Case studies

NEPSY - Second Edition (NEPSY-II) - Case studies


Completed by Sue Harrison, Educational Psychologist

I recently used the NEPSY-II as part of the psychological assessment of Ben, a 6.6 year old boy who had experienced nocturnal seizures since the age of 4. An area of developmental abnormality in his left frontal lobe was identified on an MRI scan. His parents and school were puzzled by his learning profile. They felt that he was an able, sociable boy, nevertheless he was struggling to keep up with his classmates and was falling further behind with literacy and numeracy. This picture was reflected in initial psychological assessment, which showed average to above-average verbal and non-verbal intellectual ability, but poor academic attainments.

Ben enjoyed the fun game-like presentation of the NEPSY-II assessment tasks; their short, practical activities and colourful pictures suited his developmental stage. Examination of a range of cognitive domains revealed that Ben had normal memory and motor abilities for his age, but he demonstrated weak performance on attention measures and mild difficulties with language tasks.

In Ben's case the NEPSY-II illuminated the problems with attention and language function that provided barriers to him achieving his full potential. This helped solve the puzzle of why he was doing so poorly at school. Feedback was given to Ben's family, school and school educational psychologist on Ben's profile of strengths and weaknesses.

A school visit was made and interventions to support his language problems and attention difficulties weredrawn up and incorporated into an Individual Education Plan by the Special Educational Needs Co-ordinator. A referral was made to the school speech and language therapist and the education authority's language impairment team. Teaching strategies and classroom seating were adapted so that Ben's attention difficulties were supported. The information gained from the assessment helped his teachers and parents to see that, whilst he was an able boy, he needed specific interventions and strategies to support his problems with attention and language to be put in place.

back to top

Completed by Dr Kathryn Bond, Principal Clinical Psychologist, Great Ormond Street Hospital

I recently used the NEPSY-II to assess a 6 year old girl presenting with an inborn error of metabolism following concerns about her lack of progress at school and behavioural needs, such requiring constant adult attention and support. Following a normal birth and neonatal progress, a urea cycle disorder had been diagnosed at 2.6 years subsequent to a long period of recurrent illness, failure to thrive and evidence of developmental plateau; following diagnosis, her condition had been well managed with medication and a restricted diet, and she had gone on to attain developmental milestones within the appropriate age ranges.

Assessment with the WISC-IV had indicated that her intellectual abilities fell in the average to low average range, with working memory subtests reflecting an area of personal weakness. I then used the NEPSY-II to provide information about attention and response inhibition skills, memory for faces and verbal material, in addition to assessing motor, visuo-perceptual and finger sensorimotor skills. This enabled me to test out hypotheses about the causes of her learning problems with short, fun, interesting tasks.

The results indicated a profile of significant attention difficulties, consistent with my observations that she struggled throughout the assessment to maintain her attention, to monitor and regulate her responses and toprevent herself from becoming distracted. The assessment proved to be useful in identifying specific management recommendations for home and school, such as how to structure learning tasks, adjusting her learning environment at school, and developing I.E.P targets to promote her organisational skills. It was also advised that she should be reassessed in 12 months to monitor her progress.

The NEPSY-II is an easily accessible, attractive test; I was able to gather specific information about aspects of neuropsychological function in a brief amount of time and the results proved to be useful in formulating a profile of cognitive strengths and difficulties and in developing specific recommendations for home and school.


back to top

What do you think?