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Videoconference-integrated, computer-assisted cognitive testing improves the remote assessment of processing speed

Jodie E Chapman1, Christoph Helmstaedter2, David F Abbott1,3,4

  • 1https://ror.org/03a2tac74Florey Institute of Neuroscience and Mental Health, Heidelberg, VIC, Australia.

Journal of the International Neuropsychological Society : JINS
|October 22, 2025
PubMed
Summary

Remote teleneuropsychology assessments show promise. Oral Symbol Digit Modalities Task (SDMT) and digital Trail Making Test (TMT) closely match in-person versions, offering potential for standardized remote cognitive testing.

Keywords:
attentioninformation processing speedneuropsychological testssymbol digits modalities tasktelehealthtrail making test

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Area of Science:

  • Neuropsychology
  • Digital Health
  • Cognitive Assessment

Background:

  • Remote neuropsychological assessments are underutilized.
  • Teleneuropsychology (TeleNP) offers accessible cognitive testing solutions.
  • Evaluating TeleNP-suitable versions of Symbol Digit Modalities Task (SDMT) and Trail Making Test (TMT) is crucial.

Purpose of the Study:

  • To assess the validity of oral and digital SDMT and TMT for remote videoconference administration.
  • To compare TeleNP-suitable versions against traditional in-person written tests.
  • To determine the suitability of TeleNP for cognitive speed and attention measures.

Main Methods:

  • 321 adult participants with epilepsy completed in-person written SDMT and TMT.
  • 144 participants completed oral SDMT and TMT via videoconference.
  • 177 participants completed novel digital SDMT (Symbol Decoding) and TMT via custom software.

Main Results:

  • Oral SDMT and digital Symbol Decoding showed strong correlations with in-person written SDMT (r=0.77, r=0.76).
  • Digital TMT demonstrated better correlation with written TMT-B (r=0.71) than oral TMT (r=0.52).
  • Digital TMT better reflected cognitive demands compared to oral TMT.

Conclusions:

  • Oral SDMT and digital Symbol Decoding are valid remote alternatives to in-person SDMT.
  • Digital TMT is a more accurate remote assessment tool than oral TMT.
  • Videoconference-integrated digital assessments offer standardization, automation, and rich metadata for future development.