Marrying Past and Present Neuropsychology: Is the Future of the Process-Based Approach Technology-Based?

Abstract

A cognitive assessment strategy that is not limited to examining a set of summary test scores may be more helpful for early detection of emergent illness such as Alzheimer's disease (AD) and may permit a better understanding of cognitive functions and dysfunctions in those with AD and other dementia disorders. A revisit of the work already undertaken by Kaplan and colleagues using the Boston Process-Approach provides a solid basis for identifying new opportunities to capture data on neurocognitive processes, test-taking strategies and response styles. Thus, this critical review will combine traditional process-based assessment strategies with support provided or offered by newer technologies that have the potential to add value to data collection and interpretation. There is now considerable interest in neuropsychological test administration using computer/digital technology, both in research and in clinical settings. To add value, any computerized version of an existing cognitive test should respect the administration procedure for which normative data were obtained, should be time-saving in terms of scoring and interpretation, and should, we argue, facilitate gathering information about the processes and strategies followed in test completion. This article will offer an overview of the steps needed when implementing computerization of neuropsychological tests using a Process-Based Approach (PBA) to these technology-based adaptations and will discuss further developments in this area by linking it to future technological developments that may be possible in the area of neuropsychological assessment. Additionally, an overview of neuropsychological tests that may benefit from computerization will be presented, together with suggestions on the specific processes, strategies and features that may be captured with the aid of such computerization. Finally, hypotheses on how virtual reality could be an asset for the future of the PBA to neuropsychological assessment will also be discussed.

Virtual reality expands the toolkit for conducting health psychology research

“…Other real‐world scenarios include driving (Liu et al., 1999), street crossing (Janouch et al., 2018), and classroom performance (Mühlberger et al., 2020). Many of these VR measurements have been validated in comparison with more traditional assessments, and in some cases outperform traditional tests (Diaz‐Orueta et al., 2020). The proliferation of these assessments speaks to the advantages of VR realism .…”

Digital neuropsychological assessment: Feasibility and applicability in patients with acquired brain injury

“…In addition, manual and verbal responses can be replayed afterward, avoiding observations or order of responses to be lost. Moreover, a digital response acquisition allows for a highly precise and detailed data collection, which opens the possibility to develop novel outcome measures to assess subtle cognitive impairments (Davis et al, 2015;Diaz-Orueta et al, 2020;Parsey & Schmitter-Edgecombe, 2013). A next step should be the development of additional outcome measures that go beyond the traditional outcome measures of paperand-pencil tests.…”

The journey is just as important as the destination—Digital neuropsychological assessment provides performance stability measures in patients with acquired brain injury

“…Neuropsychological paper-and-pencil tests are widely used to assess cognitive impairment [1][2][3][4]. Performances on these tests are usually scored by examining a final score, such as the total duration, number of correct responses, or a final drawing [5]. A well-known issue in neuropsychological assessment is the discrepancy between "normal" final scores and the difficulties patients encounter in daily life [6,7].…”

“…This method focuses by close observation, on the qualitative analyses of errors and the "process" or the means by which a patient attains a final outcome. Capturing and evaluating the process opens the possibility to assess more subtle cognitive impairment even when final scores are evaluated as normal [5,9,10].…”