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Pediatric Teleneuropsychology: Feasibility and Recommendations
Danielle M Ransom1, Sakina M Butt1, Emily K DiVirgilio1
1Johns Hopkins All Children's Hospital, Center for Behavioral Health, Division of Neuropsychology, St. Petersburg, FL, USA.
Insights
Teleneuropsychology (TeleNP) is feasible for pediatric patients, showing accessibility and similar attendance rates. It may serve as an efficient screening tool for quicker diagnosis and treatment planning.
Area of Science:
- Neuropsychology
- Telemedicine
- Pediatric Healthcare
Background:
- Teleneuropsychology (TeleNP) is established in adult literature.
- TeleNP offers a promising avenue within telemedicine.
- Pediatric TeleNP requires specific guidance for best practices.
Purpose of the Study:
- Demonstrate the feasibility of TeleNP in pediatric patients.
- Disseminate clinical decision-making procedures for pediatric TeleNP.
- Establish best practices for pediatric TeleNP.
Main Methods:
- Retrospective data collection from a pediatric clinical cohort (N=129).
- Study conducted during the COVID-19 pandemic (March-June 2020).
- Compared in-person assessments rescheduled to TeleNP.
Main Results:
- TeleNP was accessible for most pediatric patients and families.
- No demographic differences in attendance, testing, or referral for follow-up.
- Laptop/desktop users were more likely to complete remote testing than phone/tablet users.
Conclusions:
- Pediatric TeleNP is feasible for initial diagnosis and treatment planning.
- TeleNP may be most effective as a screening tool due to measure limitations and behavioral challenges.
- Standardized TeleNP screening can improve care efficiency with shorter batteries and reduced wait times.
Objective:
Teleneuropsychology (TeleNP) is a growing and promising practice within the telemedicine landscape that has been well established within the adult neuropsychology literature. This project aimed to demonstrate the feasibility of TeleNP in a pediatric clinical population and disseminate clinical decision-making procedures to guide best practices for pediatric TeleNP.
Method:
This project conducted during the 2019 coronavirus (COVID-19) pandemic reflects the largest clinical cohort to date of TeleNP in a pediatric population (N = 129). Data were gathered retrospectively from patients who were rescheduled from in-person assessment to TeleNP between March to June 2020.
Results:
TeleNP was an accessible option for most patients and families, with no differences in demographic variables in patient appointment attendance, whether testing was conducted, and whether the patient was referred for face-to-face follow-up. Patients using laptops/desktops were more likely to undergo remote test administration in comparison with patients using phones/tablets (χ2 = 23.83, p < .002). Sixty-three percent of the sample were referred for a face-to-face follow-up assessment.
Conclusions:
TeleNP is feasible in a pediatric clinical population ranging to begin the process of differential diagnosis and treatment planning. Pediatric TeleNP may be most efficacious as a screening procedure due to limited measures suited for remote administration and behavioral challenges interfering with testing requiring in-person follow-up. TeleNP screening as standard practice for patients who do not require a full, traditional neuropsychological battery may provide a more efficient care model, with more patients able to be seen using shorter batteries with less wait time.
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