An empirical look at how neuropsychologists structure comprehensive school-age evaluations—from the instruments that define each battery to the specific functions they measure.
What does a “typical” school-age neuropsychological evaluation look like in practice? Not an idealized model, but the batteries clinicians build every day based on clinical judgment, referral questions, and the developmental needs of children and adolescents.
To answer this question, we analyzed approximately 500 school-age evaluations created on neuroaide, representing the work of around 75 clinicians. This dataset offers two complementary perspectives: the instrument level—which tells us about battery size and the mix of performance tests versus rating scales—and the subtest level—which provides a more granular view of what’s actually assessed and serves as a better proxy for evaluation length and testing time.
Together, these lenses provide a clearer, more clinically faithful picture of contemporary neuropsychological practice.
Methodology
Our analysis drew from a random sample of approximately 500 school-age neuropsychological evaluations (ages 6–17) completed on neuroaide between January and October 2025. To ensure balanced representation, we capped each clinician's contribution at 5% of the total dataset, preventing any single practice pattern from dominating the results.
Performance tests were decomposed into their constituent subtests, while rating scales were analyzed at the instrument level. All results are presented in aggregate to reflect group-level trends and preserve clinician privacy.
Before diving into the granular details of which subtests clinicians administer, it's essential to understand the broader structure of school-age batteries. How many instruments do clinicians typically use? What domains receive the most attention? And how does the balance between performance testing and rating scales play out in practice?
Battery Size: Consistency Within Variation
Across our sample, the median evaluation included 9 instruments, with a range spanning from 5 to 20 instruments (mean = 9.35). While most evaluations fall within the 6–12 instrument range, there's meaningful variation—some batteries are intentionally lean and focused, while others cast a wider net to capture a broader clinical picture.
Battery Length by Age Group
Key Insight
Battery length is remarkably stable across age groups. Whether evaluating an 8-year-old or a 17-year-old, clinicians tend to use a similar number of instruments. The difference isn't in how much is assessed, but what is prioritized.
This consistency suggests that while developmental considerations certainly shape which instruments are selected, the overall scope of evaluation remains relatively constant across the school-age spectrum.
Domain Coverage: Where Clinical Attention Concentrates
At the instrument level, two domains emerged as clear priorities, accounting for more than half of all measures administered:
This distribution aligns with common school-age referral patterns, where evaluations often address attention regulation, executive functioning, learning differences, and social-emotional or adaptive challenges. The strong representation of social-emotional and adaptive functioning measures largely reflects the use of rating scales, which are commonly employed to capture behavior and functioning in everyday settings.
The prominence of executive functioning and attention instruments, however, warrants a closer look. Many tools classified under this domain include only a handful of subtests, and the mix of measures is often eclectic rather than systematic. As a result, while attention and executive skills appear heavily represented at the instrument level, their share of actual testing time, and the number of subtests administered, tends to be lower.
Key Insight
At the instrument level, half of all measures administered address either social-emotional or executive functioning concerns, underscoring their clinical salience in school-age evaluations. Yet as we’ll see at the subtest level, this emphasis shifts—revealing how actual testing time and focus are distributed across domains.
Performance Tests vs. Rating Scales: A 70/30 Split
When we examine the instrument mix, we see a roughly 70/30 split between performance tests and rating scales. This balance reflects the dual aim of comprehensive evaluation: to directly assess a child’s abilities while also understanding how those abilities manifest in everyday life.
Rating scales—whether completed by parents, teachers, or the child themselves—provide critical ecological validity. They answer the question: Do the patterns we observe in the testing room translate to everyday functioning?
Why the Instrument View Isn't Enough
Knowing that an evaluation typically includes around nine instruments tells us something about scope, but it doesn’t capture how those instruments are actually used. Two clinicians might both administer the NEPSY–II, but if one selects two subtests and the other twelve, they’re conducting fundamentally different evaluations. Subtests within a single instrument can also vary widely in the functions they measure.
That’s why we turn to the subtest level—to see where clinicians actually spend their time and which domains receive the greatest focus.
While instruments provide the structural framework of an evaluation, subtests reveal the clinical decisions that shape it. Which processes receive the deepest examination? How does this focus shift as children move through elementary and into adolescence?
How Many Subtests Are Administered?
Across our sample, clinicians administered a median of approximately 30 subtests per evaluation. Half of evaluations include between ~19 and ~44 subtests, with a smaller group extending well beyond that range.
Where Do Subtests Concentrate? The Core Domains
When we examine where clinicians allocate subtests, four domains anchor most school-age evaluations:
Together, academic achievement, cognitive/intellectual functioning, memory, and executive functioning/attention account for 80%+ of all subtests administered. That concentration makes clinical sense: these areas typically require direct performance testing to localize skills and inform recommendations.
Key Insight
The subtest distribution highlights a tension between lenses. At the instrument level, social-emotional and executive functioning measures dominate (≈51% combined), driven in large part by rating scales, and a diverse mix of tools used to capture EF. At the subtest level, academic achievement and intellectual functioning take precedence (≈52% combined). In practice, rating scales amplify social-emotional coverage at the instrument level, while performance-based domains demand deeper subtest exploration.
Many instruments classified under executive functioning include only a few subtests, and even within broader EF measures, clinicians often administer only a subset of available tasks. In contrast, instruments assessing academic, intellectual or memory abilities tend to include many subtests that collectively provide deeper, more comprehensive coverage of each domain.
As a result, while executive functioning is well represented in terms of the number of instruments used, its share of total subtests administered is smaller.
How Coverage Shifts with Age
While overall battery length is broadly stable across age groups, domain emphasis shifts modestly from early elementary to adolescence.
Largest shifts from ages 6–9 to ages 14–17:
A notable trend is the rise in executive/attention subtests in middle and high school—consistent with increasing organizational demands and self-management expectations.
In contrast, academic coverage tapers slightly by adolescence, often because academic patterns are well established by that stage and clinicians focus more on mechanisms (e.g., EF) that mediate classroom performance.
Clinician Variation: Expected and Appropriate
Across clinicians with at least 5 evaluations in our sample, the median number of subtests ranged from 7 to 68—a striking span reflecting real differences in setting, referral mix, and training.
Clinicians work in different settings (schools, hospitals, private practice), see different referral populations (ADHD-focused vs. complex medical cases), and bring different training backgrounds. A clinician who specializes in learning disabilities may administer more academic and language subtests, while one focused on TBI may prioritize executive functioning and processing speed.
Putting It Together: Instruments x Subtests
The power of this dual-lens approach becomes clear when we integrate both perspectives:
Thinking across both levels helps teams benchmark battery length and focus without flattening clinical judgment. It acknowledges that while there's a recognizable structure to school-age evaluation, there's also meaningful—and clinically appropriate—variation in how that structure is implemented.
Methodological Notes
Weighting Strategy
To avoid overweighting any single high-volume clinician, we capped contributions so no clinician accounted for more than 5% of the dataset. This helps ensure patterns reflect the broader field rather than a few prolific users.
Domain Mapping
Each subtest was mapped to a primary domain based on its most central clinical use. When a subtest measures multiple constructs (as many do), we assigned it to the domain most relevant to typical interpretation, balancing precision with practical utility.
Understanding what a “typical” school-age battery looks like - at both the instrument and subtest levels - offers a common framework for discussing evaluation design, training emerging clinicians, and benchmarking practice. Yet it also reminds us that neuropsychology remains a hypothesis-driven discipline: the data define the structure, but clinical judgment shapes the meaning.