A neuropsychological assessment is a detailed look at how your brain is working. It is carried out by a psychologist with specialist training in brain and behaviour, usually called a clinical neuropsychologist. It combines an interview with standardised tests of memory, attention, language, problem-solving, processing speed and visual skills. It often includes questionnaires about mood.
It is much longer than a memory screen. NHS services describe sessions of one to four hours, and some assessments are spread over several appointments. The result is a written report. The report describes your strengths and weaknesses and compares your scores with people of a similar age and background. It also answers the question your doctor asked.
It is not the same as an ADHD or autism diagnostic assessment. It is also not a pass-or-fail test. This guide explains what it is for, what happens on the day, and how to get one in Ireland, the UK and the US.
The American Academy of Clinical Neuropsychology (AACN) describes clinical neuropsychology as a specialty within clinical psychology. It focuses on the relationship between brain and behaviour, and applies it to diagnosis, assessment and treatment.
In practice, the assessment has three parts:
Cambridge University Hospitals puts it plainly: being referred "does not mean that there is something wrong with your brain."
North Bristol NHS Trust lists common reasons for referral:
The AACN adds learning and developmental questions, and the question of whether changes in personality are psychiatric or brain-related.
For memory problems, the UK's National Institute for Health and Care Excellence (NICE) gives specific guidance. Its dementia guideline says specialists should consider neuropsychological testing in three cases. These are when it is unclear whether a person has cognitive impairment, whether dementia is the cause, or which type of dementia it is.
If you are worried about a head injury, our page on concussion covers the current advice on recovery.
A memory screen, such as the MoCA or Mini-Cog, takes a few minutes and gives one total score. Its job is to decide whether someone needs a fuller look. A neuropsychological assessment is that fuller look.
The screen tells you whether something might be wrong. The full assessment looks at what is affected, how much, and what might explain it. Our guide to memory worries and normal ageing covers the earlier stage.
People often assume an ADHD or autism diagnosis needs a battery of brain tests. It does not.
NICE's ADHD guideline says ADHD should be diagnosed by a specialist on the basis of three things. These are a full clinical and psychosocial assessment, a full developmental and psychiatric history, and observer reports with an assessment of mental state. It adds that a diagnosis should not rest on rating scales or observation alone.
NICE's adult autism guideline describes a team-based assessment. It should cover core autism features from childhood onwards, developmental history, daily functioning and other conditions. It suggests structured diagnostic tools such as the ADOS-G or ADI-R for more complex cases. It also says not to use biological tests, genetic tests or brain scans routinely to make the diagnosis.
So an ADHD or autism assessment asks, "Does this person meet the criteria for this condition?" A neuropsychological assessment asks, "How is this person's thinking working, and why?" The two can overlap. NICE's autism guideline, for example, says formal tools should be used when a learning disability is a possibility. Some people have both.
For the diagnostic routes themselves, see our guides to adult ADHD assessment in Ireland and adult autism assessment in England and Ireland.
The Psychological Society of Ireland's Division of Neuropsychology publishes a competency framework for adult clinical neuropsychology. It says the foundation is a PSI-accredited doctorate (or equivalent) in clinical, counselling or educational psychology. Specialist training in neuropsychology follows. The target credential is "chartered clinical neuropsychologist".
Psychology is not yet a state-regulated profession in Ireland. CORU, the health and social care regulator, says its first registers, for clinical, counselling and educational psychologists, are "now expected in 2027".
The British Psychological Society runs a Specialist Register of Clinical Neuropsychologists. To join, a psychologist must be registered with the Health and Care Professions Council (HCPC) as a practitioner psychologist. They must also hold a recognised neuropsychology qualification and be in active clinical practice.
The AACN describes a clinical neuropsychologist as a doctoral-level psychologist with about two extra years of specialist training and a state licence. It also warns that "most states allow licensed psychologists to call themselves neuropsychologists" without proving specialist training. Board certification through the American Board of Clinical Neuropsychology is the clearest evidence of competence, it says.
The NHS services we checked give similar advice. Sleep well the night before and eat beforehand. Bring your glasses or hearing aids, and any previous assessment reports. You do not need to study or prepare. If English is not your first language, ask about an interpreter in advance.
You will talk about your symptoms, health and daily life. The neuropsychologist may also want to speak to a relative or close friend, with your consent.
The tasks cover a range of skills. North Bristol lists:
You will find some tasks easy and others hard. That is expected. Cambridge's leaflet says the tests cannot be passed or failed. Instead, your score is compared with people similar in age, gender and background.
The testing itself is often carried out by an assistant psychologist, supervised by a qualified neuropsychologist. It involves no needles, scans or physical procedures.
North Bristol says appointments range from one to four hours. Cambridge says the first assessment may take up to three hours. The AACN says it can range from about an hour for a brief screening to eight hours or more, spread over several appointments. You can take breaks. If you feel unwell or too tired, the session can stop and continue another day.
Part of the assessment checks whether the scores give a true picture of your abilities. The AACN consensus statement says every evaluation must address how valid the test results are. The PSI framework includes performance and symptom validity "if relevant". It also says practitioners should consider fatigue, motivation and anxiety.
This is routine. It is not an accusation. Pain, exhaustion, low mood and worry can all pull scores down. The check helps the neuropsychologist interpret what they see.
After the session, the neuropsychologist scores the tests and writes a report. According to the AACN and the NHS services above, it usually covers:
The report usually goes to the doctor who referred you. North Bristol says it is often, but not always, copied to you. Sometimes the referring doctor explains it, alongside other test results. You may be offered a feedback appointment. Ask for one if not.
It can:
It cannot:
Results can also change. If you had a bad day, were unwell or very anxious, say so. Our article on mild cognitive impairment explains why single test results move.
Public neuropsychology services in Ireland are mostly based in hospitals and rehabilitation services. You are usually referred by a consultant rather than by yourself. For example, St Vincent's University Hospital runs a neuropsychology service for patients of its neurology department. It asks patients to contact their medical team about referral.
If you are already under a neurologist, geriatrician, psychiatrist or rehabilitation team, ask them whether a neuropsychological assessment would help.
The PSI's online directory lets you search for Chartered psychologists, including those with the specialist title Chartered Clinical Neuropsychologist. Only members who opt in are listed. We could not find published private fees we could verify, so ask each provider for the total cost, including the report.
On the NHS, referral usually comes from your GP, consultant or another medical professional. For private assessment, check the HCPC register and the BPS Specialist Register of Clinical Neuropsychologists.
The AACN says referral usually comes from a physician or other health professional. Most large hospitals and academic medical centres have neuropsychologists on staff. Board-certified clinical neuropsychologists are listed in the AACN's directory.
No. The tests are not pass-or-fail. Your scores are compared with people of a similar age and background, and everyone finds some tasks harder than others.
Not usually. NICE says ADHD is diagnosed through clinical assessment, history and observer reports, not rating scales alone. Adult autism is diagnosed through a team-based clinical assessment. A neuropsychological assessment may be added if there is a separate question, such as a possible learning disability.
It varies by service. North Bristol says report timelines differ, and suggests asking the psychologist you see.
No. Some assessments include measures of general intellectual ability. A neuropsychological assessment looks at many separate skills, alongside your history and mood.
Often, yes. The testing needs concentration and effort, and some people feel tired afterwards. Breaks are built in, and sessions can be split.
Proco is preparing clinician-led adult ADHD and autism assessments, which are diagnostic assessments rather than neuropsychological ones. You can read about them at procohq.com/assessments.
This article is general information, not medical advice. It cannot tell you whether you need an assessment. Talk to your GP or the specialist looking after you.
Reviewed by: Proco Team
Last updated: November 2026