When to Ask for a Neuropsychological Assessment, or a Cognitive Functional Capacity Evaluation
The following chart outlines the differences between neuropsychological assessments and cognitive functional capacity evaluations. First, let’s start with definitions:
Neuropsychological Assessment
A Neuropsychological Assessment is a performance-based method of assessing cognitive functioning. It is used to examine the cognitive consequences of brain injury and mental health diagnoses.
The assessment includes standardized psychological tests, including:
- Validity scales
- Preinjury cognitive function
- Memory
- Executive functioning
- Attention
- Processing speed
- Reasoning
- Judgement
- Problem solving
- Spatial perceptual function
- Language
- Motor speech and coordination
- Normative comparison linking findings to mechanism of injury.
Recommendations are provided regarding cognitive abilities, restrictions/limitations, diagnoses, prognoses and treatment recommendations.
Cognitive Functional Capacity Evaluation
A Cognitive Functional Capacity Evaluation (CFCE) includes functional testing from a physical and cognitive perspective. The outcome is a report that demonstrates capabilities with regards to a particular job. It requires information about the essential job demands, either through formal CDA/PDA, verbal job analysis or information from a database such as ONet.
A CFCE examines the fit between the client’s cognitive functioning and the demands of the job in question. The assessment is focused on work-related executive function. The evaluator considers the physical, functional/cognitive, perceptual/sensory, communicative, psycho-emotional and behavioral issues that may be present in the client post-concussion, CVA, mental health issue, etc.
Recommendations are provided regarding feasibility for employment, overall work capacity and return-to-work goals.
Comparison Table:
| Referral Questions Answered | Neuropsychological Assessment | Cognitive Functional Capacity Evaluation |
|---|---|---|
| Cognitive Abilities, Limitations/Restrictions & Suggested Accommodations | x | x |
| RTW Recommendations | x | x |
| -Physical Work Capacity | x | |
| -Cognitive Work Capacity | x | x |
| -Capacity for Work Overall | x | x |
| -Graduated RTW planning | x | |
| Job Match Comparison (with PDA/CDA) | x | |
| Diagnosis | x | |
| Prognosis | x | |
| Treatment Recommendations | x | |
| Motivation/effort/consistency | x | x |
| -Validity Testing | x | |
| Driving Safety | x | x |
| -Cognitive | x | x |
| -Psychological | x | |
| -Physical | x |
