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The American Medical Association Current Procedural Panel developed a new billing code making behavioral health screening a reimbursable healthcare service. The use of computerized testing as a means for cognitive screening and brief cognitive testing is increasing at a rapid rate. The purpose of this education paper is to provide information to clinicians, healthcare administrators, and policy developers about the purpose, strengths, and limitations of cognitive screening tests versus comprehensive neuropsychological evaluations. Screening tests are generally brief and narrow in scope, they can be administered during a routine clinical visit, and they can be helpful for identifying individuals in need of more comprehensive assessment. Some screening tests can also be helpful for monitoring treatment outcomes. Comprehensive neuropsychological assessments are multidimensional in nature and used for purposes such as identifying primary and secondary diagnoses, determining the nature and severity of a person's cognitive difficulties, determining functional limitations, and planning treatment and rehabilitation. Cognitive screening tests are expected to play an increasingly important role in identifying individuals with cognitive impairment and in determining which individuals should be referred for further neuropsychological assessment. However, limitations of existing cognitive screening tests are present and cognitive screening tests should not be used as a replacement for comprehensive neuropsychological testing.
Cognitive decline after cardiopulmonary bypass (CPB) surgery has been a concern since the advent of CPB procedures. A primary focus of many studies on this topic has been to quantify the incidence of post-CPB cognitive impairment. However, studies that have used traditional parametric statistics have generally failed to confirm that long-lasting (> or = 1 month) cognitive declines occur reliably after CPB surgery. For the present study, the authors used a split-plot analysis of variance model that revealed preoperative memory impairments in the CPB patients and new postoperative impairments of attention. The authors discuss the assumptions of, and problems associated with, analysis methods that are often used to quantify the incidence of cognitive impairment following CPB surgery.
Objective: The Inter Organizational Practice Committee (IOPC) convened a workgroup to provide rapid guidance about teleneuropsychology (TeleNP) in response to the COVID-19 pandemic. Method: A collaborative panel of experts from major professional organizations developed provisional guidance for neuropsychological practice during the pandemic. The stakeholders included the American Academy of Clinical Neuropsychology/American Board of Clinical Neuropsychology, the National Academy of Neuropsychology, Division 40 of the American Psychological Association, the American Board of Professional Neuropsychology, and the American Psychological Association Services, Inc. The group reviewed literature, collated federal, regional and state regulations and information from insurers, and surveyed practitioners to identify best practices. Results: Literature indicates that TeleNP may offer reliable and valid assessments, but clinicians need to consider limitations, develop new informed consent procedures, report modifications of standard procedures, and state limitations to diagnostic conclusions and recommendations. Specific limitations affect TeleNP assessments of older adults, younger children, individuals with limited access to technology, and individuals with other individual, cultural, and/or linguistic differences. TeleNP may be ARTICLE HISTORY
Objective
The Inter Organizational Practice Committee convened a workgroup to provide rapid guidance about teleneuropsychology (TeleNP) in response to the COVID-19 pandemic.
Method
A collaborative panel of experts from major professional organizations developed provisional guidance for neuropsychological practice during the pandemic. The stakeholders included the American Academy of Clinical Neuropsychology/American Board of Clinical Neuropsychology, the National Academy of Neuropsychology, Division 40 of the American Psychological Association, the American Board of Professional Neuropsychology, and the American Psychological Association Services, Inc. The group reviewed literature; collated federal, regional, and state regulations and information from insurers; and surveyed practitioners to identify best practices.
Results
Literature indicates that TeleNP may offer reliable and valid assessments, but clinicians need to consider limitations, develop new informed consent procedures, report modifications of standard procedures, and state limitations to diagnostic conclusions and recommendations. Specific limitations affect TeleNP assessments of older adults, younger children, individuals with limited access to technology, and individuals with other individual, cultural, and/or linguistic differences. TeleNP may be contraindicated or infeasible given specific patient characteristics, circumstances, and referral questions. Considerations for billing TeleNP services are offered with reservations that clinicians must verify procedures independently. Guidance about technical issues and “tips” for TeleNP procedures are provided.
Conclusion
This document provides provisional guidance with links to resources and established guidelines for telepsychology. Specific recommendations extend these practices to TeleNP. These recommendations may be revised as circumstances evolve, with updates posted continuously at OPC.online.
To learn how culture may affect neuropsychological performance, eight tests were administered to non-brain damaged adult volunteers in the United States and Russia. The tests included Ruff Figural Fluency Test (RFFT), Color Trails Test (CTT), Digit Span Forward and Backward, and Category Fluency Test. Verbal and Visual Memory measures and Blind Clock Test were selected from Luria's (1980) battery. Forty-two Russian and 42 American volunteers (age 18-44) were assessed. It was hypothesized that the American group would outscore the Russian on timed measures (RFFT & CTT) due to cultural differences in familiarity with timed testing procedures. Otherwise, significant differences between the two groups were not expected to emerge. Consistent with the hypotheses, significant effect of culture was found on CTT and RFFT in favor of the American group. ANCOVA suggested that intergroup differences were not fully explained by differences in subjective relevance of the tasks to culture-specific experiences. The rest of the tests appeared similar for potential application in both cultures.
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