Dr. Koziol provides services in both clinical neuropsychology and forensic psychology. As a clinical neuropsychologist, he offers comprehensive neuropsychological evaluations of children, adolescents and adults with attention or concentration problems, memory difficulties, executive dysfunction, and learning disabilities. As an experienced forensic psychology expert, he is available for forensic case consultation, forensic evaluations, and expert testimony.


His clinical services include:

• Comprehensive assessment of problems with attention, learning and memory
• Neuropsychological assessment of learning disabilities and academic skills
• Individual and group supervision available for licensed psychologists, for individuals in preparation for the neuropsychology diplomate examination and for graduate students

Read more information on:

• Neuropsychological evaluations
• Pediatric neuropsychological assessment
• Expert testimony and Guidelines for Preparing Cases of Mild Head Injury

Fees:

• Standard consultation fee is $150.00 per hour
• Forensic consultation fee ranges from $250.00 to $350.00 per hour

Office Location

Dr. Koziol's office is centrally located in Arlington Heights, Illinois (a Northwestern suburb of Chicago) , near the O'Hare Airport, with easy access to all major expressways. The office address is:

3800 N. Wilke Road
Suite 160
Arlington Heights, IL 60004
(847) 686-3643

Get Directions

The office is near accommodations with reasonable rates for those traveling from out of town. Please call or email for assistance in making arrangements for lodging.

Most people realize that accurate diagnosis is important because correctly identifying the problem is the first step towards organizing a proper treatment plan and intervention. Dr. Koziol has seen patients from locations throughout the United States as well as from other countries.

His office is centrally located in the hub of the United States, so that travel and lodging arrangements can easily be made. On occasion, a family finds it more efficient to subsidize Dr. Koziol's travel, room, and board expenses. In these instances, Dr. Koziol will consider a "house call" type of arrangement if a setting can be determined where the individual can be seen. Dr. Koziol is well connected with professionals in most areas of the country, and therefore, office space can sometimes be arranged in other locations.

 

Neuropsychological Evaluations

Neuropsychological evaluation is a systematic assessment of brain-behavior relationships. The areas of functioning that are evaluated include attention, learning, memory, language, visuospatial, and sensory-motor processes. Metacognitive skills such as planning, organization, and problem-solving are also systematically tested. These evaluations are based upon the highest scientific integrity, and the ability to administer and interpret these assessments requires highly specialized training and expertise, well beyond the educational experiences of the typical clinical or school psychologist.

Over the past several decades, our understanding of how various aspects of thinking and behavior are organized within the brain has been generated by the neuroscience disciplines. Neuropsychology is one such representative field. Our understanding of attention, learning, memory, reading, math, and related functions has come from cognitive assessment and the integration of the results with a scientific knowledge base. Neuropsychological assessment is not a gimmick, it is not a"snake oil" potion, and it is not a panacea or cure all. However, it is the best clinical and scientific methodology for identifying and characterizing brain-related scholastic, achievement, and adaptation problems. If you are interested in accurate diagnosis, success, and in identifying and understanding that which stands in its way, then you should consider this type of evaluation.

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Pediatric Neuropsychological Assessment

When a child is evaluated for the first time, it is essential to formulate an accurate diagnosis and treatment plan to get the child on the right track, to point him/her in the proper direction, and to provide the optimal type of treatment support. Many children have histories of being "tested" multiple times, either within school systems or by general psychological/behavioral practitioners, while it is never clear what the diagnosis is and what can or should be done about the vaguely defined problem. Misdiagnosis often occurs because the original evaluation did not center around understanding brain-behavior relationships, or because the diagnosis was based upon an overly simplistic interpretation of summary test scores."Scores" DO NOT identify a child's innate ability. The "score" does not equal the ability. A "score" merely states how a child performed on a test, relative to other children.

Problems with attention, learning and memory, planning and organization, task completion, and motivation and persistence are not easily found by measuring global levels of achievement in reading, spelling, arithmetic, or tests of knowledge in other academic areas. Knowing what a child has achieved is a conclusion based upon comparing the child to other children, but this says nothing about the reason for that level of achievement.

A neuropsychological evaluation is a cognitive assessment that looks at all of the subcomponent skills that are necessary for successful functioning. In this type of evaluation, the results will not only identify how well or how poorly a child reads, spells, does math, or pays attention, etc., but also indicates why. Knowing how and why a child has trouble paying attention, learning, reading, etc., are the essential keys to identifying what should be done about the problem. In addition, Dr. Koziol's evaluation includes a standardized behavioral history review. One of the purposes of obtaining this information is to explain how the behaviors are a manifestation of the test findings, relating to the child's cognitive or brain-related functioning. This results in a highly integrated, synthesized description and understanding of the child that is not frequently seen in other behavioral disciplines.

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Guidelines for Preparing Cases of Mild Head Injury

Head injuries that appear to be mild or even trivial can often result in a persisting group of subjective complaints that has been called the post-concussive syndrome (PCS). The most common complaints include headache, concentration difficulty, forgetfulness and memory problems, dizziness, irritability, anxiety and depression. There is a long-standing debate regarding the etiology of these persisting symptoms. Some experts say the syndrome is physical, and others say the problem is psychological. Still others suggest an aspect of malingering is involved.

In evaluating, defending, and awarding compensation for these subjective disabling problems, several factors need to be considered. These important factors include the documentation of possible brain damage, the measurement of learning/memory problems, the identification of possible psychological symptoms, and an assessment of possible malingering. The following outline can be useful as a guide in constructing a defense in cases of post-concussive syndrome.

One index for detecting brain injury and estimating its severity is the period of post-traumatic amnesia, or PTA. PTA refers to the period of time during which the subject is unable to remember anything since the trauma. The longer the PTA, the more severe the brain injury. Length of PTA is typically obtained from reviewing the medical record. Although the lack of PTA does not always mean an absence of brain injury, it typically implies a very mild head injury with a good prognostic outcome.

It is always useful to evaluate brain damage through the objective evidence of neuropathological studies. CT scans and MRI tests can provide physical evidence of head injury. This objective evidence of injury then has to be matched, or correlated, with behavioral evidence of deficits in attention/concentration, learning and memory. Behavioral evidence can be obtained from neuropsychological testing and from the subject's history of complaints.

When CT/MRI tests do not provide physical evidence of brain injury, some experts might argue that the damage is microscopic, or too minute to be detected by physical tests. However, it is perfectly logical and acceptable to counter with the argument that "microscopic damage" would also result in only microscopic or undetectable changes in behavior, and not in major complaint or in any impairing group of persisting, disabling symptoms.

In cases where CT and MRI do not document head injury, neuropsychological testing is often used to "validate" complaints of brain damage. However, there are pitfalls in this methodology, since physical and psychological tests differ in important ways. CT/MRI are very objective. Images or pictures of the brain are obtained, but the subject does not influence the outcome of the test in any way. On the other hand, learning, memory, and personality testing are based on subject performance. The performance of a subject can be influenced by many factors.

Neuropsychological tests are measurements of behavior, usually focusing upon attention/concentration, learning, memory and other cognitive skills. However, these are not tests of brain damage. People with brain damage typically do poorly on neuropsychological tests. But people can perform poorly for reasons other than brain damage as well. The evaluation needs to consider these other reasons before concluding brain damage. Motivation is obviously one factor important to consider in cases of potential financial gain.

In this regard, neuropsychological tests are vulnerable to the effects of motivation. Therefore, any neuropsychologist or psychologist, for either the plaintiff or the defense, has to make some reasonable effort to evaluate motivational influences, including malingering. This can be done in several ways. A good report will comment on improbable symptoms and their lack of anatomical basis, as well as commenting on inconsistencies in neuropsychological test data, since certain patterns of inconsistency often reflect suspect motivation. Secondly, there are specific, brief tests of malingering that can easily be administered, and that a knowledgeable, board-certified neuropsychologist will likely employ to address the issue.

It is a good practice to use one of these tests, since the patient with genuine complaints has nothing to lose and since the test helps in understanding those symptoms. Finally, it is useful to obtain a personality inventory from the person. This inventory can help in the detection of malingering, as well as in identifying conditions such as anxiety, depression, and personality disorder. These conditions can effect Neuropsychological test results as well as the report of other subjective complaints.

The plaintiff is actually at a disadvantage because of the practical limits in assessing brain injury and associated complaints. The burden is to prove both a causal connection between an accident and a purported injury, and the nature and extent of that injury. Some research suggests that although post-concussive complaints may have an initial neurological basis, the persistence of these symptoms after six months is primarily due to psychological factors. For example, ratings of daily stress have been correlated with the intensity, frequency, and duration of complaints.

The simple incidence or occurrence of post-concussive symptoms in head injury groups does not really differ from the base-rate occurrence of these symptoms in normal control groups. An occasional headache, an occasional lapse in attention, forgetting something, and occasional irritability and nervousness affect most people some of the time. Stress and cognitive appraisal play a role in post-concussive complaints. The subject pays more attention to these complaints and becomes more sensitive to their occurrence after a head injury.

The person begins to attribute these minor complaints to the injury, assigning the complaints a more important meaning. Research data shows these symptoms can be minimized by educating subjects about what to expect after they sustain a mild or trivial head injury. Similarly, when these complaints do develop, research findings demonstrate that they can be treated effectively through a very specific type of cognitive-behavioral therapy. Therefore, symptoms of post-concussive syndrome need not persist or be disabling.

Litigation in cases of post-concussive syndrome is a time consuming and expensive process. The guidelines presented here will hopefully be useful in both presenting a plaintiff's position and in defending cases against unwarranted compensation.

References used for this guideline are available upon request. Dr. Koziol is also available for case consultation and expert witness testimony.

From more information please contact Dr. Koziol.

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