Neuropsychological Tests

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PidgeonNY

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PidgeonNY
Hey everyone,

I posted earlier looking for Neurophysiologists in the NY area and I thank you for all the comments and the help I received. I received a letter from FAA requesting additional information in order to approve (hopefully not deny) my 1st class medical, to make the story short I am HIV positive and it's my first time applying, I has always been my dream to fly and at my 37 years I decided to finally do it.

Just to expose a little about my experience, there is only 3 neurophysiologists recognized by the FAA in the New York City and close surrounding areas which are nearly impossible to connect with. I was on a rush to fulfill the requirements for the enrolling in the school (they accepted me with the certification that the AME sent the regular exams), I also accepted a loan for my classes and for those who don't know the interests are up the roof, I am also a resident so I had to go through TSA clearance and this has an expiration date, luckily the FAA knows all the doctors have waiting lists so they grant extensions to send the results.

All the doctors that I contacted, even further north in the state a side from, don't perform the CogScreen anymore so I have to go through the battery of tests that the FAA has listed on their secure portal. I was able to get an appointed for this month and I hope I do good in the test, they say you don't need preparation but who know.

All the fees were really high from $4000 as base up to $5300.

If any of you has any information or tips for the tests I would be really grateful!

I will also keep the feed posted on any information for anyone in the future that has questions about this particular issue. This a sensitive subject with a lot of stigma and a very personal.

Thank you!
 
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PidgeonNY said:
If any of you has any information or tips for the tests I would be really grateful!
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I was required to take the full neuropsych battery in 2020 to pass my 3rd class. The best advice I got was from my HIMS neuropsych who said "get a good nights' sleep the night before and make sure to have breakfast."

I did a write up on the testing back then but basically it boiled down to if you don't have ADD/ADHD and you're mildly intelligent, you'll probably do just fine.
 
PidgeonNY said:
I am taking the full battery as neither of the doctors perform the cogscreen.
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Perhaps I'm wrong, but I thought the full battery included the cogscreen?
Or did you mean to say that neither of the doctors will perform the cogscreen as a one-off?
 
Are there any instances where the FAA would make you take the cogscreen twice? I took it once already, passed, but now have to undergo an "updated neuropsychological evaluation in accordance with the ADHD protocol." I have no idea where the ADHD protocol came from as that was not the reason for the deferral.
 
why is the FAA requiring the cogscreen or battery for HIV positive diagnosis ? there must be something else. . .
 
allPrimes said:
Perhaps I'm wrong, but I thought the full battery included the cogscreen?
Or did you mean to say that neither of the doctors will perform the cogscreen as a one-off?
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I did the full battery, and the cog screen was performed.

My advice — eat and sleep well. Also, start exercising if you’re not already. Play brain games. Try to get your mind and body in shape.

Go to a doctor that isn’t just winging these things, or sending in an assistant to read you the directions.

You’re allowed to talk to yourself during the cogscreen. This is huge. Do it.
 
Anthem said:
why is the FAA requiring the cogscreen or battery for HIV positive diagnosis ? there must be something else. . .
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Seems like it’s part of the protocol.

At least one FAA study claims they have observed statistically significant higher rates of neurocognitive decline in HIV positive patients, but the literature on this is mixed as other studies cited in this study found no significant relationship between neruocognitive decline and HIV. Furthermore the FAA study didn’t find any significant decline associated with age as a comorbidity so that sort of puts the entire dataset in question IMO…

 
Anthem said:
why is the FAA requiring the cogscreen or battery for HIV positive diagnosis ? there must be something else. . .
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No. Most americans don’t remember progressive HIV, because at least for now “we got it stopped”.

I still remember the first four cases at the Michael Reese in 1982 (I was an Infectious Disease Fellow). They had toxoplamosis in the brain, and died of dementia even when we got the Toxo stopped with Amphoterrible B (Amphotericin B).

B
 
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Recently underwent the full cog screen evaluation, took about 4.5 hrs. It’s a whip for sure. It’s an interesting assessment as some of it I don’t see as valuable to evaluating someone’s cognitive abilities as relates to piloting.

The dual attention tests, for sure. The memory tests, yes. Fine motor skills, sure.

Math word problems and defining or describing places, people or things? Not so sure.

At one point you even have to draw a pretty elaborate picture of intertwined shapes and lines first from sight, then from memory, then again from memory about 20-30 minutes later after only one opportunity to look at.

I already passed the initial SSRI cog screen over a year ago but the FAA made me take the full one again if I want SI. $3K per test.
 
Hello everyone, I’m back with updates!

I finally completed the full panel of evaluations listed in the FAA's special portal (including the CogScreen AE) during the second week of September. In my search for authorized doctors to perform the tests, I took your advice and focused on doctors in New Jersey. Unfortunately, every other airman was on the same path, none of them had available appointments until late September or early October. With time ticking due to a loan I took out and the other authorizations I needed as a green card holder to start pilot training, I ultimately had to go with a more expensive but less crowded doctor in New York. Thank you all for your recommendations!

My experience with the doctor was better than I expected. She answered every email and question I had and was very clear about the expectations for the tests. The FAA, however, is a different story. They take weeks to respond to any requests, and the limited number of authorized experts makes it nearly impossible to fulfill their requests for additional documents on time. To complete all the necessary documentation, I requested two extensions of 30 days on top of the original 60 days they granted in their first communication.

My mother tongue is Spanish, and I was offered the chance to take some of the tests in that language, but I declined and opted to take all the tests in English.

My best advice for anyone taking the full panel is to sleep well the night before and bring some sweet snacks. Prepare for a long day of tests: in my case, we started at 9 a.m. and finished at 5:30 p.m., with a couple of short 5-minute breaks (take them! It’s a lot of forced brain activity) and a quick 45-minute lunch break. The CogScreen was not as bad as I thought it would be; it took about 2.5 hours. Of the 22 different parts, the most complicated were the dual tests—keeping a gray bar centered in a specific area while comparing numeric and alphabetical sequences—and the mathematical logic problems.

Some other parts involved following sequences of numbers and letters, as well as recognizing "rules" based on four monitor squares with conditions displayed below (for example, rectangular shapes at the bottom, where two display a blank center—one with a solid color frame and the other with just an outline—while the other two show arrows in the center, one solid and one outlined). You then have to identify which "rules" apply based on the condition displayed above the monitors. The system uses different sounds to indicate whether your choice is correct or incorrect, and the "rules" can change unexpectedly. It’s a bit difficult to explain, but it’s not as hard as it sounds.

After the CogScreen, there was another test, the name of which I can't remember, that required me to focus my attention for 20 minutes on a white square blinking every second on a black screen. The white square contained a black square that sometimes appeared at the bottom and sometimes at the top, with varying alternation patterns. I had to press a button with my dominant hand's thumb every time the black square appeared at the top. It sounds easy, but after the first 600 blinks (halfway through the test), it gets more challenging.

Next was a test that involved tapping a button with the index finger of each hand as fast as possible for one-minute intervals, alternating between dominant and non-dominant hands, while keeping my hands flat on a table—surprisingly, this made it harder.

This was followed by a personality test with 569 questions, where you had to indicate whether you agreed or disagreed with various statements. Some statements may be a bit questionable, but you must answer all of them. This is the only test you can repeat if the result is inconclusive. I had to retake this test two weeks later because my first result was inconclusive; I apparently answered too "defensively," giving a too-perfect image of myself. The doctor emphasized that they want honesty, not perfection.

After a quick lunch break, the remaining tests began. This panel focused mainly on memory, alternating graphic memory tests with an interview and a series of stories and lists of words to remember. It started with the doctor showing me increasingly complex drawings for a certain period, which I needed to replicate. The first was an elaborate design I had to replicate six times as accurately as possible. Then, there were six drawings on one sheet that I also had to replicate six times in the same order. In between drawing tasks, I was told three stories and given three lists of words to remember. Throughout the interview, the doctor paused to evaluate how well I recalled the drawings, stories, and lists of words.

The results of the neurophysiological tests are confidential and sent directly to the FAA, so I don’t have access to them. However, I could add documentation to the interview part; personal achievements, diplomas, and volunteer work are taken into account.

At this point, the doctor has already sent the test results, and I submitted my primary care physician's report along with my medical records and lab results. Everything is now in the hands of the FAA, and I hope to receive a decision on my medical certification soon.

This has been a long and very expensive process. It makes you wonder if they are eliminating candidates with all the steps you need to follow and the patience required to provide all the necessary information and then wait for results. This is truly a passion of mine, and I’m willing to take every step needed to be able to fly.
 
I found the full neuropsych interesting and intellectually stimulating. It was almost enjoyable!

Note that you can’t receive the test scores, but you should be able to get your doc’s write up they send the FAA which includes thier interpretation of your results.
 
allPrimes said:
I found the full neuropsych interesting and intellectually stimulating. It was almost enjoyable!

Note that you can’t receive the test scores, but you should be able to get your doc’s write up they send the FAA which includes thier interpretation of your results.
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Everything but the 500+ questionnaire at the end!
 
allPrimes said:
I found the full neuropsych interesting and intellectually stimulating. It was almost enjoyable!

Note that you can’t receive the test scores, but you should be able to get your doc’s write up they send the FAA which includes thier interpretation of your results.
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Thank you! I did get that the doc's write up with their interpretation of the results, for what I understood it was ok, now I'm just waiting for the FAA decision on my application.
 
Just for an update here. I checked with the FAA on the phone and they received all the documentation that they requested on time, the Medxpress portal takes forever to be updated with the information.

Now I am waiting for them to decide if granting the special issuance of the medical (Hopefully they will) or request more information. Patience with the FAA timing....
 
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