Neuropsychological Evaluations for Adults, Teens, and Children

Clinical Neuropsychology is the field that studies the relationship between brain functioning and behavior.  It uses standardized testing protocols developed in psychology to explore changes to one's thinking that can result from various neurological conditions or from other circumstances (i.e. the influence of medications used to treat other conditions, use of mood altering chemicals, or psychiatric conditions).

At the Institute for Brain-Behavior Integration (IBBI) at Partners in Healing, neuropsychology can be applied in a wide range of situations, including:

•    Attention-deficit/hyperactivity disorder
•    Disorders related to aging (e.g. Alzheimer's disease)
•    Brain injuries
•    Developmental conditions (e.g. learning disabilities, Autistic Spectrum Disorders)
•    Neurodegenerative disorders (e.g. Parkinson's disease and Multiple Sclerosis
•    Strokes
•    AIDS Dementia Complex
•    Thyroid Disorders
•    Renal Disease
•    SAT/ACT/GRE accommodations

The decision to seek a Neuropsychological Evaluation can be a sensitive issue.  Sometimes, the patient is the one to raise a concern about mental functioning, while at other times it is family members, health professionals, or teachers who raise the initial concern.  The results of a Neuropsychological Evaluation often are necessary to provide solid evidence of what has changed, identify the reason the change has occurred, describe what can be done to potentially reverse or minimize the change, and begin to guide people in their decision-making efforts to better manage their future.

Call Dr. David Alter and Dr. Nancy Foster at the Institute for Brain-Behavior Integration at 763-546-5797 to schedule a Neuropsychological Evaluation.


Dr. Deborah Simmons to Speak at Resolve Conference

Dr. Deborah Simmons will be speaking at the annual conference of Resolve, the National Infertility Association on April 21st at Calvary Lutheran Church in Golden Valley, MN.  She will be speaking on gestational surrogacy, depression and infertility, and decision-making about ending treatment.  Join with the Resolve community for information on Western and holistic fertility treatment and adoption.  For more information, go to Exploring Paths of Hope: 28th Annual Infertility and Adoption Family Building Conference


Kids with ADD/ADHD & Related Conditions: Collaborative Evaluations are Key

Paying Attention to the Problem of Attention

Without a doubt, there has been an increase in the prevalence of concerns related to attention management in pediatric patients. Distinguishing ADD/ADHD from attention problems that are related to learning issues, anxiety, depression, or conflict with peers or family is not easy, and often requires more than one set of eyes and ears to make an accurate diagnosis. Obtaining a comprehensive neuropsychological evaluation is often a critical step to arrive at a clear diagnosis and generate an appropriate treatment plan.

A Synopsis of ADD/ADHD Facts

  • There has been a 20-fold increase in the prescription of stimulant medication in the past 30 years
  • Stimulant medication clearly produces short-term benefits in the ability to focus attention
  • A diagnosis of ADD/ADHD needs to be based upon multiple sources of information about other causes of attention management difficulties
  • There is strong evidence that use of stimulant medications alone is limited in its ability to effectively address co-morbid problems with anxiety, depression or the effects of intra-familial conflict or distress

A Clear Diagnosis Supports Positive Outcomes

Disruption of attention is one of the most common features of numerous cognitive and psychological conditions. While detection of inattention is important, it does not provide a complete picture to provide an accurate diagnosis of the underlying cause of the inattention.

At the Institute for Brain-Behavior Integration (IBBI), our comprehensive neuropsychological evaluation process generates a detailed picture of:

  • Attention management skills
  • Learning and information processing abilities
  • Behavioral and emotional self-regulation skills
  • Family history and current family functioning factors
  • Relevant medical concerns, including dietary factors

The information derived from the evaluation is designed to diagnose the specific factors that activate, maintain and/or exacerbate each child’s or teen’s attention difficulties. These can include primary learning or psychological challenges, as well as ADD/ADHD. We will provide the referring physician with thorough evaluation results within 1-2 weeks after the evaluation is conducted.

Collaborative Responses to Multiple Challenges

The problems that go along with attention difficulties include academic performance concerns, family and peer relationship strife, sleep disturbances, and mental health concerns related to anxiety and depression. The co-morbidity of attention problems and learning disabilities is also quite high. Therefore, the biggest challenge lies in how to respond to the concerns regarding attention and behavior when the concerns are brought up with the child’s or teen’s health care provider.

A Multi-disciplinary Health Care Team Can Help—

At Partners in Healing of Minneapolis and the Institute for Brain-Behavior Integration, our integrated health care team consists of professionals trained in:

  • Neuropsychology
  • Health Psychology
  • Clinical Psychology
  • Child and Family Therapy
  • Nutritional Medicine

Our experienced team of professionals actively collaborates with the pediatric team and the family to discuss the diagnosis, and then develop and implement the treatment plan that works best for each child or teen. Beginning with the diagnosis of causes of inattention through treatment of the child’s or teen’s needs, our collaboration with the pediatric medical team allows us to serve as true Partners in Healing. We look forward to working with you.


Got a Concussion? Neuropsychological Evaluations at IBBI Guide Optimal Game Planning

Brought to you by Dr. David Alter

First came the stories about cognitive problems (e.g., early onset dementia) experienced by Dr. David Alterretired professional football players. Then came increased concerns about active professional athletes who suffered on-field concussions and the guess-work as to when they could return to the playing field. Next came stories about athletes under age 18 who suffered concussions, and the legitimate questions as to whether their younger brains made them more vulnerable to the effects of repeated blows to the head sustained in the course of their chosen sports. Other questions about managing concussions in young athletes abound. For example:

  • Should kids be required to leave the game after their “bell is rung” or they “see stars?”
  • What is the timetable for a safe return to play?
  • On what basis is the decision to return to play made?

These and other questions have been raised about how to balance the benefits of participation in school sports with the need to manage the near-term and potential long-term consequences of concussion in athletes younger than 18 years of age.

Current statistics indicate that more than 140,000 youth suffer concussions each year, with approximately one third of them suffered in the course of playing organized sports. Most of the injuries occur as a result of participation in football and ice hockey, but according to a recent article in Scientific American (February 2012), soccer, wrestling and other sports, contribute their fair share to the total.

Identifying the Signs of Concussion

Concussion involves when a blunt force to the head produces altered concentration, memory, judgment, balance or coordination problems, however transient. Loss of consciousness is not a required symptom. The alteration of normal mental status, which often lasts only a short period of time, nevertheless indicates a minor traumatic brain injury has been sustained.

Evaluations Can Guide Safe Return to Play
There are a number of factors that limit accurate assessment of when it is safe to return to the field of play. Players themselves, their coaches, and on occasion even parents may encourage resumption of play prematurely. Legislation recently passed in Minnesota requires a physician’s note attesting that the athlete can safely return to play. This begs the question of how to establish when a return to athletics and academic activities is safe?

A neuropsychological evaluation assesses key functions that are sensitive markers of readiness to resume play:

  • Attention, concentration, and vigilance
  • Reaction time, divided attention, and mental flexibility
  • Learning and memory abilities (verbal and non-verbal)
  • Problem-solving, planning and reasoning skills

A neuropsychological evaluation of the athlete at the Institute for Brain-Behavior Integration (IBBI) carefully examines these cognitive abilities and determines whether current levels of functioning are consistent with estimates of how they have functioned in the past. IBBI uses this data to help guide subsequent treatment plans and assist in making decisions related to safe levels of activity that the athlete can be engaged in during the various phases of recovery.

Managing the After-Effects of Concussion


It is said that, “time heals all wounds.” How much time is really needed to heal the wound of concussion? In the case of pediatric concussion, several issues combine to determine the length and extent of an individual’s recovery. 1) What was the baseline functioning prior to the concussion? 2) Was this the first concussion and what was the interval of time between the current and prior concussion if there was more than one? 3) Have changes in the functions or behaviors seen in Post-Concussion Syndrome been observed? Answering these and other questions as part of the IBBI evaluation helps determine the optimal plan for each affected athlete (or for a child or adolescent who has sustained a concussion for any reason).

Clinical Collaboration is the Key to Treatment Success

Managing the after-effects of concussion is challenging because in addition to cognitive concerns, problems with sleep, emotional disturbance, somatic complaints and also changes in family and peer relationships prove to be very challenging. At IBBI we actively work with the referring team of health professionals to formulate the optimal plan of care for each patient. Our professional staff is available to address the psychological, interpersonal and behavioral issues that can arise with the patient and his/her family.

Prompt & Actionable Evaluation Findings

At IBBI, we work to schedule and evaluate patients as soon as possible after their injury. Following the evaluation process, we provide prompt results to the referring physician, which contain comprehensive and actionable recommendations that guide the student, his/her family and treating physicians in how best to manage the neuropsychological and psychological aspects of the post-concussion recovery process. Also, we remain available to consult with the physicians throughout the evaluation and treatment process.


Diet Soft Drinks Are Bad For You (We're Just Sayin'...)


Are Diet Soft Drinks Bad for You?

ScienceDaily (Jan. 31, 2012) — A new study finds a potential link between daily consumption of diet soft drinks and the risk of vascular events.

Individuals who drink diet soft drinks on a daily basis may be at increased risk of suffering vascular events such as stroke, heart attack, and vascular death. This is according to a new study by Hannah Gardener and her colleagues from the University of Miami Miller School of Medicine and at Columbia University Medical Center. However, in contrast, they found that regular soft drink consumption and a more moderate intake of diet soft drinks do not appear to be linked to a higher risk of vascular events. The research appears online in the Journal of General Internal Medicine published by Springer.

In the current climate of escalating obesity rates, artificially sweetened soft drinks are marketed as healthier alternatives to sugar-sweetened beverages, due to their lack of calories. However, the long-term health consequences of drinking diet soft drinks remain unclear.

Gardener and team examined the relationship between both diet and regular soft drink consumption and risk of stroke, myocardial infarction (or heart attack), and vascular death. Data were analyzed from 2,564 participants in the NIH-funded Northern Manhattan Study, which was designed to determine stroke incidence, risk factors and prognosis in a multi-ethnic urban population. The researchers looked at how often individuals drank soft drinks -- diet and regular -- and the number of vascular events that occurred over a ten-year period.

They found that those who drank diet soft drinks daily were 43 percent more likely to have suffered a vascular event than those who drank none, after taking into account pre-existing vascular conditions such as metabolic syndrome, diabetes and high blood pressure. Light diet soft drink users, i.e. those who drank between one a month and six a week, and those who chose regular soft drinks were not more likely to suffer vascular events.

Gardener concludes: "Our results suggest a potential association between daily diet soft drink consumption and vascular outcomes. However, the mechanisms by which soft drinks may affect vascular events are unclear. There is a need for further research before any conclusions can be drawn regarding the potential health consequences of diet soft drink consumption."