Traumatic Brain Injuries and Neuropsychological Testing

Neuropsychological testing was performed on Jason at Toronto Rehab. From what we understand this is an assessment only done for those in the program that are planning on returning to work or school. As we mentioned in our posts on Brain FX, some of the results overlapped but it seemed to our uneducated perspective that they did cover different skills and situations at times.

Treatment type: Neuropsychological testing

How to find: Referrals from your doctor or specialist, and select Neuropsychology as the category you are searching

Price: in a hospital setting covered by OHIP, private often above $200.00 an hour as far as I can find

Credentials: Look for someone that is registered with the College of Psychologists of Ontario, with Clinical Neuropsychology as an area of practice

What is it? Neuropsychological assessment is a performance-based method to assess cognitive functioning. This method is used to examine the cognitive consequences of brain damage, brain disease, and severe mental illness.

Notes from our assessment:

This testing was done in two 1.5-2 hour sessions but can be implemented in a variety of time frames, I’ve heard of some people paying for 8 hours of testing to have data for lawsuits etc. Jason said most of the testing was intriguing and task/game based. He had to find patterns, remember words and lists, navigate games without knowing rules based only on the response from the neuropsychometrist who gives the testing.

After each appointment he was EXHAUSTED. To be fair, just hearing about the tasks he had to do made my brain tired so it certainly is not easy testing. The neuropsychologist met with me to go through symptoms and provided Jason and I questionnaires on his symptoms and self awareness and all of this information was combined with the testing data to give us a thorough report on Jason’s strengths and limitations post injury.

The testing is done in a quiet room, one on one, with no distractions. The neuropsychologist and neuropsychometrist made it very clear to us that these results are only indicative of how Jason is able to navigate these tasks to in this specific environment. If you pursue testing I think that is a really important piece to keep in mind, real life (especially most workplaces) is rarely uninterrupted or calm and those confounding factors can change how one is able to think in those environments. Nonetheless it is a thorough report and helpful to keep in his file and in our minds as Jason prepares to navigate the return to work.

Brain FX: The wife’s perspective

Jason spoke the other day about his assessment from BrainFX and we hope to feature some information from the creators in the near future (she’s pretty busy since she also works as an OT!).

Obviously I did not have the chance to work with the software or the assessment. I did have a chance to chat with  Tracy Milner, one of the creators (also Jason’s private OT) and sat in on one of their webinars for health professionals. Approximately a third of my massage therapy clientele are suffering from traumatic brain injuries and post concussion syndrome so having a deeper understanding of resources out there is always a good thing. This was another case, similar to our eperiences with behavioural optometry, where we are so very lucky to have the connections we have and that Tracy Milner is a friend of our doctor.

So here is my review:

Treatment type: Actually an assessment, BrainFX

How to find:

Price: $300-500.00 (estimated)

Credentials: Use the Find An Administrator tab on their website

What is it? From their website “BrainFx 360 was created to measure cognitive (thinking skills), mood, social, behavioural, fine motor and balance effects through self-report, collateral report, and standardized performance testing, through real-life skills and game-like activities for people who are age 10 and up. “

Notes from our assessment:

This was really our first chance to have Jason assessed by someone that knew what they were doing (see our posts on doctors for more on that story). Tracy sat with Jason while he completed about 3 hours of testing on the tablet, I heard bits of her instructions as I worked and was impressed by how succinctly she explained the tasks and encouraged Jason throughout.

Post assessment Jason was exhausted to the point of experiencing a panic attack while trying to cook dinner. There were a lot of tears about how tiring the assessment was and how really truly unfortunate it was that this was our life 6 months into marriage. We didn’t know enough about what we were dealing with to make some good decisions about energy conservation that night. To anyone getting this assessment I would recommend not working before the assessment and planning to rest for the rest of the day or at least not having anything that HAS to be done.

BrainFX 360 includes the option for 3 people to answer questions and submit their views on the subject’s symptoms and behaviours post TBI. I was able to complete the survey for Jason (along with 2 others that saw him frequently during the first 6 months) and was excited to finally be able to give my opinions and have my chance to talk about what we were living with. All the input from those surveys is included in the final report.

A week later we were able to sit down again with Tracy and review the results of the assessment. She brought a beautiful document that compared Jason’s results to averages and clearly highlighted areas of difficulty and areas of success. This was the first time we had concrete data showing the difficulties Jason was living with and having them laid out for us allowed us to start planning how to make life work.

A month later Jason was invited to Toronto Rehab for an assessment. We were very happy to have the BrainFX 360 to show and the physiatrist we met with was amazed by how easy the report was to read. He spoke of other patients he met that spent thousands on assessments only to be given reports that were unclear and unreadable by other professionals. Brain FX 360 uses language and terms that are standard in TBI medical care and is easily understood by everyone we’ve worked with. In each case (including Tracy) health professionals have been able to read the reports and estimate where the bleeds were based on Jason’s symptoms.

The first two weeks of Toronto Rehab were assessments  – in total I think Jason spent about 13 hours doing assessments with various professionals. Often at the end of the day he would explain the assessments starting with “It’s like what I did on Tracy’s but like this….”. At the end of the two weeks we had the opportunity to review the results and build a treatment plan with the team and pretty much without fail the results of these long tests mimicked the results of BrainFX 360.

I am not trying to be so arrogant as to claim to have understood all the tests or to know if EVERY test could be supplemented by BrainFX 360. I am sure there are reasons people use the tests they do and I am grateful that we have SO much documentation about Jason’s abilities and challenges. But for those of you that don’t have the ability to attend a rehab program or have felt lost without some solid assessments – BrainFX may be the company you need to contact. I’m attaching a brochure from their website and I strongly encourage exploring their website and contacting their administrators to find out if they can help you.


BrainFX 360 – My Experience

The BrainFX 360 assessment wore me out.  Don’t get me wrong, I really enjoyed completing the assessment and found it really interesting to complete but it was an exhaustive test.  The test may not be this exhaustive for most but at the time I was working full time (which I shouldn’t have been) and trying to recover from a TBI.  The whole concept of this program is well ahead of traditional testing completed by Occupational Therapists.  In a couple of hours I was given results that validated the symptoms I was feeling and provided specific areas of recovery for Tracy (my OT) to focus on.  This was HUGE!  At this point I was struggling at work and constantly exhausted; the results from the BrainFX 360 assessment provided a glimpse at the symptoms that were causing these issues.

The entire assessment is completed on a tablet and you are occasionally provided with a keyboard and/or some headphones.  There are puzzles questions, and some small game-like section, each meant to test a specific area of you cognitive function or abilities.  Part of the fun for me was attempting to guess what was being assessed as I completed each of the tasks.  After the assessment is complete Tracy went over some of the results with me immediately but a comprehensive report followed on my next appointment which hit the nail on the head when compared to how I was feeling.

Looking back on the testing after seeing another OT through a rehabilitation program I can definitely see the advantages to BrainFX360.  Although I was exhausted the day I completed this testing, the standard paper/pen testing takes more time and energy and the results are less comprehensive.  This testing saved Tracy and I several hours over several days of testing which can be a toll on both energy levels and my wallet.

I am lucky to have had this testing and if you are lost figuring out your symptoms I’d recommend checking out BrainFX 360.