When Should You Seek a Neuropsychological Evaluation?

It’s hard to know when to schedule an evaluation. Many of my client hope that time will resolve a concern, particularly given the expense of an evaluation. Unfortunately, those delays can also hold back needed support.

The guide below highlights signs that suggest it’s time to book a neuropsychological assessment rather than hoping challenges fade on their own.

Key Signs in Early Childhood (18 Months–5 Years)

• Missing early milestones

  Late walking, limited speech, or narrow play interests may point to neurodevelopmental differences such as autism or motor planning delays.

• Extreme sensory reactions

  Covering ears at typical noises or refusing certain textures can signal sensory processing concerns tied to ASD or anxiety.

• Persistent tantrums after age four

  Excessive difficulty calming once upset may indicate regulation challenges worth examining.

Early testing builds a foundation for targeted therapies and supports entry into early­-intervention programs.

Red Flags in the School Years (6 – 12 Years)

• Reading, writing, or math gaps despite effort

  Struggles that persist after quality instruction may reflect dyslexia, dysgraphia, or dyscalculia.

• Inconsistent focus or “daydreaming”

  Teachers noting forgotten homework, lost materials, or easy distraction could be observing ADHD or executive function weaknesses.

• Social misunderstandings

  Missing cues, literal interpretation of language, rigid patterns of behavior, or playground isolation often prompt screening for autism.

An evaluation clarifies whether intervention plans, 504 accommodations, or an Individualized Education Program (IEP) are warranted.

Concerns During Adolescence (13 – 18 Years)

• Academic drop despite average or high ability

  Sudden grade decline can stem from untreated ADHD, depression, or emerging learning differences.

• Chronic procrastination or disorganization

  Executive functioning skills lagging behind same aged peers often surface when workloads increase in middle and high school.

• Emotional swings tied to stress

  Anxiety can mask attention issues or social difficulties and comprehensive testing teases apart root causes and appropriate supports.

Identifying needs before college or vocational training allows teens to build self-advocacy skills early.

Indicators in Adulthood (18 + Years)

• Workplace performance gaps

  Repeated missed deadlines, forgetfulness, or difficulty multitasking may suggest unrecognized ADHD or executive function deficits.

• History of “always trying harder”

  Adults who compensate well in childhood might reach a tipping point when job demands outpace coping strategies.

• Long-standing questions about social experiences

  Discovering an autism diagnosis late in life can reframe past challenges and inform future supports.

Evaluations also guide accommodations under the Americans with Disabilities Act and inform therapy or coaching goals.

Life Events That Can Trigger the Need for Testing

• Traumatic brain injury or concussion

  Post-injury assessments document cognitive changes and guide rehab.

• Major educational transitions

  Moving from elementary to middle school, high school to college, or returning to school after military service can expose hidden difficulties.

• Residential treatment placement

  Many facilities require updated neuropsychological data to tailor therapeutic plans; and licensure in California and Utah permits me to conduct evaluations in many residential settings.

Questions to Ask Before Scheduling

• Are academic or behavioral supports maxed out?

• Have symptoms persisted for six months or longer?

• Do concerns span multiple settings—home, school, work?

  If the answer is “yes” to one or more, a neuropsychological evaluation can replace uncertainty with an actionable roadmap.

If the answer is “yes” to one or more, a neuropsychological evaluation can replace uncertainty with an actionable roadmap.

Moving Forward

Waiting can feel easier in the short term, but clarity saves time, resources, and stress down the line. A brief introductory call determines whether testing is appropriate now or whether monitoring makes sense. My investment is in helping you to determine the best next step, not just scheduling an evaluation. Reach out to discuss next steps and learn how thorough, plain-language assessment can reshape the path ahead.

Dr. Sara Rice Schiff provides comprehensive neuropsychological evaluations for children, adolescents, and adults across Northern California, specializing in autism, ADHD, executive functioning, and learning differences.