Home-Based Pediatric Teleneuropsychology: A validation study

Abstract

Objective To evaluate home-based teleneuropsychology in a pediatric cohort to determine if assessment via in-person and home-based videoconference yield similar results. The second objective was to determine the level of satisfaction with videoconference-based assessment among participants and caregivers. Method Fifty-eight participants, aged 6–20 years, were recruited through specialty programs for pediatric demyelinating disorders. Each participant was administered the same brief neuropsychological battery of common measures twice, once during an in-person session and once during a remote home-based videoconference session. Order of sessions was counterbalanced and time between assessments ranged from 1 to 50 days. It was hypothesized that results obtained through in-person vs. remote videoconference sessions would not be significantly different and that most participants and caregivers would rate the experience with teleneuropsychology as satisfactory. Results Mann–Whitney U tests showed no significant differences in results obtained in the in-person first vs. remote videoconference first sessions or the change in performance across sessions. Satisfaction ratings by participants and caregivers were largely favorable for the use of the videoconference testing format. Conclusions The current study is the first to validate home-based teleneuropsychology and is the first to validate teleneuropsychological assessment in a pediatric sample. Future studies should replicate these findings as well as expand on sample size, diversity of populations evaluated, and the assessment tools administered. Careful consideration of ethical and practical factors should be given before providing pediatric teleneuropsychology services.

Pediatric Teleneuropsychology: Feasibility and Recommendations

“…Anecdotally, many providers have stressed concern for the technical difficulties that may arise during a TeleNP evaluation. Consistent with findings in the adult TeleNP literature and Harder and coworkers (2020) , our results demonstrated a limited frequency of interruptions related to technical difficulties, comparable to typical interferences that may occur during an-person evaluation (e.g., noise control outside of the testing room, etc.). To minimize technological interruptions, providers should ensure that they are using a reliable platform and that patients are instructed in reliable network connectivity in advance.…”

“…Therefore, we were unable to replicate findings in the adult TeleNP literature demonstrating similar test results across remote and face-to-face assessment conditions. However, Harder and coworkers (2020) have recently validated home-based TeleNP in a pediatric sample. Further investigation of pediatric TeleNP is needed to replicate these findings, expand the sample size, population diversity, and measures used with pediatric subjects.…”

“…In both studies, a trained assistant was present on-site with participants to help with any technical difficulties, provide materials as needed, and co-score the assessments alongside a research assistant who was stationed remotely and provided the web-based administration. Most recently, the first investigation of in-home pediatric TeleNP showed good feasibility and reliability compared with in-person test results ( Harder et al ., 2020 ).…”

“…Despite the growing body of literature documenting the feasibility, reliability, and validity of TeleNP in adults, few studies to date have been conducted using in-home evaluation procedures in a pediatric population to determine feasibility with different patient characteristics ( Harder et al ., 2020 ). This project aimed to demonstrate the feasibility of TeleNP in a pediatric clinical population and disseminate clinical decision-making procedures to help guide pediatric TeleNP practice.…”

A Teleneuropsychology Consultation Service Model for Children with Neurodevelopmental and Acquired Disorders Residing in Rural State Regions

“…With technological advances, clinicians are now afforded an opportunity to provide neuropsychological services using telemedicine. Harder and colleagues shared the first pediatric study that indicated that home-based neuropsychological services may be valid, feasible, and acceptable for specific clinical populations with limitations due to medical conditions ( Harder et al., 2020 ). The importance of recognizing the breadth of clinical services neuropsychologists can offer patients has increased during the COVID-19 pandemic given the physical distancing constraints for in-person clinical neuropsychological evaluations ( Bilder et al., 2020 ).…”