School Neuropsychologists....wait, what?

[WisNeuro]

T4C, it's just the brain, how hard could it be? I mean, as long as you know it has 2 hemispheres and it's bad if you get hit there really hard, you're good.

---

Members don't see this ad.

 

[AcronymAllergy]

That's my take as well; simply because it's practiced solely in a school setting doesn't then somehow make it less complex than if it were in another environment (e.g., hospital, private practice, community mental health clinic). If the individual isn't able to practice neuropsychology outside of a school, how are they then able to practice it in a school, particularly as some of those same students will be the ones presenting to a pediatric neuropsychologist?

As for the school vs. clinical/counseling psychologist as a neuropsychologist bit, if the school psychologist (doctoral-level) obtained adequate supervised clinical training and completed a formal two-year fellowship in neuropsychology, then I view them as a neuropsychologist. But simply having more or less training in psychometrics doesn't make them inherently any more of a neuropsychologist than the average non-fellowship trained clinical/counseling psychologist. If there's one thing I've learned on fellowship, it's that the testing itself (including the tests' psychometric principles) is only one (potentially small) part of what I actually do day to day.

 

[OneNeuroDoctor]

That's my take as well; simply because it's practiced solely in a school setting doesn't then somehow make it less complex than if it were in another environment (e.g., hospital, private practice, community mental health clinic). If the individual isn't able to practice neuropsychology outside of a school, how are they then able to practice it in a school, particularly as some of those same students will be the ones presenting to a pediatric neuropsychologist?

As for the school vs. clinical/counseling psychologist as a neuropsychologist bit, if the school psychologist (doctoral-level) obtained adequate supervised clinical training and completed a formal two-year fellowship in neuropsychology, then I view them as a neuropsychologist. But simply having more or less training in psychometrics doesn't make them inherently any more of a neuropsychologist than the average non-fellowship trained clinical/counseling psychologist. If there's one thing I've learned on fellowship, it's that the testing itself (including the tests' psychometric principles) is only one (potentially small) part of what I actually do day to day.

Well stated..."neuropsychology is not just psychometrics." This is precisely the reason for post-graduate training for School Psychologists and post-doctoral training for Clinical\Counseling Psychologist in neuropsychology. Rules\regulations are different when working in schools with different standards than working in other settings such as private practice, academia, and hospitals.

Due to these differences in regulations, it is more practical to have School Psychologist receive neuropsychology training post EdS degree with one-year of didactics\practicum and one-year of supervision rather than having Clinical\Counseling Psychologist with a two-year clinical neuropsychology training return to complete the School Psychology and Special Education courses and then do a one-year full-time internship in a school setting, and then take the NCSP exam to acquire licensing as a School Psychologist.

It seems that if you follow a mindset that School Psychologist need to complete a two-year postdoctoral clinical neuropsychology fellowship to practice neuropsychology in a school setting; what prevents Neurologist from having similar viewpoints and insist that Clinical Neuropsychologist need to have MD/DO training and do three-year residencies in neurology to be considered competent Neuropsychologists.

I do not see this as an option or desire for most Clinical Neuropsychologist regarding working as a School Psychologist at a salary of $55,000 per year when they may earn $100,000 or more in other settings. Also, I cannot comprehend that MD/DO would expect Clinical Neuropsychologist to be trained in MD/DO programs with three-year residencies.




Posted using SDN Mobile

 

[AcronymAllergy]

This isn't directed at anyone specifically, but it just sounds like a perfect storm scenario for fostering a "you don't know what you don't know" kind of situation.

 

[OneNeuroDoctor]

"Due to these differences in regulations, it is more practical to have School Psychologist receive neuropsychology training post EdS degree with one-year of didactics\practicum and one-year of supervision rather than having Clinical\Counseling Psychologist with a two-year clinical neuropsychology training return to complete the School Psychology and Special Education courses and then do a one-year full-time internship in a school setting, and then take the NCSP exam to acquire licensing as a School Psychologist."

Ha!!!! Neuropsych is more complicated than the latter nonsense. It is more practical to refer out. . .

School districts do refer to clinical neuropsychologist when the clinical neuropsychologist accepts Medicaid or the child's health insurance. In some cases there is not a clinical pediatric neuropsychologist in the City or even in the State so the parent has to go out of State. In some situations, the Clinical Neuropsychologist may charge $700 to $1000 or more for a neuropsych evaluation. Many of the Children's Hospitals are fully scheduled for neuropsychology evaluations and the evaluation may be a year or more waiting for the child, parents, and school district.






Posted using SDN Mobile

 

[Therapist4Chnge]

School districts do refer to clinical neuropsychologist when the clinical neuropsychologist accepts Medicaid or the child's health insurance. In some cases there is not a clinical pediatric neuropsychologist in the City or even in the State so the parent has to go out of State. In some situations, the Clinical Neuropsychologist may charge $700 to $1000 or more for a neuropsych evaluation. Many of the Children's Hospitals are fully scheduled for neuropsychology evaluations and the evaluation may be a year or more waiting for the child, parents, and school district.

What you have described is an access problem due to limited/no resources….not a lack of providers. With the exception of some of the more rural parts of the country (where there are shortages of many speciality providers), there are child neuropsychologists around, they just are not willing to accept peanuts/nothing for their work. Medicaid often does not approve *any* testing, so it is not reasonable to expect a provider to work for free. Private insurance companies will also balk at the testing and claim it is "educational" and that they don't have to cover it. The problem is a broken system, not a lack of qualified providers.

 

[smalltownpsych]

Well, we could always "fix the system" by lowering the standards and compensation so that we end up with poorly or inadequately trained providers getting paid less and less. Isn't that the direction we are going already?

 

[PikminOC]

One problem is this creates masters level "neuropsychologists" and another is the board requirements for specialty (the school neuro board is not very stringent compared to our neuro boards) and yet another is confusion for patients, and another, the court system. All around it's just bad professional juju and further obfuscates the process for consumers including other professionals.

This is the way everything is heading. In every field. Everywhere.

 

[dale.gribble]

That's my take as well; simply because it's practiced solely in a school setting doesn't then somehow make it less complex than if it were in another environment (e.g., hospital, private practice, community mental health clinic). If the individual isn't able to practice neuropsychology outside of a school, how are they then able to practice it in a school, particularly as some of those same students will be the ones presenting to a pediatric neuropsychologist?

As for the school vs. clinical/counseling psychologist as a neuropsychologist bit, if the school psychologist (doctoral-level) obtained adequate supervised clinical training and completed a formal two-year fellowship in neuropsychology, then I view them as a neuropsychologist. But simply having more or less training in psychometrics doesn't make them inherently any more of a neuropsychologist than the average non-fellowship trained clinical/counseling psychologist. If there's one thing I've learned on fellowship, it's that the testing itself (including the tests' psychometric principles) is only one (potentially small) part of what I actually do day to day.

Agreed.

Notwithstanding all other mentioned concerns, I also wonder about the efficacy of the ideal of this specification. There isn't even enough money to pay teachers (at all, and/or an appropriate amount) in most schools, let alone an in-house doctoral-level neuropsychologist. Of course, that's assuming the training and subsequent requisite pay is equal, the former of which doesn't appear to be.

 

[psych84]

There are M.ed programs in Canada (reputable) that teach cognition and neuropsychological assesment in the School Psychology and Applied Child Psychology Programs. They also have a practicum on it, and an opportunity to do an internship in that area, or other areas. (academic assesment or social/emotional/behavior) But I'm not sure what this enables the school psychologist to do. I guess you guys in this area would know better what their capability may be with such training. I have no idea of the assesment process or process in general for people who are neuropsych patients, so I'm not sure.

 

[Therapist4Chnge]

It's fine if someone wants to take a course and/or learn more about the field of neuropsychology, but it does not make them proficient to start administering assessments and serving in the role of a neuropsychologist. A few years back I completed an in-depth neuroanatomy seminar that included the removal of an intact spinal cord. It was a great learning experience, but it didn't make me remotely qualified to repeat the procedure in my own practice and represent myself as a qualified person for this procedure.

 

[WisNeuro]

It's fine if someone wants to take a course and/or learn more about the field of neuropsychology, but it does not make them proficient to start administering assessments and serving in the role of a neuropsychologist. A few years back I completed an in-depth neuroanatomy seminar that included the removal of an intact spinal cord. It was a great learning experience, but it didn't make me remotely qualified to repeat the procedure in my own practice and represent myself as a qualified person for this procedure.

Wait, you don't routinely perform laminectomies? It's a very lucrative side business, you should give it a go

 

[Therapist4Chnge]

Wait, you don't routinely perform laminectomies? It's a very lucrative side business, you should give it a go

I heard there is a wait for it in many communities, so I might as well use that training and start doing them for myself because many of the qualified providers do not accept sub-par fees to do the work. It's better than not getting the work done, right?