP'd neuropsychologists, with a significant portion identifying as either solely as a pediatric neuropsychologist or as both an adult and pediatric neuropsychologist. According to the 2010 TCN salary surgery (Sweet et al. 2011), 15.2% of respondents identified as exclusively a pediatric neuropsychologist, an additional 25.5% identified with adult+pediatric. Yes there are a subset of clinicians (N=75) who identify with ABpN designation, but they were in the minority. The survey (N=1685) is probably the most well known and largest sample from the field, FWIW.

The ABPP designation is a clinical designation, as it requires direct clinical expertise to achieve. Yes boarded people work in academia, but the vast majority of ABPP'd neuropsychologists work in a clinical setting. Sweet et al (2011) also found that institutional employment accounts for 40% of the sample, with 27.5% exclusively in private practice, and 26.1% working in both settings. Institutional employment does not equal academic only. I'm actually one of many in an institutional/academic setting who provide clinical assessment services, as that is what typically funds these types of positions.

 

[Jxz]

1000. Wow. Now that impresses me. 1 for every 50,000 kids. What's do you think that wait time will be (especially in a lower population area)?

My point is that psychology organizations have a tendency to raise the standards so high that the end result is that the people who need the services don't get any at all. There have been studies within elementary school teaching (where there's a much greater N) that the more skills a teacher has (national certification, MA degrees, etc.) the less likely they are to teach lower socioeconomic kids (i.e., the kids who actually need a very skilled teacher).

The same thing is happening in all these Southern states that are ratcheting up the requirements for running an abortion clinic. They aren't doing it to up the standards of care--they're doing it to limit access.

 

[WisNeuro]

1000. Wow. Now that impresses me. 1 for every 50,000 kids. What's do you think that wait time will be (especially in a lower population area)?

That is a low estimate on those who have completed the process. There is a much larger number who have the requisite training and are eligible, or in the process of becoming boarded. And, even if there was a massive shortage, which I am not convinced of, subpar, potentially dangerous substitutions are not the answer.

 

[smalltownpsych]

I just want to state for the record that I don't think the term psychologist should have ever been applied to a Master's level practitioner and now we are seeing the potential for further dilution of our titles. Conversation above is much too mild from my perspective. School neuropsychologist? OMG! WTF!

 

[Jxz]

There was a comment about, "Another common example is the over diagnosis of ADHD. Putting a child on a psychostimulant at an early age can have a number of significant consequences for them down the road."

Are psychiatrists putting kids on ADHD medication because school neuropsychologists or school psychologists are making them?

Are kids being tested by any type of psychologist before they're put on these meds?

Nope to both questions, the vast majority of these kids were put on meds by their general pediatricians, some of whom probably would not be able to name a neuropsychologist in their area.

 

[WisNeuro]

That is not a problem with a dearth of neuropsychologists for kids. That is a problem of over medication, which is a larger problem in healthcare in general. Also, ADHD is not diagnosed by neuropsych testing.

 

[Jxz]

Somebody has to stop these school neuropsychologists from prescribing ritalin.

http://www.smithsonianmag.com/smart...lin-180951554/?utm_source=facebook.com&no-ist

 

[WisNeuro]

I really don't know where the strawman ritalin argument comes from. Are you assuming that an increase in school neuropsychologists will lead to a reduction in ritalin prescriptions? And, even if you believe that by some flight of fancy, why use prescriptions to children not yet in school as an example for having more school neuropsychologists?

 

[Jxz]

The problem of overprescription is unrelated to the presence or absence of school neuropsychologists.

 

[siny228]

I just want to state for the record that I don't think the term psychologist should have ever been applied to a Master's level practitioner and now we are seeing the potential for further dilution of our titles. Conversation above is much too mild from my perspective. School neuropsychologist? OMG! WTF!

APA Model Act for State Licensure of Psychologists:

3. The prior version of this Model Act included an exemption for the use of the terms school psychologist or certified school psychologist for all individuals credentialed by the state agency regulating practice in public schools. This version acknowledges the authority of the relevant state education agency to credential individuals to provide school psychological services in settings under their purview and continues to restrict those individuals to practice within those settings. Additionally, the title so conferred, which must include the word “school”, is to be used solely while engaged in employment within those settings.

Nothing in this Act shall be construed to prevent (cite relevant state education authority or statutory provisions) from credentialing individuals to provide school psychological services in those settings that are under the purview of the state education agency. Such individuals shall be restricted in their practice and the use of the title so conferred, which must include the word "school", to employment within those settings.

SO YOU ARE CORRECT, SUB-DOCTORAL LEVEL SCHOOL PSYCHOLOGISTS CANNOT CALL THEMSELVES PSYCHOLOGISTS, BUT MAY CALL THEMSELVES SCHOOL PSYCHOLOGISTS IF CERTIFIED/LICENSED BY THE STATE. ALSO, THE NEW STANDARD FOR SCHOOL PSYCHOLOGISTS IS A SPECIALIST DEGREE, WHICH IS ABOVE THE MASTERS AND BELOW THE DOCTORATE. IT IS A PRACTITIONER ORIENTED DEGREE.

 

[siny228]

I recently learned about "school neuropsychologists" from a recent discussion on a listserv I frequent. I had never heard of the title, though it's creation and proliferation is concerning on multiple levels. Has anyone encountered someone who uses this title?

Read chapters 1-3 of Best Practices in School Neuropsychology.

 

[Therapist4Chnge]

"Best Practices" is to enroll in an APA-acred doctoral psych program, complete the training to be a clinical neuropsychologist (including a 2yr fellowship program), and not pretend to be a neuropsychologist.

 

[siny228]

"Best Practices" is to enroll in an APA-acred doctoral psych program, complete the training to be a clinical neuropsychologist (including a 2yr fellowship program), and not pretend to be a neuropsychologist.

Many of your questions are answered by those chapters. Your confusion and contention may stem from a lack of knowledge on the topic. There is no debate over what is the appropriate training for a neuropsychologist, it is what you have stated. However, the speciality of school neuropsychology is proliferating and the field of school psychology will continue to integrate these practices. Your argument is over the use of the title "neuropsychologist" and will have to be regulated at the professional association and state levels.

 

[OneNeuroDoctor]

It seems that a large number of school psychologists at the PhD level hold pediatric neuropsychologist position in Hospitals. Texas A&M and TWU PhD school psychology graduates are employed at many pediatric hospitals since their school psychology training has a heavy psychometric emphasis but limited therapy emphasis.

If you look at the ABSNP website many of their Diplomats hold the PsyD or PhD and they are licensed by both the psychology board and the school psychology board. They can only use the title school neuropsychologist if they hold a doctoral degree. If they hold the MS + 30 hours or EdS school psychology degree they must refrain from calling themselves school neuropsychologist and must use the title of Diplomat in School Neuropsychology. A number of psychology board complaints have been filed against non doctoral level school psychologist using the school neuropsychologist title. Apparently using these titles vary pending State regulations where individuals practice psychology and school psychology.

Licensure/certification as a school psychologist is EdS level training or MS plus an additional 32-36 credtit hours and a one-year full time internship. Some States have EdS degrees and others do not have EdS degrees so this is why many of the ABSNP Diplomats indicate they have MS degrees but to be licensed as a School Psychologist EdS or equivalent is required.

Here are the ABSNP Diplomat requirements:

To claim competency in school neuropsychology there are five educational paths that may be chosen:

1. Obtain a Ph.D. in School Psychology with an area of specialization in school/pediatric neuropsychology and have documented supervised experience working with children in the field.

2. Obtain a Ph.D. in Clinical Psychology with an area of specialization in pediatric neuropsychology and have documented supervised experience working with children in the field.

3. Obtain a Ph.D. in School Psychology or Clinical Psychology without the child/pediatric neuropsychology specialization but after graduation complete a competency-based school neuropsychology post-graduate certification program, like the one offered by KIDS, Inc (www.schoolneuropsych.com).

4. Obtain a specialist-level of training in school psychology and after graduation complete a competency-based school neuropsychology post-graduate certification program, like the one offered by KIDS, Inc. (www.schoolneuropsych.com).

Postgraduate training programs are at Alliant, Fielding, and Kids, Inc. unless the school psychologists completes a traditional two-year postdoctoral neuropsychology fellowships.

Because of the heavy psychometric based training in school psychology training programs these graduates have an advantage over most clinical/counseling psychologist in the field of neuropsychology.

Cecil Reynolds and the Texas A&M School Psychology PhD program is basically a pediatric neuropsychology program as is TWU PhD School Psychology program with Daniel Miller.

Many of the high profile test developers for Cognitive Assessment, Achievement, and neuropsychology came from school psychology training programs or Educational Psychology training programs, rather
than clinical psychology training programs. Many of them were from the Educational/school Psychology program at the University of Georgia when Alan Kaufman was on faculty.

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[WisNeuro]

Postgraduate training programs are at Alliant, Fielding, and Kids, Inc. unless the school psychologists completes a traditional two-year postdoctoral neuropsychology fellowships.

Whew, that is a relief! As long as they're getting their advanced training at schools known to be terrible at what they do, we're golden.

 

[OneNeuroDoctor]

Reynolds' training was in school psychology and he worked as a school psychologist before completing his Educational psychology doctoral degree at UG. He is probably the most famous and he was president of several neuropsychology boards and he probably is the father of pediatric neuropsychology.


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[WisNeuro]

I wasn't talking about TA&M in my post. I was talking about the diploma mills.

 

[edieb]

It seems that a large number of school psychologists at the PhD level hold pediatric neuropsychologist position in Hospitals. Texas A&M and TWU PhD school psychology graduates are employed at many pediatric hospitals since their school psychology training has a heavy psychometric emphasis but limited therapy emphasis.

If you look at the ABSNP website many of their Diplomats hold the PsyD or PhD and they are licensed by both the psychology board and the school psychology board. They can only use the title school neuropsychologist if they hold a doctoral degree. If they hold the MS + 30 hours or EdS school psychology degree they must refrain from calling themselves school neuropsychologist and must use the title of Diplomat in School Neuropsychology. A number of psychology board complaints have been filed against non doctoral level school psychologist using the school neuropsychologist title. Apparently using these titles vary pending State regulations where individuals practice psychology and school psychology.

Licensure/certification as a school psychologist is EdS level training or MS plus an additional 32-36 credtit hours and a one-year full time internship. Some States have EdS degrees and others do not have EdS degrees so this is why many of the ABSNP Diplomats indicate they have MS degrees but to be licensed as a School Psychologist EdS or equivalent is required.

Here are the ABSNP Diplomat requirements:

To claim competency in school neuropsychology there are five educational paths that may be chosen:

1. Obtain a Ph.D. in School Psychology with an area of specialization in school/pediatric neuropsychology and have documented supervised experience working with children in the field.

2. Obtain a Ph.D. in Clinical Psychology with an area of specialization in pediatric neuropsychology and have documented supervised experience working with children in the field.

3. Obtain a Ph.D. in School Psychology or Clinical Psychology without the child/pediatric neuropsychology specialization but after graduation complete a competency-based school neuropsychology post-graduate certification program, like the one offered by KIDS, Inc (www.schoolneuropsych.com).

4. Obtain a specialist-level of training in school psychology and after graduation complete a competency-based school neuropsychology post-graduate certification program, like the one offered by KIDS, Inc. (www.schoolneuropsych.com).

Postgraduate training programs are at Alliant, Fielding, and Kids, Inc. unless the school psychologists completes a traditional two-year postdoctoral neuropsychology fellowships.

Because of the heavy psychometric based training in school psychology training programs these graduates have an advantage over most clinical/counseling psychologist in the field of neuropsychology.

Cecil Reynolds and the Texas A&M School Psychology PhD program is basically a pediatric neuropsychology program as is TWU PhD School Psychology program with Daniel Miller.

Many of the high profile test developers for Cognitive Assessment, Achievement, and neuropsychology came from school psychology training programs or Educational Psychology training programs, rather
than clinical psychology training programs. Many of them were from the Educational/school Psychology program at the University of Georgia when Alan Kaufman was on faculty.

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Wow, the wording for a master's level school neuropsychologist ("diplomate in school neurospsychology") is so, so similar to a "neuropsychologist". They should have to use a title that more clearly indicates the difference in training. I know in Louisiana , master's level have to use the title "ATAP/Assistant to a Psychologist"

 

[Therapist4Chnge]

Wow, the wording for a master's level school neuropsychologist ("diplomate in school neurospsychology") is so, so similar to a "neuropsychologist". They should have to use a title that more clearly indicates the difference in training. I know in Louisiana , master's level have to use the title "ATAP/Assistant to a Psychologist"

That is the entire point….to conflate the titles and benefit from the lack of delineation. Once that conflation happens then the proliferation into other areas equally as inappropriate in which to practice is sure to follow.

 

[OneNeuroDoctor]

I believe there may be some unfortunate generalization here with M ED trained educational diagnosticians with EdS trained School Psychologists. School Psychologist may only use their school neuropsychology training in the capacity of working in a school setting. If they work outside the school setting, as in a private practice type setting, they would then need to work under supervision by a licensed psychologists or neuropsychologist unless they concurrently hold a license as a psychologist in their State.

Large school districts still have a consultant clinical neuropsychologist while employing school psychologists with a certificate in school neuropsychology. Additionally, there are many individuals with a doctoral degree in school psychology who are licensed psychologist in their State and they have private practice working in pediatric psychology.

It would seem odd to me if the descriptor of school neuropsychology was different than a descriptor of neuropsychology since school neuropsychology is basically neuropsychology in a school setting.


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[edieb]

This is why it is ++so important++ to become involved with your professional organization and advocate for these types of changes, people. Join your state psychological association, get on the boards and voice your concerns so you can have legislation passed in your state to prevent things like this school neuropsyhchologist travesty! Complaining is great but taking action is better

 

[Therapist4Chnge]

It would seem odd to me if the descriptor of school neuropsychology was different than a descriptor of neuropsychology since school neuropsychology is basically neuropsychology in a school setting.

..and therein is the rub. The practice of neuropsychology is a speciality area of doctorally & fellowship trained specialists. Whether it is practiced in a hospital, school, etc….it is neuropsychology. There is no such thing as "hospital neuropsychologist", "community mental health neuropsychologist", etc. This differentiation should not exist.

A neuropsychologist is ‘‘a professional psychologist trained in the science of brain-behavior relationships’’ (Hannay et al., 1998). Kane, Goldstein, and Parsons (1989) pointed out that ‘‘the unique com- petence of the neuropsychologist is that of conceptualizing assessment results within a brain-behavior framework.’’ The prefix ‘‘neuro’’ in neuropsychologist means that the psychologist is a specialist who has had explicit training in neuroscience and neurological bases of behavior. To fulfill this role, neuropsychologists must have specialized knowledge and training, a fact that is incorporated into the existing defi- nitions of a neuropsychologist (Barth et al., 2003; Bieliauskas, 1999). Both APA Division 40 (Clinical Neuropsychology) and the National Academy of Neuropsy- chology (NAN) definitions require 2 years of specialized training. The APA Division 40 definition requires formal university training in neuropsychology and the neuro-sciences, and recommends a peer review process as an indicator of competency. The NAN definition (National Academy of Neuropsychology, 2001) requires, for individuals receiving training after 2001, ‘‘the equivalent of two (fulltime) years of experience and specialized training, at least one of which is at the post-doctoral level, in the study and practice of clinical neuropsychology and related neurosciences. These two years include supervision by a clinical neuropsychologist.’’