Inter Organizational Practice Committee Recommendations/Guidance for Teleneuropsychology in Response to the COVID-19 Pandemic†

Abstract

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.

Patient Satisfaction with Telephone Neuropsychological Assessment

“…The COVID-19 pandemic catapulted the use of telehealth using a variety of modalities (telephone, video, computer based) in order to continue to provide services when in-person assessments were not possible or posed unnecessary risk. Although there are clear advantages to a video-based approach to teleneuropsychology, there are many patients who are unable to access this medium, often because of lack of access or familiarity with the technology (e.g., as discussed in Bilder et al., 2020 ). Thus, there continues to be a place for TeleNP, even as multiple platforms for video-based assessment are now available.…”

Pediatric Teleneuropsychology: Feasibility and Recommendations

“…Continuing to utilize TeleNP as standard screening practice for patients who do not require a full, the traditional neuropsychological battery may provide a more efficient care model, with more patients able to be seen using shorter batteries with less wait time. If impairment is found in a screening battery, patients may then be referred for a full, face-to-face neuropsychological evaluation ( Bilder et al ., 2020 ). Follow-up face-to-face assessment may be necessary for the majority of pediatric neuropsychology patients who require measures not suited for a remote administration, patients with behavioral challenges interfering with testing, or for children unable to access TeleNP services due to environmental or technological limitations.…”

“…In March 2020, an advocacy team established within The Inter Organizational Practice Committee (IOPC) provided recommendations regarding the use of TeleNP during the COVID-19 pandemic ( Bilder et al ., 2020 ). The IOPC is a team of practice chairs from the American Academic 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.…”

Identifying response and predictive biomarkers for Transcranial magnetic stimulation outcomes: protocol and rationale for a mechanistic study of functional neuroimaging and behavioral biomarkers in veterans with Pharmacoresistant depression

“…All self-report assessments will be administered via computer or tablet. Assessments that are not computerized will be administered and scored by a research coordinator or neuropsychology trainee via clinically developed teleneuropsychology procedures consistent with published guidelines [27][28][29][30] [34]. This measure was developed as a parallel instrument to the AUDIT and will be administered via computer or tablet.…”

“…However, under public health circumstances in which assessments may have to be conducted remotely, we will use teleneuropsychological administration. Teleneuropsychological administration is considered an appropriate alternative for several cognitive measures that will be used within this study [28,[60][61][62] and will be guided by best practices [27,29,30,63,64]. Certification requires attending a training seminar developed by a licensed clinical neuropsychologist, being cleared by the neuropsychologist or the appropriate proxy who is supervised by the neuropsychologist to administer each measure, and attending quarterly supplemental refresher courses.…”