What is neurocognitive testing?

Neurocognitive testing is a standardized neuropsychological assessment — a set of computer-based tasks that measure how your brain is performing, scored on the speed and accuracy of your responses. It is not an IQ test. CNS Vital Signs measures a broad spectrum of brain domains. The assessment is self-guided and takes about 30 minutes.

Why neurocognitive testing is important

Brain health is one of the most important — and least measured — parts of overall health. Cognitive function is a meaningful biomarker for many conditions, and it can now be measured objectively with millisecond precision. Your results are scored against a lifespan normative database (ages 8 to 90), which lets your provider grade the level of any difficulty and catch changes early. We use neurocognitive testing in three ways: to detect even subtle cognitive changes, to add objective information alongside your history and exam, and to track your cognitive function over time so we can see how treatment is working. The battery uses ten age-normed tests drawn from established neuropsychological measures, in keeping with DSM-5 recommendations, along with built-in validity checks.

The neurocognitive tests we use

A CNS Vital Signs assessment is built from ten standardized, age-normed tests:

• Verbal Memory (VBM) — recognition memory for words.
• Visual Memory (VIM) — recognition memory for shapes and figures.
• Finger Tapping (FTT) — motor speed and fine motor control.
• Symbol Digit Coding (SDC) — information-processing speed and complex attention.
• Stroop Test (ST) — reaction time, inhibition, and executive/processing speed.
• Shifting Attention (SAT) — cognitive flexibility and executive function.
• Continuous Performance (CPT) — sustained attention and impulse control.
• Four-Part Continuous Performance (FPCPT) — working memory and sustained attention.
• Perception of Emotions (POET) — social cognition and emotional acuity.
• Non-Verbal Reasoning (NVRT) — visual-abstract reasoning and problem-solving.

The cognitive domains we measure

From these tests, your report includes an overall Neurocognitive Index — a single summary score that averages your main results — plus the individual domain scores below. Here is what each one means in everyday life:

Composite Memory. How well you take in and later recall both words and images. In everyday life: remembering appointments, instructions, names, and where you put things. (Verbal + Visual Memory tests.)

Verbal Memory. Recognizing and recalling words. In everyday life: following a conversation, remembering medication instructions or a lecture. (Verbal Memory test.)

Visual Memory. Recognizing and recalling shapes, images, and layouts. In everyday life: remembering faces, finding your way, or recalling something you saw. (Visual Memory test.)

Processing Speed. How quickly you take in information and respond accurately. In everyday life: keeping up at work or school and reacting while driving. (Symbol Digit Coding.)

Psychomotor Speed. How well your thinking and hand movements work together. In everyday life: using tools, typing, or coordinating physical tasks. (Symbol Digit Coding + Finger Tapping.)

Reaction Time. How fast you respond, measured in milliseconds. In everyday life: braking in traffic or reacting in a fast-moving moment. On the report, a longer time means a slower response. (Stroop Test.)

Complex Attention. Staying accurate while tracking several things over time. In everyday life: focusing on a demanding task without losing track or making errors. (Several tests combined.)

Sustained Attention. Holding focus over a longer stretch. In everyday life: finishing a long task, reading, or sitting through a meeting or class. (Continuous Performance tests.)

Working Memory. Holding and using information in the moment. In everyday life: mental math, following multi-step directions, or keeping a number in mind. (Four-Part Continuous Performance.)

Cognitive Flexibility. Shifting smoothly between rules or tasks. In everyday life: adapting when plans change, switching jobs, and controlling impulses. (Shifting Attention + Stroop.)

Executive Function. Planning, sequencing, and managing more than one task at once. In everyday life: organizing your day, juggling responsibilities, and following through. (Shifting Attention.)

Motor Speed. Simple, rapid hand movements. In everyday life: basic dexterity and coordination. (Finger Tapping.)

Reasoning. Seeing patterns and drawing conclusions from visual information. In everyday life: problem-solving and figuring out how things fit together. (Non-Verbal Reasoning.)

Social Acuity. Reading emotions and social cues. In everyday life: recognizing how others feel and responding appropriately. (Perception of Emotions.)

Simple Attention. Staying alert to a single, basic task. In everyday life: reliably noticing and responding to one thing. (Continuous Performance.)

Available in more than 60 languages

So you can be tested in the language you know best, CNS Vital Signs is available in more than 60 languages — including Tagalog, Ilocano, Cebuano, Filipino, Japanese, Korean, Chinese (Traditional and Simplified), and Spanish, which reflect many of the communities we serve in Hawaiʻi. The full list includes: Afrikaans, Arabic, Bengali, Bulgarian, Cebuano, Chinese (Traditional), Chinese Simplified (China), Chinese Simplified (Malaysia), Croatian, Czech, Danish, Dutch, English (UK), English (US), Estonian, Farsi, Filipino, Finnish, Flemish, French (Canada), French (France), German, Greek, Gujarati, Hebrew, Hindi, Hungarian, Ilocano, Indonesian, Italian, Japanese, Kannada, Korean, Latvian, Malay, Malayalam, Marathi, Norwegian, Polish, Portuguese (Brazil), Portuguese (Portugal), Punjabi, Romanian, Russian, Serbian, Sesotho, Slovak, Spanish (Latin America), Spanish (Mexico), Spanish (Spain), Swedish, Tagalog, Tamil, Telugu, Thai, Turkish, Ukrainian, Urdu, Xhosa, and Zulu.

When neurocognitive testing helps

Neurocognitive testing adds objective insight across a wide range of conditions:

ADHD. Objectively measures attention, impulsivity, processing speed, and executive function to support an accurate diagnosis and to guide and monitor treatment.

Memory concerns & healthy aging. Detects early changes in memory and processing, establishes a baseline, and tracks cognition over time to help distinguish normal aging from mild cognitive impairment or dementia.

Concussion & brain injury. Measures reaction time, processing speed, and memory after a head injury to guide recovery and a safe return to school, work, or sport.

Depression & anxiety. Low mood and anxiety can cloud concentration and memory; testing clarifies the cognitive impact and tracks improvement with treatment.

Sleep problems. Poor sleep impairs attention, memory, and reaction time — testing shows the effect and the gains as sleep improves.

Substance use & recovery. Documents the cognitive effects of substance use and tracks the recovery of attention, memory, and executive function over time.

Chronic pain. Pain and some pain medications can affect focus and memory; objective testing helps separate and monitor these effects.

Multiple sclerosis & other neurological conditions. Monitors the cognitive changes that can accompany neurological illness, supporting earlier intervention.

Cancer-related cognitive changes (“chemo brain”). Documents and tracks the memory and concentration difficulties that can occur during and after cancer treatment.

Occupational & return-to-work. Provides objective data on cognitive readiness for safety-sensitive roles or for returning to work after illness or injury.

How it works

The assessment is completed on a computer, in office or remotely by telehealth, usually in about 30 minutes. Results are scored automatically, and your provider reviews them with you to guide your care. Download the patient testing guide (PDF) to see what to expect and how to do your best.

Preparing for your test — and what your results mean

Neurocognitive testing is simple, and you do not need any computer experience. Each test gives short, easy-to-follow instructions, most include a quick practice round, and you will use only a few keys (mostly the space bar). To capture your best performance, a little preparation helps:

• Be rested — if you can, avoid testing when you are very tired or unwell.
• Bring and wear your glasses or contacts if you use them.
• Choose a quiet space free of distractions, and silence your phone.
• Read each test’s instructions carefully before you begin.
• Give your full effort — the results guide your care.
• Let us know about any hand or vision issues that could affect testing.

When you finish, the assessment is scored automatically. Your provider receives a clear report — an overall Neurocognitive Index plus individual domain scores compared with others your age — and reviews it with you. Testing is often repeated over time so we can track changes and see how treatment is working.

Why it matters for ADHD

Because ADHD centers on attention and executive function, objective neurocognitive testing helps confirm the diagnosis, distinguish ADHD from other causes, and guide whether medication — including stimulants — is appropriate. Learn more about our ADHD evaluation and treatment.

Why you can trust this testing

CNS Vital Signs is a standardized, FDA-registered assessment scored against a normative database spanning ages 8 to 90, and it has been used in more than 150 peer-reviewed studies and clinical trials.

Insurance — Medicaid (QUEST), Medicare & commercial plans

OhanaPsych accepts Hawaiʻi Medicaid (QUEST), Medicare, and most major commercial insurance plans. Call (808) 777-9460 to confirm your specific plan.

Getting care by telehealth

Neurocognitive testing with CNS Vital Signs is self-guided and can be completed from home, so you can take it by telehealth or in our office — whichever is easier for you. As we complete the final stages of becoming a Rural Health Clinic (RHC), telehealth for mental-health care is here to stay with us. Under Medicare’s rural-health rules, RHCs are permanently authorized to provide behavioral and mental-health care by telehealth — including into your home, anywhere in Hawaiʻi — not under the temporary flexibilities that expire and must be renewed.

Wherever you live, OhanaPsych is your statewide practice. We provide care across the entire state of Hawaiʻi by telehealth, reaching every island — Hawaiʻi Island, Maui, Oʻahu, Kauaʻi, Molokaʻi, Lānaʻi, and Niʻihau. If you would rather be seen in person, you have that option at our offices in Hilo and Honolulu.

When to reach out

You do not need to be in crisis to reach out — new patients are welcome. Call (808) 777-9460 or start your request online.

If you or someone you love is thinking about suicide or self-harm, get help right away. Call or text the 988 Suicide & Crisis Lifeline (call or text 988, or chat at 988lifeline.org). In Hawaiʻi, Hawaiʻi CARES is available by calling or texting 988, or at 808-832-3100 / 800-753-6879. In a life-threatening emergency, call 911.

Medically reviewed by George Mackel, MSN, APRN, NP-C, PMHNP-BC, CARN-AP — President & Owner, OhanaPsych / Ohana Care Clinic.
Last reviewed: June 28, 2026. Citations verified: June 28, 2026.

This page is general health education from OhanaPsych. It is not a substitute for a personal evaluation by a qualified clinician who knows your situation, and reading it does not create a provider–patient relationship. If you think you may have a mental health condition, reach out to us or another licensed provider. In an emergency, call 911.

References

Attarha, M., Mahncke, H., & Merzenich, M. (2024). Real-world usability, feasibility, and performance of deploying a digital toolbox of computerized assessments to remotely evaluate brain health. JMIR Formative Research, 8, e53623. https://doi.org/10.2196/53623

Boelders, S. M., Gehring, K., Postma, E. O., Rutten, G. M., & Ong, L. S. (2024). Cognitive functioning in untreated glioma patients: The limited predictive value of clinical variables. Neuro-Oncology, 26(4), 670–683. https://doi.org/10.1093/neuonc/noad221

Çakır, B., Uzun Çakır, A. D., Yalın Sapmaz, Ş., Bilaç, Ö., Taneli, F., & Kandemir, H. (2024). Cognitive functioning of adolescents using methamphetamine. Applied Neuropsychology: Child. https://doi.org/10.1080/21622965.2024.2323643

CNS Vital Signs. (2025). Publications (peer-reviewed manuscripts and clinical trials using CNS Vital Signs; updated November 17, 2025). https://www.cnsvs.com/Publications.html

CNS Vital Signs. (n.d.). Computerized neurocognitive assessment software. https://www.cnsvs.com/

CNS Vital Signs. (n.d.). Tests and clinical domains guide. https://www.cnsvs.com/

DesRuisseaux, L. A., Gereau Mora, M., & Suchy, Y. (2024). Computerized assessment of executive functioning: Validation of the CNS Vital Signs executive functioning scores in a sample of community-dwelling older adults. The Clinical Neuropsychologist, 39(1), 159–181. https://doi.org/10.1080/13854046.2024.2354953

Estelle, M. C. P., & Voelbel, G. T. (2024). The effect of processing speed on verbal and visual memory of adults with a chronic acquired brain injury. Brain Injury, 38(3), 170–176. https://doi.org/10.1080/02699052.2024.2309250

Gualtieri, C. T., & Johnson, L. G. (2006). Reliability and validity of a computerized neurocognitive test battery, CNS Vital Signs. Archives of Clinical Neuropsychology, 21(7), 623–643. https://doi.org/10.1016/j.acn.2006.05.007

İnci İzmir, S. B., Aktan, Z. D., & Ercan, E. S. (2024). Assessing the mediating relationships between psychological factors in children with ADHD and cognitive disengagement syndrome. Applied Neuropsychology: Child. https://doi.org/10.1080/21622965.2024.2341251

Little, B., Anwyll, M., Norsworthy, L., Corbett, L., Schultz-Froggatt, M., & Gallagher, P. (2024). Processing speed and sustained attention in bipolar disorder and major depressive disorder: A systematic review and meta-analysis. Bipolar Disorders, 26(2), 109–128. https://doi.org/10.1111/bdi.13396

Meador, K. J., Seliger, J., Le, S., Li, Y., Razavi, B., et al. (2025). Cognitive and behavioral effects of perampanel 4 mg daily dose. Epilepsy & Behavior, 164, 110268. https://doi.org/10.1016/j.yebeh.2025.110268

Miao, I. Y., Gifford, K., Kerr, Z. Y., Cole, W. R., Guskiewicz, K. M., McCrea, M. A., & Brett, B. L. (2025). Intraindividual variability, subjective cognitive difficulties, and head injury history in former collegiate athletes. The Clinical Neuropsychologist. https://doi.org/10.1080/13854046.2025.2479213

Stafford, C. (2024). CNS Vital Signs. In Clinical integration of neuropsychological test results (p. 215). Taylor & Francis.

Vaessen, T., Mark, R. E., De Baene, W., Gehring, K., Overeem, S., & Sitskoorn, M. M. (2024). Cognitive complaints in patients with untreated obstructive sleep apnea versus patients with neurological and respiratory diseases. Sleep & Breathing. https://doi.org/10.1007/s11325-024-03056-7

New patients welcome

Call (808) 777-9460 or start your request online.

New Clients Begin Here

Does OhanaPsych accept QUEST, Medicaid, and insurance for neurocognitive testing?

Yes. We are in network with the Hawaiʻi QUEST Integration plans — AlohaCare, HMSA, ʻOhana Health Plan, and UnitedHealthcare Community Plan — and we also accept Medicare and most commercial insurance. If you are not sure about your coverage, contact our office and we will help you check.

Can I receive neurocognitive testing by telehealth, or do I need to come into the office?

We offer both. You can be seen in person at our Honolulu or Hilo office, or by secure telehealth from anywhere in Hawaiʻi. Some visits or treatments may require an in-person appointment, and we will let you know if that applies to your care.

How do I make an appointment for neurocognitive testing?

You can request an appointment through our online scheduling page, or call us at (808) 777-9460 for Honolulu or (808) 867-8002 for Hilo. We welcome new patients and will help match you with the right provider.

Who provides neurocognitive testing at OhanaPsych?

Care is provided by our team of licensed, board-certified psychiatric providers. You can read about each member of our team on our Providers page.