When Should a Support Coordinator Refer to Neuropsychology?

Refer to neuropsychology when there is a specific question about a participant's thinking skills that matters to their daily function or support planning, and current evidence does not answer it.

"Please assess cognition" is broad. "We need to understand why the participant cannot retain new routines or safely manage multi-step tasks" gives the neuropsychologist a clear clinical question. This guide covers the signs that a referral may help, what to include and how to prepare the participant.

Signs a neuropsychology referral may help

• the participant has difficulty retaining new information or routines, even with repeated support

• they struggle to plan, start or complete multi-step tasks

• their thinking skills have changed after an injury, stroke, illness or neurological event

• therapy is not progressing as expected and no one knows why

• the team disagrees about whether a difficulty is cognitive, emotional or behavioural

• a major decision, such as a living arrangement or return to work, depends on understanding cognition

When another referral may fit better

• Emotional or psychosocial difficulties with no cognitive question: consider psychology. See Neuropsychology vs Psychology.

• A broad picture of everyday function and support needs: consider a Functional Capacity Assessment. See Neuropsychological Assessment vs Functional Capacity Assessment.

• Behaviours of concern: consider Positive Behaviour Support.

• A suspected new medical condition: the participant's GP or treating specialist should be involved first.

What to include in a neuropsychology referral

• The functional concern: what the participant finds difficult in daily life, with specific examples.

• The question to answer: what the team needs to understand, and why.

• Relevant history: diagnoses, injuries, previous assessments and current supports.

• How findings will be used: for example, guiding support planning, therapy, a living arrangement decision or evidence for a plan review.

• Practical considerations: communication needs, fatigue, sensory needs, interpreter needs or anything that may affect testing.

• Consent and timing: who has agreed to share information, and the date the report is needed by.

Example: a weak vs a strong referral question

• Weak: "Cognitive assessment please, participant has ABI."

• Strong: "Since a brain injury two years ago, the participant forgets medication and appointments despite phone reminders, and struggles to cook a simple meal without step-by-step prompting. We need to understand which cognitive difficulties are driving this, so supports and OT strategies can be targeted before the plan reassessment in March."

What a neuropsychological assessment involves

Knowing what happens helps you set expectations with the participant and family. Most assessments include:

• A clinical interview: the neuropsychologist asks about the participant's history, daily routines and the difficulties prompting the referral. With consent, family, carers or support workers are often asked for their observations too.

• A review of existing information: previous assessments, therapy reports and relevant medical history. Sending these with the referral saves time.

• Standardised testing: structured tasks that look at different thinking skills, such as attention, memory, processing speed, language, visual and spatial skills, and executive functions like planning, organising and problem-solving.

• A report: a profile of the participant's cognitive strengths and difficulties, how these affect daily life, and practical recommendations.

Testing often takes several hours, which is why it can be split across appointments.

Preparing the participant and family

• explain that testing looks at how thinking works, not whether someone is "smart"

• let them know sessions can be tiring and breaks are expected

• suggest bringing glasses, hearing aids and any communication aids

• encourage family to share examples of everyday difficulties, with consent

• ask them to bring a list of current medications

• if the participant is unwell, in crisis or has recently changed medication, talk to the neuropsychologist about whether to reschedule, as this can affect results

Funding and timing

Check the participant's plan for capacity building funding before referring, and read Does the NDIS Fund Neuropsychology? If the report is for a plan reassessment, evidence for a participant-requested reassessment should usually be from within 4 months of the request (NDIA).

Making the report useful

A neuropsychology report is most valuable when its recommendations reach the people supporting the participant day to day.

• Read the recommendations first. They usually translate the test findings into practical strategies, such as how to give instructions or which memory aids may help.

• Share it with the team, with consent. OTs, behaviour support practitioners, support workers and family can all use the findings to adjust how they work with the participant.

• Ask for a feedback session. Many neuropsychologists will explain the results to the participant and family in plain language, which helps them understand and use the findings.

• Use it as evidence. If the report supports a change in funded supports, include it with plan reassessment evidence alongside other current reports.

What a report can and can't do

A neuropsychology report can explain why a participant struggles with certain tasks, identify strengths that supports can build on, and give the team a shared understanding. It does not make NDIS funding decisions, which rest with the NDIA, and it does not replace medical investigation of a new or worsening condition.

Referring to CARED

CARED's neuropsychological assessments are available to NDIS participants, with family or carers consulted with consent. Sessions can be split across appointments, and reports are written in plain English with practical recommendations. If you are unsure whether neuropsychology is the right pathway, CARED can triage the question across Psychology, Occupational Therapy, Positive Behaviour Support and other services.

Next step

This article is general information, not individual clinical or NDIS advice.

Refer a participant or read NDIS Neuropsychology: Assessments, Reports and Support.