My reports give a highly detailed analysis of an individual’s cognitive abilities in relation to;
• A known or suspected cognitive or neurological deficit.
• An estimated level of pre-morbid cognitive functioning.
• Their capacity to undertake a range of legally binding tasks in accordance with specified legal criteria.
These reports are tailored tightly to the specific needs of each individual and their referrers.
My typical referring clients are clinicians and legal practitioners, both of whom find benefit in the combined quantitative and qualitative elements of Neuropsychological evaluation.
I look forward to working with you.
What information does Dr Lonie require in a referral?
The three essential components of a clinical neuropsychology referral include;
- The patient/individual’s name, date of birth and contact details.
- A clearly stated referral question(s).
- Background medical information of potential relevance to the patient’s presenting cognitive complaints.
What sort of detail do Dr Lonie’s reports contain?
Neuropsychological reports typically comprise a statement of referral, a summary of the relevant background information, a detailed analysis of an individuals pre-morbid and current cognitive and emotional functioning, observations pertaining to qualitative aspects of the patient’s presentation during the consultation period and most importantly, statements/opinions and explanation pertaining to how the assessment findings address/elucidate the referral question.
Do you recommend patients be referred for Neuroimaging at the same time as Neuropsychology?
It is not necessary for a patient to have undergone neuroimaging prior to being referred for a Neuropsychological Assessment, although in some cases neuroimaging forms a useful adjunctive means of investigating a cognitive complaint. Where neuroimaging is required, it can be arranged in conjunction with a neuropsychological evaluation by the referring consultant. Neuroimaging is available on site at Macquarie University Hospital or can be undertaken at a range of alternative imaging centres.
Typically, how much notice do you need to see a patient and how long does it take to prepare the report?
Appointments with Dr Lonie are usually available within 7-10 days of receipt of referral. Standard Clinical Neuropsychology reports are made available no later than 7 days post consultation. Reporting times for medico-legal cases vary in accordance with case complexity.
What benefit does Neuropsychological Assessment offer beyond the diagnostic tests carried out by other healthcare professionals (such as Clinical Psychologists, Neurologists, Geriatricians, Psychiatrists and General Practitioners.)
When an individual attends a GP, Neurologist, Geriatrician, Physician, Practice Nurse or Psychiatrist complaining of poor memory, they will frequently be asked a number of relatively easy questions such as the day of the week, the date, the name of the prime minister and perhaps also be asked to remember the names of several objects or to copy a drawing. These questions are referred to as ‘Cognitive Screening’. When patients with memory concerns cannot answer one or more such questions, the GP or other practitioner is alerted to the possibility that there may be a medical cause for their cognitive concerns, justifying referral on to a clinical neuropsychologist.
Unfortunately, many such cognitive screening questions are known to be insensitive to memory and other cognitive changes of a mild nature, particularly for ‘high achieving’ individuals (Starr & Lonie 2007; Lonie et al 2008; Lonie et al 2009; Lonie et al 2010). In such cases, specialist detailed neuropsychological evaluation is required to detect cognitive loss.
Furthermore, cognitive screening instruments tell us little, if anything, about an individual’s capacity to function on a day-to-day basis or to carry out a range of more specific, legally binding tasks, such as make or change a will, drive, stand trial, appoint a power or attorney, etc.
Comprehensive neuropsychological consultation and evaluation is required, in such cases, to elucidate the relationships between an individual’s cognitive disability and his/her capacity to perform a specific function in accordance with established legal criteria.
Starr, J.M & Lonie, J.A. The influence of pre-morbid IQ on Mini-mental State Examination score at time of dementia presentation. International Journal of Geriatric Psychiatry. 2007; 22:382-384.
Lonie, J.A., Herrmann, L.L., Donaghey, C.L. & Ebmeier, K. Clinical referral patterns and cognitive profile in mild cognitive impairment. British Journal of Psychiatry. 2008; 192:59-64.
Lonie, J.A., Tierney, K.M., Ebmeier, K.P. Screening for mild cognitive impairment: a systematic review. International Journal of Geriatric Psychiatry. 2009; 24(9):902-915.
Lonie, J.A. Mario A. Parra-Rodriguez, Kevin M. Tierney, Lucie L Herrmann, Claire Donaghey, Ronan E. O’Carroll, and Klaus P Ebmeier. Predicting outcome in mild cognitive impairment: 4-year follow-up study. The British Journal of Psychiatry. 2010; 197:135-140.