Home-based pediatric remote neuropsychological assessments that have been shown to be effective

Reviewed by Emily Henderson, B.Sc.September 24, 2020

It is feasible to manage neuropsychological assessments online for children comfortably in their own homes, with results comparable to traditional tests in the clinic. Survey results published online this month Archive of clinical neuropsychology, May help increase access to professionals and reduce barriers to care. Remote medicine COVID-19 Grow during a pandemic.

Patients with a variety of neuropathy require regular neuropsychological assessments to track cognition, academic ability, memory, attention, and other variables. These tests are usually done in the clinic and are often done by specialists in these diseases.

But Dr. Lana Harder, ABPP, Associate Professor explains Psychiatry And in UTSW’s neurology, many patients travel hundreds of miles to see a specialist. This is a great expense and inconvenience that can cause fatigue and affect the results. Harder also leads the Neuropsychology Services and is the Director of Neuropsychology Training at Children’s Health.

Studies on adults have shown that these assessments can be performed effectively when the examiner and the patient are in separate rooms. However, these tests were performed in a controlled clinic or laboratory setting rather than in the patient’s home. In addition, none of the previous studies included children and the population had its own challenges.

To assess whether remote neuropsychology assessments can be performed effectively in home children, Harder, and children who are UTSW neurology and pediatrics professors and co-directors of Harder’s pediatrics CONQUER program. In addition, their colleagues recruited 58 patients, primarily from the Pediatric Demyelinating Diseases Program at the Pediatric Medical Center Dallas.

The clinic treats patients with neurological autoimmune diseases that target myelin, the insulating layer of nerve cells. Disorders include transverse myelitis, multiple sclerosis, acute disseminated encephalomyelitis, optic neuritis, and neuromyelitis optica. Patients were 6 to 20 years old and traveled up to 2,033 miles for a visit to the clinic.

Each child received the same 90-minute neuropsychology battery twice. Half of the group first took the housing test. The other half first took the clinic test.

For home exams, children received a series of exam materials prior to the exam date and borrowed a tablet from the lab in advance if they did not have a computer or tablet at home. Both tests allowed parents or other caregivers to leave the room for one-on-one interaction between the patient and the researcher.

Greenberg explains that the home-based environment had unique challenges compared to clinics. Distractions and technology issues occurred intermittently during the remote session, but these were usually temporary and usually did not interfere with the test session.

When researchers compared the results obtained from home and clinical-based tests, no significant difference was found.

But it’s not enough to show that home-based testing is comparable to clinics, says Harder-patients and their caregivers are also willing to go to remote testing to make it feasible. Must be. To that end, researchers conducted a survey to assess satisfaction with video conferencing-based testing for each patient and their caregivers. The majority (94% of caregivers and 90% of participants) said they were satisfied with the home-based test. Most people did not show preference when choosing either remote or face-to-face.

According to Harder, the teleneuro psychology test needs to be evaluated in a wider age range and with different conditions and measures before becoming a staple in the field. However, making this an option will eventually eliminate the need for the child to travel far to access the specialist or avoid a direct visit-she benefits from the COVID-19 era. I add that.

This model allows these young, often medically fragile children to continue to receive the care they need, even when they are healthy. “

Lana Harder, Associate Professor of Psychiatry and Neurology, UTSW