Q&A with Dr. Hunter Leckonby: Why Neuropsychological Testing Is Important
1. What drew you to the field of psychological and neuropsychological assessment?
"I was diagnosed with ADHD later in life, while I was in graduate school, and that experience really shaped my passion for assessment. After my diagnosis, I was able to look back at pieces of my childhood that I had previously viewed through the lens of anxiety or “I just didn't try hard enough” and recognize that, in reality, my brain just worked differently.
That's one of the things I love most about testing. So often, people know that something feels different or that they're struggling, but they don't necessarily have the words to explain why. This can be especially true for high-achieving individuals. They may be doing well academically or professionally, while the difficulties show up elsewhere (relationships, work performance, anxiety, self-esteem, effort to mask, etc).
Receiving a diagnosis can be incredibly validating because it gives someone a framework for understanding their experiences. Instead of wondering, “Am I just not trying hard enough?” or “Is everyone else struggling this much too?”, they can recognize that their brain genuinely processes certain things differently. For many of my adult clients, an evaluation is the first time they feel truly understood.
That's also why I tell people that it's never too late to pursue testing. That feeling of validation and being understood is powerful and invaluable, no matter what age. And for providers, if you suspect that there may be something more going on for a client, referring them for an evaluation can be an incredibly helpful next step in their journey."
2. Are there common misconceptions about learning disorders that you wish more parents, educators, and providers knew about?
"One of the biggest misconceptions is that learning difficulties are a matter of effort. A child with a learning disorder is not struggling because they are lazy, unmotivated, or simply not trying hard enough. In many cases, these children are putting in an enormous amount of effort. They just don't understand why their brain isn't responding in the way that adults around them expect it to.
For example, a child with dyslexia may be working incredibly hard to read throughout the school day. If they become frustrated, overwhelmed, or have an outburst when they get home, it doesn't mean they're a “bad kid.” They likely are just exhausted from spending so much energy trying to do something that is genuinely more difficult for them.
I sometimes use the analogy of an executive functioning “bouncer” when explaining ADHD. For many people, the brain has a bouncer at the door deciding which information and distractions get into the venue. With ADHD, that bouncer may be letting everyone in! There isn't the same filter keeping irrelevant distractions out. That's not a character flaw; it's simply part of how that person's brain operates.
The language adults use around these difficulties matters, too. Questions like “Are you really trying?” or “Did you study hard enough?” can unintentionally communicate blame. Over time, children may begin hiding their struggles or internalizing the belief that something is wrong with them, which can contribute to anxiety and low self-esteem.
Assessment helps us shift the question from “Why aren't they trying harder?” to “What is making this harder for them, and how can we help?”.
3. With students heading back to school, what are some signs that a child's academic difficulties may be more than just an adjustment to a new school year?
"Some adjustment is completely normal at the beginning of a new school year. What I would pay attention to is when that distress persists beyond the initial transition or begins significantly affecting a child's well-being.
That might look like heightened anxiety, changes in sleep or appetite, ongoing school avoidance, or increasingly negative statements about themselves, such as “I'm so dumb,” “I should be able to do this,” or “I don't understand why everyone else gets this and I don't.”
Another important sign can actually show up after school. Children with ADHD or learning difficulties may use an incredible amount of energy regulating themselves and keeping up throughout the school day. By the time they get home, there's very little left in the tank.
A child who comes home and needs hours to decompress, seems constantly on the verge of a meltdown during the school week, or has frequent after-school outbursts but seems relatively regulated on weekends may be telling us something important. Sometimes home is simply the first place where they feel safe enough to stop performing and holding everything together.
Rather than viewing that behavior as evidence that the child is “bad” or that a parent is doing something wrong, it can be helpful to get curious about what the child is working so hard to manage throughout the day."
4. Learning disorders can sometimes be overlooked in bright or high-achieving students. What might learning difficulties look like in these students?
"Learning disorders can absolutely exist in bright, high-achieving students. In fact, their strengths can sometimes help them compensate for their difficulties for years, making the signs much more subtle.
Instead of obvious signs in their academic performance, you might see anxiety around achievement, perfectionism, low self-esteem, or a student needing significantly more time than their peers to complete the same work.
It's the subtle differences we want to notice. Does your child need a lot of time to read a passage despite understanding what they read? Do they consistently need more time to finish tests? Do timed assignments cause significant anxiety? For some students with math-related learning difficulties, even the format can make a difference. They may perform much better when they can work problems out on paper than when they're expected to complete them on a computer.
Testing doesn't have to be about finding something “wrong.” I see it as a tool for helping someone reach their potential. A strengths-based evaluation identifies what someone does well alongside the areas where they may need additional support. If you're a square trying to fit into a round hole, the answer isn't to shave down the square. It's to find the square hole."
5. How can parents and providers distinguish between a learning disorder, ADHD, anxiety, or other factors that may be affecting a student's academic performance?
"It can be very difficult to distinguish between these concerns based on behavior alone because there can be significant overlap in how they present.
For example, difficulty concentrating could be related to ADHD, but it could also be connected to anxiety, a learning disorder, or another underlying factor. A child who avoids reading may appear unmotivated, but they may actually be avoiding an activity that requires significantly more effort for them than it does for their peers. Similarly, academic struggles can create anxiety, while anxiety itself can also interfere with academic performance.
Rather than focusing only on one symptom, comprehensive testing allows us to look at the whole picture, specifically, how a child thinks, learns, processes information, pays attention, and functions emotionally and behaviorally. That broader picture can help us better understand not only what a child is struggling with, but why."
6. When should a pediatrician, therapist, ADHD coach, or other provider consider referring a child or teen for comprehensive testing?
"One common thread I see among many of the clients who come to me for testing is distress. Regardless of whether the difficulty involves reading, writing, comprehension, attention, impulsivity, or hyperactivity, I want to know how that experience is affecting the child emotionally.
Are they becoming increasingly worried or frustrated? Is their self-esteem being affected? Are they frequently comparing themselves with siblings, friends, or classmates?
You might hear statements like, “Joey can finish his test on time, so why can't I?” “I can't do this,” or “I should be able to do this.”
Those statements can be subtle ways of asking for help, particularly in children whose academic performance otherwise looks “fine” from the outside.
You don't necessarily need to wait until a child is failing before considering an evaluation. If they're succeeding but experiencing significant distress or having to work disproportionately hard to maintain that success, it may be worth looking a little deeper."
7. What do you hope families and referral partners walk away with after an evaluation?
"More than anything, I hope people leave with a better understanding of themselves, like how their brain works, how they experience the world, and where their strengths lie.
Testing can be particularly validating because we're able to put objective data behind experiences someone may have struggled to explain. A person might discover, for example, that they are an exceptionally strong visual learner. Suddenly, it makes sense why the verbal strategies they've been trying haven't been particularly effective. Or the data may confirm that their processing speed is lower than expected, giving them permission to acknowledge that they genuinely need more time rather than continuing to blame themselves.
That information can also be incredibly helpful for parents. Instead of wondering why a particular strategy isn't working for their child, they can begin making adjustments at home and advocating for supports at school that are better aligned with how their child learns.
I also want families to leave with something practical. In addition to helping them understand the results, I provide concrete recommendations and resources they can begin using at school and at home. That way, the evaluation isn't simply a diagnosis or a report. This evaluation can be a roadmap for using the person's strengths to support the areas that are more challenging.
Ultimately, I want people to leave testing feeling understood, validated, and more equipped to move through the world in a way that works with their brain rather than constantly fighting against it."
About Dr. Hunter Leckonby
Dr. Hunter Leckonby approaches each assessment with compassion, recognizing neurodivergence as part of human diversity and identifying each person's unique cognitive, social, and emotional strengths and challenges. She specializes in evaluating women and children with ADHD, autism, and other high-masking forms of neurodivergence that are often overlooked or misidentified. Dr. Leckonby draws on her professional expertise and personal experience as a woman with ADHD to provide clarity, validation, and practical recommendations that foster confidence, self-understanding, and long-term well-being.
