The Neuropsychonline system is a rich internet application (RIA) in that we actually provide working, interactive programs and applications that run directly in your web browser. There is no software to purchase or install except possibly to update your web browser's Adobe Flashplayer (a free download from < www.adobe.com >). Upgrades are automatic since you run from the one and only master every time you select a program. And, once you subscribe as a provider, you have unlimited use of the software to assess, diagnose, write clinical reports about and treat an unlimited number of patients. Since NPO is delivered over the internet you can login from any computer, anywhere, to run reports or do therapy with a patient. We will highlight a few of our applications through this tour so you can learn more about what we provide, but the best way to experience the site is to take out a subscription or request our one week free trial and give it a try. If you prefer, or your situation requires that you purchase software rather than subscribe to our website, please visit our parent company, Psychological Software Services Inc.

If you are seeking treatment for an injury, disease or anomaly of the brain then please take a look at our Provider Directory (Provider link above on the blue navigation bar!) to find a Neuropsychonline clinician subscriber in your area that may be using our system. If you want to do our cognitive rehabilitation therapy and no one is listed as a provider in your area please call us at (317) 257-9672, Monday through Friday, or email us at info@neuropsychonline.net, anytime, and we can help you find a therapist or make other special arrangements for you to be able to do the therapy program.

Who can subscribe? Any professional in the healthcare or education fields who provides assessment, therapy and/or educational services is eligible for membership. This includes, but is not limited to, psychologists, physicians, nurses, speech therapists, occupational therapists, cognitive therapists, counselors, professors, teachers etc..

To best use our website you should have a PC or Macintosh capable of displaying at a minimum of 1024x768 resolution with 24 bit (thousands) or 32 bit (millions) color. Our applications will adjust to your screen but basically higher resolution is better and lower resolution is not.

About Neuropsychonline

Neuropsychonline now has over 300 members providing diagnostic and therapy services to 3000+ brain impaired patients. Dr. Odie Bracy, a neuropsychologist, founder of Neuropsychonline and a leader in the development of cognitive rehabilitation therapies since 1982, says that this new internet based system for neuropsychological diagnostics and cognitive rehabilitation therapy, "is a natural evolution of the services that we have provided at the Neuroscience Center of Indianapolis (NSC) since 1984." NSC is a clinical service and research facility established in 1984 to provide diagnostic, rehabilitation and psychotherapy services to those with cognitive and/or psychological problems having a neurological basis or producing neurological symptoms. Clinical services at NSC include diagnostic and therapeutic treatment programs for individuals who are experiencing brain injury, stroke, learning/developmental disabilities, attention deficit disorders or other neurological based anomalies.

The purpose of the cognitive rehabilitation therapy offered at the NeuroScience Center is to help an individual acquire the highest level of cognitive functioning and functional independence possible for that individual. This is accomplished through treatment programs utilizing retraining strategies, teaching the use of compensatory skills (for areas not amenable to retraining), counseling, environmental restructuring, utilizing the services of educational and vocational training facilities and following our patients as they go into their next placement, be it work, school or just better living at home. Our work with the patient centers around that person's thinking skills, perception, memory, problem solving and decision making skills. We (with hard work from our patients) have succeeded in producing statistically significant improvements in psychometrically measured indices of cognitive functioning; however, it is our goal that these changes result in significant improvement in functioning and meaningful participation in daily life events. Neuropsychonline and Challenging Our Minds form the core of our cognitive rehabilitation activities.

Our therapy program is set up as a combination clinic and homebased, outpatient computer assisted rehabilitation program. The patient is seen at our center for 1 one-hour visit each week. During this intensive, interactive session, we evaluate the patient on all therapy exercises prescribed at the last session, troubleshoot cognitive strategies and performance difficulties, re-evaluate our treatment plan and prescribe the therapy exercise assignments for the upcoming week. We discuss compensation skills, strategy development and deployment and how all of what is learned in therapy can be used in daily life activities. The patient then performs the therapy exercises at home, on their own computer, for at least 1 to 3 one-hour periods each and every day between the weekly sessions at the center, incorporating and practicing the compensation skills and strategies discussed during the face-to-face session. The whole program, as we administer it, typically takes the patient about 9 to 12 months to complete.

Therapy utilizing our Neuropsychonline system and conducted in the manner described above would be in compliance with the multimodal model of cognitive rehabilitation therapy (page 1607) as per Cicerone's, Evidence-Based Cognitive Rehabilitation: Recommendations for Clinical Practice (Archives of Physical Medicine and Rehabilitation 81(12), 1596-1615). The Chen et.al. (1997) research article referenced on page 1607 was conducted at our center utilizing our software applications.

Now, we are providing the homebased portion of our therapy services to our patients over the internet and through Neuropsychonline we are enabling other facilities and professionals to do this therapy in their facilities and also offer it to their patients for homebased use. In addition we have recently added Semi-Automated Comprehensive Chart Note capabilities to each and every exercise within the therapy system to guide and help clincians conduct and document their therapy endeavors. Just click the Chartnotes button and indicate what you want included in your chartnote. One must experience NPO over the internet to fully appreciate how nicely this teletherapy system operates.

NPO Libraries

The NPO website is divided into two Libraries -- the Library Of Neuropsychological Applications (LONA), which contains applications for assessment, differential diagnosis, clinical report writing, and treatment, and the Library Of Neuropsychological Information (LONI), which contains educational information about neuroanatomy and neurophysiology along with full access to the eJournal of Cognitive Rehabilitation and 25+ years of its archived articles.

Library Of Neuropsychological Applications (LONA)

LONA contains programs and dynamic web pages for:

1. Assessment
2. Differential Diagnosis
3. Clinical Reports
4. Treatment

Assessment

Our current assessment applications include the Brief Examination for Aphasia (BEA), the NPO-Brief Mental Status Examination with automated report (NPO-BMSE) and the Visual Fields Screening Test.

The BEA provides a comprehensive, computer administered examination for symptoms of aphasia. This program does provide diagnostic interpretation of the data provided by the patient's responses. ( Example Report)

The NPO-BMSE was designed to provide a brief evaluation of mental status that is more in concert with a neuropsychological perspective. In addition, we wanted to be able to generate an automated report from the NPO-BMSE that would provide more meaningful information to the clinician concerning the patient's capabilities and also serve as a starting point for further clinical procedures. The examination is a little more comprehensive than the typical mental status examination but can be completed in less than 20 minutes. (Example Report)

The Visual Fields Screening Test produces a visual field map showing problematic areas via shadows generated from reaction time data.

Differential Diagnosis

We have developed a differential diagnosis program, "Dx of Congenital Syndromes and Anomalies" based closely on the text "Smith's Recognizable Patterns of Human Malformation, 5th Edition". After you select, define and submit your patient's symptoms from the interactive interface, you receive a report showing the three most likely syndromes, given the symptoms selected.

Our Headache Evaluation is the most comprehensive we have seen and it writes a report that can be utilized with little or no editing. It has already been adopted by one large insurance company as their instrument for evaluating and documenting their covered headache patients. In addition to organizing the evaluation data collected into a clear and precise report the program offers the top three "most probable diagnoses" given the symptoms provided. Click on each of the thumbnail pictures below to see screen captures of the Headache Evaluation and Report.

The AphasiaDx program is a quick differential diagnosis for aphasia that can be based on clinical observation and/or clinical testing. Upon responding to questions concerning the patient's symptomology, the user is presented with the name and definition of the most likely aphasia syndrome along with an illustration showing the most likely areas of the brain that, when damaged, would produce the aphasia.

The VisionDx program is a quick differential diagnosis for localization of brain lesions based upon visual field defects. With data from a visual fields examination, the clinician can browse through the display panels to match up the results. The panel displays the possible lesion sites and indicates the vascular distribution that might be involved, when appropriate.

Clinical Reports

We currently provide Clinical Reports for the WISC-III, WISC-IV and WAIS-III batteries for intellectual assessment. If you enter data you have collected from full examinations (ie you administered all the subtests and optional procedures) you will receive back a comprehensive, narrative report of about 15 pages written in a clear and informative manner making it most useful to you and to your referral sources for comprehensive diagnosis and treatment of your patients. Data tables and performance graphs are equally clear and understandable. However, if you elect to do only partial batteries you can still get a meaningful report, even if you only administered one subtest. All of our reports can be printed directly from the web page or copied and pasted into your word processor for editing by you. All reports now include weakness specific recommendations for remediation. Click on the thumbnails below to see screen captures from the data entry screens and the clinical reports.

Treatment

We are most proud to present our web-based Neuropsychonline Cognitive Rehabilitation Therapy System to you. We have developed and provided software for cognitive rehabilitation for over twenty-five years with our PSSCogRehab System which is still available, now on flashdrive, at < www.psychological-software.com > . In developing our new Neuropsychonline Cognitive Rehabiltiation Therapy System we applied everything we have learned over that time period to make this system the very best it can be for the treatment of our patients with brain function impairment from whatever cause. The system consists of six Tracks of exercises comprised of:

1. Track I: Attention Skills
   
   1. Simple Visual Reaction (fixed point)
   2. Simple Auditory Reaction (fixed point)
   3. Simple Visual Reaction (random point)
   4. Simple Auditory Reaction (random point)
   5. Choice Visual Reaction (fixed point)
   6. Choice Auditory Reaction (fixed point)
   7. Choice Visual Reaction (random point)
   8. Choice Auditory Reaction (random point)
   9. Divided Visual Attention I
   10. Divided Auditory Attention I
   11. Divided Visual Attention II
   12. Divided Auditory Attention II
   
   
2. Track II: Executive Skills
   
   1. Organizing Information (commonality)
   2. Attributes and Groups
   3. Flash Count
   4. Even or Odd
   5. Digit Symbol Transfer
   6. Sequences
   7. Stroop Effects
   8. Stroop Effects II
   9. Serial Addition
   10. Simultaneous Multiple Addition
   11. Dials
   12. Keeping Track
   
   
3. Track III: Memory Skills
   
   1. Sequenced Recall { Digits [ visual ] }
   2. Sequenced Recall { Digits [ auditory ] }
   3. Reversed Sequenced Recall { Digits [ visual ] }
   4. Reversed Sequenced Recall { Digits [ auditory ] }
   5. Sequenced Recall { Tones [ auditory ] }
   6. Sequenced Recall { Graphics [ visual ] }
   7. Colormatch
   8. Trail Trace
   9. Sequenced Blocks
   10. Recall for Objects
   11. Recall for Locations
   12. Recall for Objects and Locations
   
   
4. Track IV: Visuospatial Skills
   
   1. Luminosity Discrimination
   2. Line Discrimination
   3. Angle Discrimination
   4. Design Completion
   5. Shape and Pattern Discrimination
   6. Complex Animated Pattern Discrimination
   7. Ball-in-a-Box
   8. How Many Blocks?
   9. Paddle Ball
   10. Designer Patterns
   11. Visual Analysis and Synthesis
   12. Visualization from Blueprints
   
   
5. Track V: Problem Solving Skills
   
   1. Deduce It (Number puzzle requiring deductive reasoning)
   2. Nines All Around (Missing numbers puzzle)
   3. Kubos (Simplified Rubik's cube type puzzle)
   4. Deductions
   5. Sink It
   6. Escape
   7. Out of Order (Re-sequencing puzzle)
   8. Simply Logical (Logic Master type puzzle)
   9. Machines
   10. Matrix Deductions
   11. Pyramids (Towers of Hanoi type puzzle)
   12. Checker Exchange
   
   
6. Track VI: Communication Skills
   
   1. Recognizing Emotions (From facial expression)
   2. Body Language
   3. What Am I Doing?
   4. Tone Discrimination I
   5. Tone Discrimination II
   6. Auditory Figure-Ground
   7. Follow My Instructions (written)
   8. Follow My Instructions (vocal)
   9. Phoneme Discrimination I (Consonants)
   10. Phoneme Discrimination II (Vowels and Dipthongs)
   11. Word Completion I (vowels)
   12. Word Completion I (consonants & diphthongs)

Screenshots from therapy exercises.

We currently have 72 fully functional tasks online and ready to use with four levels of skill in all but three of those tasks. The Tasks within each Track are already arranged in the most appropriate protocol/order for presentation to your patient. Patients' performance is continuously assessed by the system and they are automatically passed up to the next level when performance reaches a certain criterion. If you choose to use our Automatic Rx path, the system will also advance a patient to the next Task within a Track when the current Task is fully mastered. However, under manual control the therapist can modify Rxs and choose what will be presented to the patient. With just a click on a menu item presented on the therapist control panel screen the therapist can "Add a new patient, Select the patient from a roster, Write a Rx, Run a task with a patient, View/Print a patient's data table or progress report or Sign Up a patient for homebased therapy."

For patients treated in your facility or office through your interface, there is no fee and no limit on the number of sessions. For patients that you want to set up on an outpatient, homebased/+office cognitive rehabilitation scenario (this means - you see the patient on a regular basis for a face-to-face therapy session, typically at your office, and then you have the patient practice the exercises, on a daily basis, at home, between the office visits) , you can help the patient establish their own patient interface subscription for a very low fee to the patient ($25.00 per month). You control everything the patient does at home through prescriptions that you set up for them (or choose to use our preset automated prescription). The patient can access their subscription from any computer connected to the internet. They could do their therapy from a different computer every day and it would make no difference to the system. You can monitor their progress through our automatic progress reports and data tables (both suitable for printing out to include in the patient's paper charts). Reports and tables are made comprehensive by the fact that all data generated by the patient, as they do their therapy at home or in your office, are stored in our central database. In addition, a clinician can now print a comprehensive chart note that details areas of discussion concerning the demands of the task, compensation techniques, performance strategies and more. Ratings of patient performance within a number of task specific parameters can be selected and additional patient specific comments can be easily added to the chart note by typing the comments directly on the screen.

Screenshots from the Administrator's Module.

You may run a trial version of one of our exercises by clicking on the link below. If you experience any difficulty running the program you may need to obtain and install the Flash Player from www.adobe.com, free of charge, by clicking --

Library Of Neuropsychological Information (LONI)

LONI provides more informational and educational type services for our subscribers. We already have presentations covering some basic neuroanatomy and plenty more already in progress for later inclusion.

The premiere offering of the LONI side of our website is the complete, searchable archives of 25+ years of The Journal of Cognitive Rehabilitation. Use our clickable index of all past articles or search by keyword or author's name and receive back a listing (with abstract) of all articles in the archive relevant to your search. If you find an article of interest just click on the download button and a PDF format, full reprint copy of the article is quickly downloaded to your computer. There are no limits imposed on your use of this service.

We hope you have enjoyed our tour enough to prompt you to subscribe to Neuropsychonline. Just click on the Subscribe button above or on our home page to get to our automated order form. Your application and credit card can be authorized immediately and you could be using our site within the next 15 minutes or less. Hope to see you there!

If you need to order on purchase order/invoice or would rather order by phone please call us (317) 257-9672.

Subscription Rates for Providers:

1. Monthly Draft @ $50.00 per month
2. Semi Annual Draft @ $275.00 per six months (save $25.00 every six months)
3. Annual Draft @ $525.00 per year (save $75.00 per year)

Subscription Rates for Patients:

1. For therapy in your therapist's office, using their membership -- no charge from NPO
2. Personal subscription for at home use @$25.00 per month (if there are no therapists in your area, call us to arrange a personal subscription 317-257-9672)