Forensic Evaluations
Forensic psychological and neuropsychological evaluations are a valuable resource to a wide range of legal matters. Informing the court about the defendant's mental health functioning can have important implications to maintain the defendant's rights, advise sentencing or treatment recommendations, and promote safety.
Dr. Graham has been working in the realm of forensic psychology for the past 15 years. Current best practices recommend that forensic neuro/psychological evaluations include a clinical interview with the evaluee, comprehensive record review, objective neuro/psychological testing, and information from collateral sources. This is the standard I follow in conducting forensic evaluations.
Forensic Neuropsychology
Forensic Neuropsychology is the application of neuropsychological evaluation to any of the domains listed above. A defendant's neuropsychological functioning can have significant implications in the legal arena. Standard forensic psychological evaluations do not encompass neuropsychological testing. However, a defendant's intellectual and cognitive functioning may greatly inform the legal system and its outcomes -- of information that can be missed in a standard forensic evaluation.
Examples
Below are some examples in which a neuropsychological evaluation may be useful in a legal case. A comprehensive neuropsychological evaluation can be applied to any of the forensic specialty areas identified above.
After a review of case information, we would determine the appropriate route of evaluation to answer the legal question.
Competence to Stand Trial
Common neuropsychological issues include neurodevelopmental issues such as low intellectual abilities, Autism Spectrum Disorder, or an interplay of cognitive problems, substance abuse, and repetitive brain injuries.
For example, you may be working with a teenager or young adult who just doesn't seem to understand their charges and potential outcomes ... no matter how much you explain it to them. There is no indication of psychosis, but you cannot pinpoint what is going on. A neuropsychological evaluation would likely be helpful.
Another common example would be an individual with chronic Schizophrenia. Although they are not having active hallucinations or delusions, you find it difficult to keep their attention while explaining their charge; they have trouble learning and remembering information between your meetings. The cognitive deficits associated with Schizophrenia may warrant a neuropsychological evaluation.
Are you working with an older adult who, despite having no legal history, has recently picked up a significant offense? Their out of character behavior may be indicative of a neurodegenerative process. Their ability to remember and, or, recognize the wrongfulness of their actions could impair their competency. This would warrant a neuropsychological evaluation.
Death Penalty
Defendant's must be deemed competent to be executed. A deficit in intellectual and/or cognitive functioning may impede a defendant's ability to have a factual and rational understanding of their execution.
Juveniles
Normal brain development continues into our early 20's. As such, there should be consideration for a neuropsychological evaluation of all juveniles involved in a criminal proceeding --whether relevant for competence to stand trial; violence risk assessment; waiver to adult court; or for mitigation.
Moreover, many of the juveniles (and young adults) involved with the juvenile / criminal justice system, are exposed to a multitude of factors that may further hinder normal brain development including in-utero problems, exposure to trauma and abuse, repeat head injuries, and substance use.
Personal Injury
A neuropsychological evaluation can help understand whether any cognitive deficits were sustained from a specific injury or event, how severe the deficits may be, and the anticipated recovery of the injury.