Clinical and Forensic
Neuropsychological Associates
Seasoned psychologist and expert witness, specializing in comprehensive clinical and forensic neuropsychological evaluations, utilizing evidence based assessments. Select a service
About CFNA

Clinical and Forensic Neuropsychological Associates (CFNA) specialize in comprehensive neuropsychological evaluations with evidence-based assessments, drawing upon the latest discoveries in neuroscience, psychological theories, and educational research.

Neuropsychology is the study of brain-behavior relationships and how functional skills change and impact daily life as a result of brain dysfunction.

A clinical neuropsychologist is a psychologist with a doctorate degree and specialized training in how cognitive functions, emotions, and behaviors relate to brain structures and systems. Clinically, it is the role of the neuropsychologist to sort out the factors that influence how the brain is working in order to understand disease expression, progress, and recovery.

A neuropsychological evaluation is a pragmatic and interactive process that includes a clinical interview, review of relevant medical and academic records, and the administration of various standardized paper-pencil and computer tests. These tests assess for areas like functioning of cognitive abilities (e.g., learning and memory, attention, executive functioning), emotions and behaviors, symptom/performance validity, and abilities to complete complex activities of daily living independently. Test scores are compared to normative data of healthy people in the individual’s same age, educational, and cultural group, when such data is available. If the individual’s performance is below expectation, CFNA studies the scores to determine if they reflect a particular disease pattern. Following the face-to-face evaluation, review of records, scoring of administered tests, and interpretation of results, CFNA writes a thorough yet concise report of findings. This report aims to tie together the patient’s psychosocial and clinical history, test results, and mechanisms of brain injury and/or disease, to make sense of present mental functioning and clinical presentation. Recommendations and referrals are provided when indicated.

CFNA’s main office locations are in Sherman Oaks, CA and Burbank, CA, but have several remote offices throughout California. When Dr. Mangassarian founded CFNA, her vision was to provide neuropsychological services both in-office and through mobile means, to ensure that those even in the most remote areas have access to neuropsychological care. CFNA’s approach is to provide diagnostic support and practical feedback to help patients resolve current functioning difficulties. We collaborate with the referring provider, the medical care team, and other professionals to ensure the highest quality of care.

Meet the Professionals

Dr. Selina Mangassarian

Psy.D., CBIS

Dr. Mangassarian is a Licensed Clinical Psychologist in California (PSY 30847) and New Mexico (PSY 1515), and a Certified Brain Injury Specialist (CBIS) through the Brain Injury Association of America’s (BIAA) Academy of Certified Brain Injury Specialists (ACBIS).

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Services
Criminal and Civil Litigation

Dr. Mangassarian has considerable experience in forensic neuropsychological and psychological evaluations in the med-legal arena, including Independent Medical Evaluations (IME). She serves as expert witnesses for attorneys across a variety of legal settings, and is retained by Plaintiff and Defense for her impartial evaluations.

CFNA, Inc. utilizes a systematic approach of analyzing information obtained through multiple data sources to clarify a claimant’s diagnoses, credibility, the cause(s) of the presenting symptoms, treatment(s) warranted, prognosis, and damages associated with claims.

A neuropsychological evaluation is indicated when impairment in cognitive, behavioral, and/or emotional functioning is suspected.  While neuroimaging is essential to understanding the structural integrity of the brain, only neuropsychological assessment allows for an examination of the brain’s functionality (e.g., cognitive abilities). The evaluation includes a clinical interview, a review of relevant clinical/medical, and psychosocial records, and the administration of objective, standardized cognitive and personality/behavioral measures via paper-pencil or computer tests. Due to the complexity of some forensic cases, the evaluation may require significant more time to complete.

The assessment may be the only objective evidence of damages, by presenting quantifiable data of current functioning and how it compares to previous functioning, prior to brain injury and/or disease. Neuropsychological testing can identify symptom and cognitive performance validity. Neuropsychological assessment can be used to reveal or diagnose brain dysfunction when no structural brain abnormalities can be seen. When structural brain abnormalities have been found, neuropsychological assessment determines what functions may be impaired because of the structural defects. It can also reveal the severity of these impairments.

Forensic services include but are not limited to:

  • Case consultation
  • Record review
  • Analysis of opposition experts’ methods and opinions
  • Psychological and neuropsychological testing
    • Symptom/Performance Validity
    • Cognitive functioning (e.g., Intelligence, Memory, Executive Functioning)
    • Social-emotional functioning (e.g., Objective Personality Testing)
    • Academic functioning
  • Research relevant to issues at hand
  • Advising attorneys preparing to depose opposition experts
  • Expert testimony concerning:
    • Credibility (e.g., Symptom validity, Symptom/Performance Validity)
    • Diagnoses
    • Treatment
    • Causation
    • Prognosis
    • Damages

Examples of Personal Injury cases:

  • Traumatic Brain Injury (TBI)
  • TBI in people with pre-existing TBI history
  • Posttraumatic Stress Disorder (PTSD)
  • Psychiatric and Personality Disorders
  • Chronic Pain/Somatoform Disorders/Fibromyalgia
  • Post-surgical complications
  • Physical and emotional abuse

Examples of Criminal Forensic cases:

  • Competency to stand trial
  • Risk assessments/Recidivism risk assessments
  • Specific Intent
  • Criminal responsibility

Examples of Employment cases:

  • Fitness for duty
  • Vocational accommodations
  • Disability evaluations
  • Psychological disability
  • Hostile work environment
  • Wrongful termination
  • Discrimination

Examples of Family Law cases:

  • Parental capacity

Examples of Elder Law cases:

  • Conservatorship of person
  • Capacity to make medical decisions
  • Capacity to make financial decisions
  • Undue influence
  • Dementia
  • Psychiatric and Personality Disorders

Examples of Education Law cases:

  • Academic accommodations and services
  • Program Placement
Clinical Neuropsychological Evaluations

A referral for a clinical neuropsychological assessment is appropriate whenever there is doubt about a patient’s cognitive functioning. Neuropsychologists assess a broad range of cognitive domains, not just memory. Neuropsychological assessment can detect pathological processes before structural abnormalities are observable on neuroimaging and in cases where no abnormalities can be visualized. Our approach is to provide diagnostic support and practical feedback to help adult and juvenile patients resolve current functioning difficulties. Our mission is to capitalize on personal strengths and empower each individual with the knowledge and tools needed to live a fulfilling and successful life. We work closely with the patient and family and collaborate with the referring provider, medical care team, and other professionals in the community to ensure the highest quality of care.

Psychodiagnostic Testing

Psychodiagnostic assessment services are often utilized to assess for various types and severity of mental illnesses that may also be accompanied by cognitive problems. Psychodiagnostic assessment may be particularly important in forensic cases involving bodily injury and emotional distress. Many patients with behavioral and emotional disorders may present with associated cognitive complaints and deficits that are not associated with primary neurological disorders. Thus, a comprehensive differential diagnosis may prove invaluable in the development of an effective treatment program with resolution of the cognitive complaints. Personality measures and psychiatric testing are designed to answer questions related to patients’ emotional status. These measures assess psychiatric symptoms and diagnoses, whereas neuropsychological measures provide an understanding of patients’ cognitive assets and limitations.

Accommodations Testing

Accommodations are alterations in the way tasks are presented that allow individuals with academic and/or learning difficulties to complete the same assignments as others. Accommodations do not alter the content of assignments, give individuals an unfair advantage, or, in the case of standardized tests, change what the test measures. Accommodations offer an opportunity for an individual to properly demonstrate their aptitude in what they have learned (e.g., on standardized tests).

In order to be considered for academic accommodations, testing agencies have a complex set of requirements that must be met. Most agencies require a current comprehensive neuropsychological/psychoeducational evaluation in which specific tests are administered, normed according to their guidelines, and reported in a format they may specify. Neuropsychological assessment identifies the strengths and weaknesses of the student using a number of systematic standardized measures that assess for intellect, cognition, academic achievement, social-emotional, behavioral, and adaptive functioning. It is the comprehensiveness of a neuropsychological evaluation assessment that is crucial in understanding the individual’s unique abilities in order to identify appropriate and reasonable interventions, and evidence-based accommodations.

The neuropsychologists at CFNA have extensive experience in documenting the existence of learning disabilities, and/or neurological conditions for accommodations in traditional academic settings, as well as for high-stakes standardized examinations (e.g., LSAT, MCAT). CFNA provides evaluations for individuals (ages 16+) who have been diagnosed with, or suspect, ADHD, specific learning disorders, acquired brain injury, or complex psychiatric mental health and/or medical issues that may interfere with optimal functioning in academic settings.

academic-accommodations
Depending on diagnosis(es), an individual may be eligible for one or more of the following test accommodations in the following categories:

  1. Presentation: Large print; reduced number of items per page or per line; having the test questions and instructions read aloud; repetition of instructions.
  2. Response: Allowing for verbal responses; allowing for answers to be dictated to a scribe, to speech-to-text software, or to a tape recorder; allowing a computer to be used for responses (with or without spell check or grammar programs).
  3. Time: Allowing frequent breaks; extending allotted time to complete a test.
  4. Location: Providing special lighting or acoustics (e.g., noise cancelling headphones); providing a space that minimizes distractions; minimizing the number of other people in the room; giving preferential seating.
  5. Scheduling: Allowing subtests to be taken in a different order; administering a test at a specific time of day; allowing different sections to be taken on different days
  6. Other: Accommodations may include special test preparation, allowing food/snacks during test or at breaks, offering on-task/focusing prompts, as well as any reasonable accommodation that may best meet the needs of the individual.

Fitness for Duty Evaluations

A Fitness for Duty Evaluation (FFDE) is an examination conducted by a qualified healthcare provider to determine whether an employee or prospective employee is fit (physically, mentally or emotionally) to perform essential job functions. A neuropsychological and/or psychodiagnostic evaluation is often requested by employers, or government agencies, to determine whether an employee is able to perform the essential job functions of their position safely (without risk to himself, herself or others), with or without an accommodation. Employers rely on the results of a fitness for duty evaluation to make decisions regarding accommodations, work assignments, location placement, and the appropriateness of a particular position for an employee.

Pre-Surgical Psychological Evaluations

Insurance companies and surgical teams typically require patients to undergo a psychological evaluations before major surgeries such as organ transplants, epilepsy surgery, spinal cord procedures, or bariatric procedures. A pre-surgical psychological evaluations is used to identify the risks and positive attributes that could impact successful post-surgical outcomes. The evaluations is comprised of a clinical interview, questionnaires, and various standardized assessments, as needed. Some specific goals of the pre-surgical psychological evaluations include:

  • Document the condition or need for surgery
  • Assess patient’s health status
  • Discover previously unknown conditions that could cause complications
  • Determine risk factors
  • Reduce chances of surgical or anesthetic problems
  • Develop post-operative care plan
  • Educate patients about the surgical procedure

Evaluation Areas

At CFNA, our evaluations can help differentiate between organic vs. psychological/emotional etiology through an objective and thorough assessment. We conduct comprehensive record reviews and integrate them with neuropsychological and/or psychodiagnostic test results, in order to obtain a full understanding of an individual’s functioning. Part of the detailed evaluation includes assessing an individual’s motivation to perform optimally through the use of a variety of symptom and performance validity measures.

The nature of the evaluation, regardless of case type will depend on the specific concerns to be addressed and the reason for referral.

The following areas of functioning are typically assessed:

  • Intellectual Functioning
  • Attention & Concentration
  • Visuospatial Functioning
  • Personality & Emotional Functioning
  • Executive Functioning (Cognitive Flexibility, Problem Solving)
  • Language Abilities
  • Academic Achievement
  • Daily Living Functionality
  • Learning & Memory (Verbal & Nonverbal)
  • Verbal & Nonverbal Reasoning
  • Gross & Fine Motor Functioning
  • Behavioral Functioning
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