This article reviews several assessment factors useful identifying the pres
ence of a possible medical illness or neurodevelopmental disorder contribut
ing to a client's adjustment problems. Use of behavioral observations, reco
rd reviews, brief neuro-behavioral screening tests, and the taking of a his
tory are outlined that can assist in raising the index of suspicion for org
anic influence. Also addressed are issues pertaining to referral for medica
l and specialty assessments, including neuropsychological evaluation.