This article discusses current approaches in the neuropsychological assessment of children and young people. An audit of assessments found that nearly a quarter of referrals for neuropsychological assessments could have been resolved more effectively without completing a cognitive assessment. The audit also found that families and young people often found the report difficult to understand or unhelpful. We highlight the difficulties we have had with specific aspects of this process in a paediatric and adolescent medicine psychology service, and discuss the approaches we have taken in the light of feedback from children, young people and parents. The article describes how a systemic framework has been used in processing and responding to referrals. It also gives case examples illustrating how systemic theory and principles have been incorporated into the written reports. Families have responded very favourably to the use of creative and child friendly language in the feedback.
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