TY - JOUR
T1 - How We Work Now
T2 - Preliminary Review of a Pediatric Neuropsychology Hybrid Model in the Era of COVID-19 and beyond
AU - Lichtenstein, Jonathan D.
AU - Amato, Jennifer T.
AU - Holding, Emily Z.
AU - Grodner, Kelsey D.
AU - Pollock, Erica N.
AU - Marschall, Kelsea P.
AU - Scull, Sara
N1 - Publisher Copyright:
© 2021 The Author(s) 2021. Published by Oxford University Press. All rights reserved.
PY - 2022/2/1
Y1 - 2022/2/1
N2 - Objective: Although telehealth has become a central component of medical care in response to the coronavirus disease 2019 (COVID-19) pandemic, comprehensive pediatric neuropsychological assessment over virtual platforms lacks empirical efficacy. This paper presents: a) the results of a quality improvement project examining the feasibility of in-person evaluation in the context of safety measures that alter test standardization, b) the impact such changes had upon neuropsychological test scores, and c) how using a hybrid model of clinical service delivery affected access to care. Method: We compared demographic and outcome variables between patients seen during the pandemic (N = 87) to a group of patients seen in our service immediately prior to COVID-19 (N = 87). A subset of those patients were case-matched for age and diagnosis (N = 39 per group). Children seen for neuropsychological re-evaluation during the pandemic (N = 10) were examined using pairwise comparison. Results: Groups did not differ on age, sex, or FSIQ. Despite changes to standardized administration, no group differences were found for any selected neuropsychological test variables in the larger sample or subsamples. In fact, all variables were moderately to highly correlated in the re-evaluation subgroup. The hybrid model expedited feedback sessions and increased face-to-face (telehealth) feedbacks. Conclusions: A hybrid model incorporating modified in-person testing and intake and feedback encounters via telehealth may be a feasible and effective way to provide pediatric neuropsychological services. These preliminary findings suggest such novel aspects of neuropsychological evaluation could represent an improvement over pre-COVID models, especially in rural settings.
AB - Objective: Although telehealth has become a central component of medical care in response to the coronavirus disease 2019 (COVID-19) pandemic, comprehensive pediatric neuropsychological assessment over virtual platforms lacks empirical efficacy. This paper presents: a) the results of a quality improvement project examining the feasibility of in-person evaluation in the context of safety measures that alter test standardization, b) the impact such changes had upon neuropsychological test scores, and c) how using a hybrid model of clinical service delivery affected access to care. Method: We compared demographic and outcome variables between patients seen during the pandemic (N = 87) to a group of patients seen in our service immediately prior to COVID-19 (N = 87). A subset of those patients were case-matched for age and diagnosis (N = 39 per group). Children seen for neuropsychological re-evaluation during the pandemic (N = 10) were examined using pairwise comparison. Results: Groups did not differ on age, sex, or FSIQ. Despite changes to standardized administration, no group differences were found for any selected neuropsychological test variables in the larger sample or subsamples. In fact, all variables were moderately to highly correlated in the re-evaluation subgroup. The hybrid model expedited feedback sessions and increased face-to-face (telehealth) feedbacks. Conclusions: A hybrid model incorporating modified in-person testing and intake and feedback encounters via telehealth may be a feasible and effective way to provide pediatric neuropsychological services. These preliminary findings suggest such novel aspects of neuropsychological evaluation could represent an improvement over pre-COVID models, especially in rural settings.
KW - Assessment
KW - Childhood neurologic disorders
KW - Children and behavioral disorders
KW - Professional issues
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U2 - 10.1093/arclin/acab041
DO - 10.1093/arclin/acab041
M3 - Article
C2 - 34050361
AN - SCOPUS:85119454026
SN - 0887-6177
VL - 37
SP - 40
EP - 49
JO - Archives of Clinical Neuropsychology
JF - Archives of Clinical Neuropsychology
IS - 1
ER -