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Neurobehavioral History Questionnaires

The Neurobehavioral History forms are well-reviewed, popular intake forms. They provide a comprehensive and organized method of gathering important clinical information that should be part of every assessment. Your testing is only part of the assessment. Test results need to be interpreted in a context, and every person is different. These questionnaires provide the background picture of your patient that is critical to making informed clinical decisions. They provide an extensive picture of your patient with details about their medical history, medications, family history, review of systems, mental health, substance use, pain, education, work history, and more. The Family History Grid provides a snapshot of potentially relevant family biological issues when making differential diagnoses.

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The history questionnaires are used to assess individuals with conditions such as brain injury, neurologic disease, and developmental disorders and provide an excellent tool to thoroughly evaluate individuals with mental health disorders as well. The forms make the initial part of your assessment efficient when they are mailed before the first appointment. The adult extended form is 12 pages and the child form is 8 pages. A short-form version (4 pages) is available for a rapid assessment of an adult. 

Neurobehavioral Signs and Symptoms Checklists   

  • How do you know if your exam findings represent new or pre-existing conditions? 

  • Which chronic disorders have worsened from a disease or injury?

 

The Adult and Child Neurobehavioral Signs and Symptoms checklists help answer these questions. 

 

The Signs and Symptoms checklists elicit patient or informant concerns about the patient's present and past cognitive and behavioral functioning. Both forms include a section on possible over-reporting by presenting implausible symptoms.

The forms...

  • Provide severity ratings for each item

  • Differentiate pre-existing problems from new problems

  • Organize presenting concerns to ensure that important concerns are not overlooked

  • Evaluate core areas: Daily Functioning, Executive Functions, Speech and Language, Nonverbal Skills, Memory, Attention and Self-Control, Motor, Sensory, and Behavior and Mood

THE 2024 SIGNS AND SYMPTOMS CHECKLISTS ARE NOW AVAILABLE.

Excel spreadsheets are available to help organize and evaluate the Signs and Symptoms information.

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"...allow the clinician to collect comprehensive historical information in a systematic way...serves to reduce subjective aspects of the interview and increase diagnostic accuracy between clinicians.”
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"Comprehensive...efficient, organized and thorough, reducing the likelihood that pertinent information will be overlooked."

Erin Bigler PhD, APBB
Past Present, National Academy of Neuropsychology

"They ask the type of questions I would ask and they provide a very nice permanent record in the chart of a patient's history."
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