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Tele-neuropsychological Assessment of Children and Young People: A Systematic Review
Elise J Walker1, Fenella J Kirkham1,2, Hanne Stotesbury1
1Developmental Neurosciences Unit and Biomedical Research Centre, UCL Great Ormond Street Institute of Child Health, London, England.
Insights
Pediatric tele-neuropsychology (TeleNP) assessments are feasible and acceptable for children. While generally reliable, further research is needed on specific cognitive domains and diverse populations.
Area of Science:
- Neuroscience
- Psychology
Background:
- The COVID-19 pandemic highlighted the need for remote pediatric neuropsychological assessments (TeleNP).
- Limited research exists on the reliability and feasibility of TeleNP for pediatric populations.
- Clinicians require evidence-based guidance for selecting and adapting TeleNP tools.
Purpose of the Study:
- To systematically review the feasibility, patient/family acceptability, reliability, and literature quality of pediatric tele-neuropsychology assessments.
- To synthesize current evidence on TeleNP for individuals aged 0-22 years.
Main Methods:
- A systematic review of studies published between May 2021 and November 2022.
- Searches conducted on PubMed, PsycINFO, and Google Scholar using terms related to pediatric tele-neuropsychology.
- Inclusion of 21 studies with data on feasibility, reliability, and acceptability; quality assessed using the AXIS tool.
Main Results:
- Pediatric TeleNP was generally feasible, with minimal behavioral differences reported.
- TeleNP was found to be acceptable to patients and families, receiving positive feedback.
- Nineteen studies assessed reliability; most found no significant differences from in-person assessments for cognitive domains like IQ, though some noted variability in attention and visuo-spatial tests.
Conclusions:
- Pediatric tele-neuropsychology is a viable assessment method.
- Further research should focus on a wider range of cognitive domains and employ larger, more diverse samples to enhance generalizability.
- Improved reporting of demographic data (sex, race, ethnicity) is crucial for literature quality.
Abstract:
The coronavirus pandemic identified a clinical need for pediatric tele-neuropsychology (TeleNP) assessment. However, due to limited research, clinicians have had little information to develop, adapt, or select reliable pediatric assessments for TeleNP. This preliminary systematic review aimed to examine the feasibility of pediatric TeleNP assessment alongside (1) patient/family acceptability, (2) reliability, and (3) the quality of the literature. Between May 2021 and November 2022, manual searches of PubMed, PsycINFO, and Google Scholar were conducted using terms related to "pediatric" and "tele-neuropsychology." After extracting relevant papers with samples aged 0-22 years, predefined exclusion criteria were applied. Quality assessment was completed using the AXIS appraisal tool (91% rater-agreement). Twenty-one studies were included in the review, with reported qualitative and quantitative data on the feasibility, reliability, and acceptability extracted. Across included studies, TeleNP was completed via telephone/video conference with participants either at home, in a local setting accompanied by an assistant, or in a different room but in the same building as the assessor. Pediatric TeleNP was generally reported to be feasible (e.g., minimal behavioral differences) and acceptable (e.g., positive feedback). Nineteen studies conducted some statistical analyses to assess reliability. Most observed no significant difference between in-person and TeleNP for most cognitive domains (i.e., IQ), with a minority finding variable reliability for some tests (e.g., attention, speech, visuo-spatial). Limited reporting of sex-assigned birth, racialized identity, and ethnicity reduced the quality and generalizability of the literature. To aid clinical interpretations, studies should assess underexamined cognitive domains (e.g., processing speed) with larger, more inclusive samples.
Supplementary Information:
The online version contains supplementary material available at 10.1007/s40817-023-00144-6.
