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What's Nuerological and What Isn't?

My daugther, aged 6.5, has been seeing an OT for about three years for SID related issues.  She has benefited greatly from therapy in my view.

Her current OT has recommended that we have her undergo an "Neuro-Psych" evaluation at a local hospital because the OT thinks there could be other issues for J that need specific identification.  For example, J is still about half as strong as the average girl her age which might indicate nerological issues beyond SID.  She also still has trouble attending to some tasks although she can concerntrate on and attend to others very well (she reads at 4th+ grade level).  Trouble breathing at birth is part of her history (penuothorax) The tests sound like a good idea to me.

My insurance company is not so sure. They seem to think that psych part of neuro-psych makes this a mental health issue and so not coverable etc.  My view is that the point of the exam is to distinguish between possible psychological and nuerological issues.

Clearly, there is a great deal of overlap between what is psychological and what is neurological.  My question is how does the medical professsion make distinctions between these two areas, if it makes any distinctions at all? Is the average battery of nuero-psych evaluations more "medical" than "mental-health"?  To  be an effective advocate with the insurance people I have to have some idea how a professional would view this circumstance.  J's PCP Pediatrican is more or less clueless.
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242606 tn?1243782648
MEDICAL PROFESSIONAL
Neuropsychological assessment attempts to diagnose and define the neurocognitive effects of medical disorders that have a direct or indirect impact on the brain. This type of assessment is appropriate in several circumstances: to detect neurologic conditions via quantitative assessment of neurocognitive abilities, to address differential diagnosis between psychogenic and neurogenic symptoms, to delineate the neurocognitive effects of central nervous system disorders, to monitor the recovery or progression of central nervous system disorders.

In general, what we are attempting to achieve via neuropsychological testing is an understanding of the relative contribution neurological factors have in the symptom picture that is being observed. In your daughter's case, my sense is that her therapists want to determine if there are particular neurological deficts that might be contributing to her problems. Sometimes, children with sensory integration difficultires can have a perfectly normal neurological examination and negative findings on neuropsychological testing. Likewise, such children may display identifiable neurological conditions (either as part of, or alongside, the sensory integration problems), and it is important to determine this. Thus, for your daughter, the focus seems to be much more on the neurological aspects of her functioning than on the mental health aspects.
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