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Kammeyer R, Ogbu EA, Cooper JC, Stolz E, Piquet AL, Fuhlbrigge RC, Bennett JL, Hutaff-Lee C. [Formula: see text] Cognitive dysfunction in pediatric systemic lupus erythematosus: current knowledge and future directions. Child Neuropsychol 2024; 30:818-846. [PMID: 37902575 PMCID: PMC11058121 DOI: 10.1080/09297049.2023.2273573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 10/16/2023] [Indexed: 10/31/2023]
Abstract
Cognitive dysfunction (CD) is a neurologic complication of pediatric systemic lupus erythematosus (SLE) that remains poorly understood and understudied, despite the potential negative effects of CD on long-term socioeconomic status and quality of life. Data regarding the prevalence and risk factors for CD in pediatric SLE as well as the optimal screening, treatment, and long-term outcomes for CD are lacking. In this review, we present current knowledge on CD in pediatric SLE with a focus on the application to clinical practice. We discuss the challenges in diagnosis, clinical screening methods, potential impacts, and interventions for this complication. Finally, we discuss the remaining gaps in our knowledge of CD in pediatric SLE, and avenues for future research efforts.
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Affiliation(s)
- Ryan Kammeyer
- Departments of Pediatrics and Neurology, Sections of Child Neurology and Neuroimmunology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Ekemini A. Ogbu
- Division of Rheumatology, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jennifer C. Cooper
- Department of Pediatrics, Section of Pediatric Rheumatology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Erin Stolz
- Department of Child and Adolescent Psychiatry, Section of Pediatric Medical Psychology, John Hopkins Medicine, Baltimore, MA, USA
| | - Amanda L. Piquet
- Department of Neurology, Section of Neuroimmunology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Robert C. Fuhlbrigge
- Department of Pediatrics, Section of Pediatric Rheumatology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Jeffrey L. Bennett
- Departments of Neurology and Ophthalmology, Programs in Neuroscience and Immunology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Christa Hutaff-Lee
- Department of Pediatrics, Section of Neurology-Neuropsychology, University of Colorado School of Medicine, Aurora, CO, USA
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Yıldırım E, Büyükişcan ES, Kalem ŞA, Gürvit İH. Remote Neuropscyhological Assessment: Teleneuropsychology. Noro Psikiyatr Ars 2024; 61:167-174. [PMID: 38868842 PMCID: PMC11165610 DOI: 10.29399/npa.28535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 09/18/2023] [Indexed: 06/14/2024] Open
Abstract
Introduction Teleneuropsychology, which includes the remote application of neuropsychological tests to patients via telephone or videoconferencing, can expand access to health services for patients who reside in distant areas or have mobility restrictions. With the emergence of the COVID-19 pandemic, there has been a significant increase in the use of teleneuropsychology in cognitive assessment. In this review, the aim was to critically review the results of studies conducted in the field of teleneuropsychology and the fundamental principles related to tele-neuropsychological assessment. Additionally, the "guideline for home-based teleneuropsychology" developed for Türkiye's practices is outlined in this review. Method A literature search was conducted using the Web of Science and PubMed databases to include all types of articles related to the subject. Results The results of studies on in-clinic and home-based teleneuropsychological assessment indicate that tests that assess cognitive functions such as attention, memory, executive functions, and language, particularly those based on verbal administration, can be reliably applied through teleneuropsychological assessment. However, there are factors to consider when referring patients for teleneuropsychological assessment, selecting tests for assessment, and making ethical considerations. Additionally, it is important to follow recommended steps for both the clinician and the patient and/or their caregiver before and during the interview in order for the assessment to be carried out effectively. Conclusion Although direct contact with the patient is an essential element in clinical neuropsychology practice, when necessary, teleneuropsychological assessment performed by trained experts following appropriate application procedures can be a good alternative to face-to-face evaluations.
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Affiliation(s)
- Elif Yıldırım
- Işık University, Department of Psychology, Istanbul, Turkey
| | | | - Şükriye Akça Kalem
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, Istanbul, Turkey
| | - İ. Hakan Gürvit
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, Istanbul, Turkey
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Sperling SA, Acheson SK, Fox-Fuller J, Colvin MK, Harder L, Cullum CM, Randolph JJ, Carter KR, Espe-Pfeifer P, Lacritz LH, Arnett PA, Gillaspy SR. Tele-Neuropsychology: From Science to Policy to Practice. Arch Clin Neuropsychol 2024; 39:227-248. [PMID: 37715508 DOI: 10.1093/arclin/acad066] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2023] [Indexed: 09/17/2023] Open
Abstract
OBJECTIVE The primary aim of this paper is to accelerate the number of randomized experimental studies of the reliability and validity in-home tele-neuropsychological testing (tele-np-t). METHOD We conducted a critical review of the tele-neuropsychology literature. We discuss this research in the context of the United States' public and private healthcare payer systems, including the Centers for Medicare & Medicaid Services (CMS) and Current Procedural Terminology (CPT) coding system's telehealth lists, and existing disparities in healthcare access. RESULTS The number of tele-np publications has been stagnant since the onset of the COVID-19 pandemic. There are less published experimental studies of tele-neuropsychology (tele-np), and particularly in-home tele-np-t, than other tele-np publications. There is strong foundational evidence of the acceptability, feasibility, and reliability of tele-np-t, but relatively few studies of the reliability and validity of in-home tele-np-t using randomization methodology. CONCLUSIONS More studies of the reliability and validity of in-home tele-np-t using randomization methodology are necessary to support inclusion of tele-np-t codes on the CMS and CPT telehealth lists, and subsequently, the integration and delivery of in-home tele-np-t services across providers and institutions. These actions are needed to maintain equitable reimbursement of in-home tele-np-t services and address the widespread disparities in healthcare access.
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Affiliation(s)
- Scott A Sperling
- Department of Neurology, Center for Neurological Restoration, Cleveland Clinic, Cleveland, OH, USA
| | | | - Joshua Fox-Fuller
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Mary K Colvin
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Lana Harder
- Children's Health, Children's Medical Center, Dallas, TX, USA
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - C Munro Cullum
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - John J Randolph
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
- Randolph Neuropsychology Associates, PLLC, Lebanon, NH, USA
| | | | - Patricia Espe-Pfeifer
- Department of Psychiatry and Pediatrics, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Laura H Lacritz
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Peter A Arnett
- Department of Psychology, The Pennsylvania State University, State College, PA, USA
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4
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Sachs BC, Latham LA, Bateman JR, Cleveland MJ, Espeland MA, Fischer E, Gaussoin SA, Leng I, Rapp SR, Rogers S, Shappell HM, Williams BJ, Yang M, Craft S. Feasibility of Remote Administration of the Uniform Data Set-Version 3 for Assessment of Older Adults With Mild Cognitive Impairment and Alzheimer's Disease. Arch Clin Neuropsychol 2024:acae001. [PMID: 38291734 DOI: 10.1093/arclin/acae001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 11/21/2023] [Accepted: 12/19/2023] [Indexed: 02/01/2024] Open
Abstract
OBJECTIVE Assess the feasibility and concurrent validity of a modified Uniform Data Set version 3 (UDSv3) for remote administration for individuals with normal cognition (NC), mild cognitive impairment (MCI), and early dementia. METHOD Participants (N = 93) (age: 72.8 [8.9] years; education: 15.6 [2.5] years; 72% female; 84% White) were enrolled from the Wake Forest ADRC. Portions of the UDSv3 cognitive battery, plus the Rey Auditory Verbal Learning Test, were completed by telephone or video within ~6 months of participant's in-person visit. Adaptations for phone administration (e.g., Oral Trails for Trail Making Test [TMT] and Blind Montreal Cognitive Assessment [MoCA] for MoCA) were made. Participants reported on the pleasantness, difficulty, and preference for each modality. Staff provided validity ratings for assessments. Participants' remote data were adjudicated by cognitive experts blinded to the in person-diagnosis (NC [N = 44], MCI [N = 35], Dementia [N = 11], or other [N = 3]). RESULTS Remote assessments were rated as pleasant as in-person assessments by 74% of participants and equally difficult by 75%. Staff validity rating (video = 92%; phone = 87.5%) was good. Concordance between remote/in-person scores was generally moderate to good (r = .3 -.8; p < .05) except for TMT-A/OTMT-A (r = .3; p > .05). Agreement between remote/in-person adjudicated cognitive status was good (k = .61-.64). CONCLUSIONS We found preliminary evidence that older adults, including those with cognitive impairment, can be assessed remotely using a modified UDSv3 research battery. Adjudication of cognitive status that relies on remotely collected data is comparable to classifications using in-person assessments.
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Affiliation(s)
- Bonnie C Sachs
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Lauren A Latham
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - James R Bateman
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Mary Jo Cleveland
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Mark A Espeland
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Eric Fischer
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Sarah A Gaussoin
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Iris Leng
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Stephen R Rapp
- Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Samantha Rogers
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Heather M Shappell
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Benjamin J Williams
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Mia Yang
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Suzanne Craft
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
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Viñas-Guasch N, Chia PSQ, Yap MLM, Wu CY, Chen SHA. Cognitive pediatric tele-assessment: a scoping review. Front Psychol 2023; 14:1288021. [PMID: 38162979 PMCID: PMC10754967 DOI: 10.3389/fpsyg.2023.1288021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 11/27/2023] [Indexed: 01/03/2024] Open
Abstract
Cognitive tele-assessment (CTA) adoption has increased considerably recently, in parallel with the maturation of the digital technologies that enable it, and the push to move assessment to the online format during the COVID-19 pandemic in 2019. This mode of assessment stems from remote assessment applications that originated in general tele-medicine, where it was typically used for patient screening as part of an intervention. The development of remote tele-medicine was later adapted for CTA in adult populations in tele-neuropsychiatry and tele-psychology and is increasingly applied in experimental research in cognitive science research with adult and pediatric populations, and for remote academic assessment. Compared to in-person assessment, CTA offers advantages such as decreasing time and logistic costs and facilitating the assessment of remote or special needs populations. However, given the novelty of CTA, its technical, methodological, and ethical issues remain poorly understood, especially in cases where methods for assessment of adults are used in pediatric populations. In the current paper, we provide a scoping review on the evolution of remote tele-assessment from the years 2000 to 2021, to identify its main themes, methodologies, and applications, and then focus on the issues of assessment in pediatric populations. Finally, we present recommendations on how to address the challenges previously mentioned.
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Affiliation(s)
- Nestor Viñas-Guasch
- Psychology, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| | - Phoebe Si Qi Chia
- Psychology, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | - Michelle Li-Mei Yap
- Centre for Research in Child Development, National Institute of Education, Nanyang Technological University, Singapore, Singapore
| | - Chiao-Yi Wu
- Centre for Research in Child Development, National Institute of Education, Nanyang Technological University, Singapore, Singapore
- Centre for Research and Development in Learning (CRADLE), Nanyang Technological University, Singapore, Singapore
| | - S. H. Annabel Chen
- Psychology, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
- Centre for Research and Development in Learning (CRADLE), Nanyang Technological University, Singapore, Singapore
- Lee Kong Chian School of Medicine (LKCMedicine), Nanyang Technological University, Singapore, Singapore
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Walker EJ, Kirkham FJ, Stotesbury H, Dimitriou D, Hood AM. Tele-neuropsychological Assessment of Children and Young People: A Systematic Review. JOURNAL OF PEDIATRIC NEUROPSYCHOLOGY 2023; 9:1-14. [PMID: 37359106 PMCID: PMC10231293 DOI: 10.1007/s40817-023-00144-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 04/12/2023] [Accepted: 04/14/2023] [Indexed: 06/28/2023]
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.
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Affiliation(s)
- Elise J. Walker
- Developmental Neurosciences Unit and Biomedical Research Centre, UCL Great Ormond Street Institute of Child Health, London, England
| | - Fenella J. Kirkham
- Developmental Neurosciences Unit and Biomedical Research Centre, UCL Great Ormond Street Institute of Child Health, London, England
- Clinical and Experimental Sciences, University of Southampton, Southampton, England
| | - Hanne Stotesbury
- Developmental Neurosciences Unit and Biomedical Research Centre, UCL Great Ormond Street Institute of Child Health, London, England
| | - Dagmara Dimitriou
- Sleep Education and Research Laboratory, Department of Psychology and Human Development, UCL Institute of Education, London, England
| | - Anna M. Hood
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, University of Manchester, Coupland 1 Building, Manchester, M15 6FH Manchester, England
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7
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Malik HB, Norman JB. Best Practices and Methodological Strategies for Addressing Generalizability in Neuropsychological Assessment. JOURNAL OF PEDIATRIC NEUROPSYCHOLOGY 2023; 9:47-63. [PMID: 37250805 PMCID: PMC10182845 DOI: 10.1007/s40817-023-00145-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 04/11/2023] [Accepted: 04/15/2023] [Indexed: 05/31/2023]
Abstract
Generalizability considerations are widely discussed and a core foundation for understanding when and why treatment effects will replicate across sample demographics. However, guidelines on assessing and reporting generalizability-related factors differ across fields and are inconsistently applied. This paper synthesizes obstacles and best practices to apply recent work on measurement and sample diversity. We present a brief history of how knowledge in psychology has been constructed, with implications for who has been historically prioritized in research. We then review how generalizability remains a contemporary threat to neuropsychological assessment and outline best practices for researchers and clinical neuropsychologists. In doing so, we provide concrete tools to evaluate whether a given assessment is generalizable across populations and assist researchers in effectively testing and reporting treatment differences across sample demographics.
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Affiliation(s)
- Hinza B. Malik
- Department of Psychology, University of North Carolina Wilmington, 601 South College Road, Wilmington, NC 28403-5612 USA
| | - Jasmine B. Norman
- Department of Psychology, University of North Carolina Wilmington, 601 South College Road, Wilmington, NC 28403-5612 USA
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Telehealth services for cardiac neurodevelopmental care during the COVID-19 pandemic: a site survey from the Cardiac Neurodevelopmental Outcome Collaborative. Cardiol Young 2023; 33:280-287. [PMID: 35197144 PMCID: PMC8914139 DOI: 10.1017/s1047951122000579] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE COVID-19 has markedly impacted the provision of neurodevelopmental care. In response, the Cardiac Neurodevelopmental Outcome Collaborative established a Task Force to assess the telehealth practices of cardiac neurodevelopmental programmes during COVID-19, including adaptation of services, test protocols and interventions, and perceived obstacles, disparities, successes, and training needs. STUDY DESIGN A 47-item online survey was sent to 42 Cardiac Neurodevelopmental Outcome Collaborative member sites across North America within a 3-week timeframe (22 July to 11 August 2020) to collect cross-sectional data on practices. RESULTS Of the 30 participating sites (71.4% response rate), all were providing at least some clinical services at the time of the survey and 24 sites (80%) reported using telehealth. All but one of these sites were offering new telehealth services in response to COVID-19, with the most striking change being the capacity to offer new intervention services for children and their caregivers. Only a third of sites were able to carry out standardised, performance-based, neurodevelopmental testing with children and adolescents using telehealth, and none had completed comparable testing with infants and toddlers. Barriers associated with language, child ability, and access to technology were identified as contributing to disparities in telehealth access. CONCLUSIONS Telehealth has enabled continuation of at least some cardiac neurodevelopmental services during COVID-19, despite the challenges experienced by providers, children, families, and health systems. The Cardiac Neurodevelopmental Outcome Collaborative provides a unique platform for sharing challenges and successes across sites, as we continue to shape an evidence-based, efficient, and consistent approach to the care of individuals with CHD.
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McLean E, Cornwell MA, Bender HA, Sacks-Zimmerman A, Mandelbaum S, Koay JM, Raja N, Kohn A, Meli G, Spat-Lemus J. Innovations in Neuropsychology: Future Applications in Neurosurgical Patient Care. World Neurosurg 2023; 170:286-295. [PMID: 36782427 DOI: 10.1016/j.wneu.2022.09.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 02/11/2023]
Abstract
Over the last century, collaboration between clinical neuropsychologists and neurosurgeons has advanced the state of the science in both disciplines. These advances have provided the field of neuropsychology with many opportunities for innovation in the care of patients prior to, during, and following neurosurgical intervention. Beyond giving a general overview of how present-day advances in technology are being applied in the practice of neuropsychology within a neurological surgery department, this article outlines new developments that are currently unfolding. Improvements in remote platform, computer interface, "real-time" analytics, mobile devices, and immersive virtual reality have the capacity to increase the customization, precision, and accessibility of neuropsychological services. In doing so, such innovations have the potential to improve outcomes and ameliorate health care disparities.
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Affiliation(s)
- Erin McLean
- Department of Psychology, Hofstra University, Hempstead, New York, USA; Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Melinda A Cornwell
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
| | - H Allison Bender
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA.
| | | | - Sarah Mandelbaum
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Department of Clinical Psychology with Health Emphasis, Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA
| | - Jun Min Koay
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, Florida, USA
| | - Noreen Raja
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Graduate School of Applied and Professional Psychology, Rutgers University, Piscataway, New Jersey, USA
| | - Aviva Kohn
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Department of Clinical Psychology with Health Emphasis, Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA
| | - Gabrielle Meli
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Department of Human Ecology, Cornell University, Ithaca, New York, USA
| | - Jessica Spat-Lemus
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
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Rabinovitch BS, Diaz PL, Langleben AC, Katz TM, Gordon T, Le K, Chen FY, Lewis EC. Wait times and patient throughput after the implementation of a novel model of virtual care in an outpatient neurology clinic: A retrospective analysis. J Telemed Telecare 2022:1357633X221139558. [PMID: 36529888 DOI: 10.1177/1357633x221139558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
INTRODUCTION Neurology wait times - from referral to consultation - continue to grow, leading to various adverse effects on patient outcomes. Key elements of virtual care can be leveraged to improve efficiency. This study examines the implementation of a novel virtual care model - Virtual Rapid Access Clinics - at the Neurology Centre of Toronto. The model employs a patient-centred care workflow, involving multidisciplinary staff and online administrative tools that are synthesized to expedite care and maintain quality. METHODS Virtual Rapid Access Clinic efficacy was studied by determining average wait times and patient throughput, calculated from anonymous data that was extracted from the clinic patient database (n = 1542). Comparative analysis focused on new patient consultations during the 12-month periods prior to (pre-Virtual Rapid Access Clinic, n = 456) and following (post-Virtual Rapid Access Clinic, n = 1086) Virtual Rapid Access Clinic implementation. RESULTS After Virtual Rapid Access Clinic implementation, there was a mean 15-day wait time reduction, and a monthly average 52-patient increase in patient throughput. Wait time reductions and increased patient throughput were observed in all three Virtual Rapid Access Clinic sub-clinics - epilepsy, headache and concussion. Respectively, average wait times reduced significantly by 26.4 and 18.9 days and insignificantly by 1.1 days; monthly average patient throughputs increased by 235%, 95% and 161%. DISCUSSION These findings demonstrated that the Virtual Rapid Access Clinic model of care is effective at reducing patient wait times and increasing patient throughput. While the Virtual Rapid Access Clinic presents a feasible model both during and after pandemic restrictions, further research exploring its scalability in other care contexts, potential changes in care quality and efficiency outside of pandemic restrictions must be performed.
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Affiliation(s)
| | - Patrick L Diaz
- Department of Clinical Research, Neurology Centre of Toronto, Toronto, ON, Canada
| | - Amanda C Langleben
- Department of Clinical Research, Neurology Centre of Toronto, Toronto, ON, Canada
| | - Talia M Katz
- Department of Clinical Research, Neurology Centre of Toronto, Toronto, ON, Canada
| | - Tatyana Gordon
- Department of Clinical Research, Neurology Centre of Toronto, Toronto, ON, Canada
| | - Kevin Le
- Department of Clinical Research, Neurology Centre of Toronto, Toronto, ON, Canada
| | - Frank Yizhao Chen
- Department of Clinical Research, Neurology Centre of Toronto, Toronto, ON, Canada
- Jamaican Medical Cannabis Corporation, Toronto, ON, Canada
| | - Evan Cole Lewis
- Department of Clinical Research, Neurology Centre of Toronto, Toronto, ON, Canada
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11
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Harvey PD, Depp CA, Rizzo AA, Strauss GP, Spelber D, Carpenter LL, Kalin NH, Krystal JH, McDonald WM, Nemeroff CB, Rodriguez CI, Widge AS, Torous J. Technology and Mental Health: State of the Art for Assessment and Treatment. Am J Psychiatry 2022; 179:897-914. [PMID: 36200275 DOI: 10.1176/appi.ajp.21121254] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Technology is ubiquitous in society and is now being extensively used in mental health applications. Both assessment and treatment strategies are being developed and deployed at a rapid pace. The authors review the current domains of technology utilization, describe standards for quality evaluation, and forecast future developments. This review examines technology-based assessments of cognition, emotion, functional capacity and everyday functioning, virtual reality approaches to assessment and treatment, ecological momentary assessment, passive measurement strategies including geolocation, movement, and physiological parameters, and technology-based cognitive and functional skills training. There are many technology-based approaches that are evidence based and are supported through the results of systematic reviews and meta-analyses. Other strategies are less well supported by high-quality evidence at present, but there are evaluation standards that are well articulated at this time. There are some clear challenges in selection of applications for specific conditions, but in several areas, including cognitive training, randomized clinical trials are available to support these interventions. Some of these technology-based interventions have been approved by the U.S. Food and Drug administration, which has clear standards for which types of applications, and which claims about them, need to be reviewed by the agency and which are exempt.
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Affiliation(s)
- Philip D Harvey
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, and Miami VA Medical Center (Harvey); Department of Psychiatry, UC San Diego Medical Center, La Jolla (Depp); USC Institute for Creative Technologies, University of Southern California, Los Angeles (Rizzo); Department of Psychology, University of Georgia, Athens (Strauss); Department of Psychiatry, Dell Medical Center, University of Texas at Austin (Spelber, Nemeroff); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, University of Wisconsin Medical School, Madison (Kalin); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (McDonald); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford; Veterans Affairs Palo Alto Health Care System, Palo Alto (Rodriguez); Department of Psychiatry and Behavioral Sciences and Medical Discovery Team-Addictions, University of Minnesota, Minneapolis (Widge); Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston (Torous)
| | - Colin A Depp
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, and Miami VA Medical Center (Harvey); Department of Psychiatry, UC San Diego Medical Center, La Jolla (Depp); USC Institute for Creative Technologies, University of Southern California, Los Angeles (Rizzo); Department of Psychology, University of Georgia, Athens (Strauss); Department of Psychiatry, Dell Medical Center, University of Texas at Austin (Spelber, Nemeroff); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, University of Wisconsin Medical School, Madison (Kalin); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (McDonald); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford; Veterans Affairs Palo Alto Health Care System, Palo Alto (Rodriguez); Department of Psychiatry and Behavioral Sciences and Medical Discovery Team-Addictions, University of Minnesota, Minneapolis (Widge); Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston (Torous)
| | - Albert A Rizzo
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, and Miami VA Medical Center (Harvey); Department of Psychiatry, UC San Diego Medical Center, La Jolla (Depp); USC Institute for Creative Technologies, University of Southern California, Los Angeles (Rizzo); Department of Psychology, University of Georgia, Athens (Strauss); Department of Psychiatry, Dell Medical Center, University of Texas at Austin (Spelber, Nemeroff); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, University of Wisconsin Medical School, Madison (Kalin); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (McDonald); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford; Veterans Affairs Palo Alto Health Care System, Palo Alto (Rodriguez); Department of Psychiatry and Behavioral Sciences and Medical Discovery Team-Addictions, University of Minnesota, Minneapolis (Widge); Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston (Torous)
| | - Gregory P Strauss
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, and Miami VA Medical Center (Harvey); Department of Psychiatry, UC San Diego Medical Center, La Jolla (Depp); USC Institute for Creative Technologies, University of Southern California, Los Angeles (Rizzo); Department of Psychology, University of Georgia, Athens (Strauss); Department of Psychiatry, Dell Medical Center, University of Texas at Austin (Spelber, Nemeroff); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, University of Wisconsin Medical School, Madison (Kalin); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (McDonald); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford; Veterans Affairs Palo Alto Health Care System, Palo Alto (Rodriguez); Department of Psychiatry and Behavioral Sciences and Medical Discovery Team-Addictions, University of Minnesota, Minneapolis (Widge); Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston (Torous)
| | - David Spelber
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, and Miami VA Medical Center (Harvey); Department of Psychiatry, UC San Diego Medical Center, La Jolla (Depp); USC Institute for Creative Technologies, University of Southern California, Los Angeles (Rizzo); Department of Psychology, University of Georgia, Athens (Strauss); Department of Psychiatry, Dell Medical Center, University of Texas at Austin (Spelber, Nemeroff); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, University of Wisconsin Medical School, Madison (Kalin); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (McDonald); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford; Veterans Affairs Palo Alto Health Care System, Palo Alto (Rodriguez); Department of Psychiatry and Behavioral Sciences and Medical Discovery Team-Addictions, University of Minnesota, Minneapolis (Widge); Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston (Torous)
| | - Linda L Carpenter
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, and Miami VA Medical Center (Harvey); Department of Psychiatry, UC San Diego Medical Center, La Jolla (Depp); USC Institute for Creative Technologies, University of Southern California, Los Angeles (Rizzo); Department of Psychology, University of Georgia, Athens (Strauss); Department of Psychiatry, Dell Medical Center, University of Texas at Austin (Spelber, Nemeroff); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, University of Wisconsin Medical School, Madison (Kalin); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (McDonald); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford; Veterans Affairs Palo Alto Health Care System, Palo Alto (Rodriguez); Department of Psychiatry and Behavioral Sciences and Medical Discovery Team-Addictions, University of Minnesota, Minneapolis (Widge); Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston (Torous)
| | - Ned H Kalin
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, and Miami VA Medical Center (Harvey); Department of Psychiatry, UC San Diego Medical Center, La Jolla (Depp); USC Institute for Creative Technologies, University of Southern California, Los Angeles (Rizzo); Department of Psychology, University of Georgia, Athens (Strauss); Department of Psychiatry, Dell Medical Center, University of Texas at Austin (Spelber, Nemeroff); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, University of Wisconsin Medical School, Madison (Kalin); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (McDonald); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford; Veterans Affairs Palo Alto Health Care System, Palo Alto (Rodriguez); Department of Psychiatry and Behavioral Sciences and Medical Discovery Team-Addictions, University of Minnesota, Minneapolis (Widge); Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston (Torous)
| | - John H Krystal
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, and Miami VA Medical Center (Harvey); Department of Psychiatry, UC San Diego Medical Center, La Jolla (Depp); USC Institute for Creative Technologies, University of Southern California, Los Angeles (Rizzo); Department of Psychology, University of Georgia, Athens (Strauss); Department of Psychiatry, Dell Medical Center, University of Texas at Austin (Spelber, Nemeroff); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, University of Wisconsin Medical School, Madison (Kalin); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (McDonald); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford; Veterans Affairs Palo Alto Health Care System, Palo Alto (Rodriguez); Department of Psychiatry and Behavioral Sciences and Medical Discovery Team-Addictions, University of Minnesota, Minneapolis (Widge); Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston (Torous)
| | - William M McDonald
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, and Miami VA Medical Center (Harvey); Department of Psychiatry, UC San Diego Medical Center, La Jolla (Depp); USC Institute for Creative Technologies, University of Southern California, Los Angeles (Rizzo); Department of Psychology, University of Georgia, Athens (Strauss); Department of Psychiatry, Dell Medical Center, University of Texas at Austin (Spelber, Nemeroff); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, University of Wisconsin Medical School, Madison (Kalin); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (McDonald); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford; Veterans Affairs Palo Alto Health Care System, Palo Alto (Rodriguez); Department of Psychiatry and Behavioral Sciences and Medical Discovery Team-Addictions, University of Minnesota, Minneapolis (Widge); Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston (Torous)
| | - Charles B Nemeroff
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, and Miami VA Medical Center (Harvey); Department of Psychiatry, UC San Diego Medical Center, La Jolla (Depp); USC Institute for Creative Technologies, University of Southern California, Los Angeles (Rizzo); Department of Psychology, University of Georgia, Athens (Strauss); Department of Psychiatry, Dell Medical Center, University of Texas at Austin (Spelber, Nemeroff); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, University of Wisconsin Medical School, Madison (Kalin); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (McDonald); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford; Veterans Affairs Palo Alto Health Care System, Palo Alto (Rodriguez); Department of Psychiatry and Behavioral Sciences and Medical Discovery Team-Addictions, University of Minnesota, Minneapolis (Widge); Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston (Torous)
| | - Carolyn I Rodriguez
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, and Miami VA Medical Center (Harvey); Department of Psychiatry, UC San Diego Medical Center, La Jolla (Depp); USC Institute for Creative Technologies, University of Southern California, Los Angeles (Rizzo); Department of Psychology, University of Georgia, Athens (Strauss); Department of Psychiatry, Dell Medical Center, University of Texas at Austin (Spelber, Nemeroff); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, University of Wisconsin Medical School, Madison (Kalin); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (McDonald); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford; Veterans Affairs Palo Alto Health Care System, Palo Alto (Rodriguez); Department of Psychiatry and Behavioral Sciences and Medical Discovery Team-Addictions, University of Minnesota, Minneapolis (Widge); Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston (Torous)
| | - Alik S Widge
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, and Miami VA Medical Center (Harvey); Department of Psychiatry, UC San Diego Medical Center, La Jolla (Depp); USC Institute for Creative Technologies, University of Southern California, Los Angeles (Rizzo); Department of Psychology, University of Georgia, Athens (Strauss); Department of Psychiatry, Dell Medical Center, University of Texas at Austin (Spelber, Nemeroff); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, University of Wisconsin Medical School, Madison (Kalin); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (McDonald); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford; Veterans Affairs Palo Alto Health Care System, Palo Alto (Rodriguez); Department of Psychiatry and Behavioral Sciences and Medical Discovery Team-Addictions, University of Minnesota, Minneapolis (Widge); Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston (Torous)
| | - John Torous
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, and Miami VA Medical Center (Harvey); Department of Psychiatry, UC San Diego Medical Center, La Jolla (Depp); USC Institute for Creative Technologies, University of Southern California, Los Angeles (Rizzo); Department of Psychology, University of Georgia, Athens (Strauss); Department of Psychiatry, Dell Medical Center, University of Texas at Austin (Spelber, Nemeroff); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, University of Wisconsin Medical School, Madison (Kalin); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (McDonald); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford; Veterans Affairs Palo Alto Health Care System, Palo Alto (Rodriguez); Department of Psychiatry and Behavioral Sciences and Medical Discovery Team-Addictions, University of Minnesota, Minneapolis (Widge); Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston (Torous)
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12
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Meimei L, Zenghui M. A systematic review of telehealth screening, assessment, and diagnosis of autism spectrum disorder. Child Adolesc Psychiatry Ment Health 2022; 16:79. [PMID: 36209100 PMCID: PMC9547568 DOI: 10.1186/s13034-022-00514-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 09/21/2022] [Indexed: 11/18/2022] Open
Abstract
There is a significant delay between parents having concerns and receiving a formal assessment and Autism Spectrum Disorder (ASD) diagnosis. Telemedicine could be an effective alternative that shortens the waiting time for parents and primary health providers in ASD screening and diagnosis. We conducted a systematic review examining the uses of telemedicine technology for ASD screening, assessment, or diagnostic purposes and to what extent sample characteristics and psychometric properties were reported. This study searched four databases from 2000 to 2022 and obtained 26 studies that met the inclusion criteria. The 17 applications used in these 26 studies were divided into three categories based on their purpose: screening, diagnostic, and assessment. The results described the data extracted, including study characteristics, applied methods, indicators seen, and psychometric properties. Among the 15 applications with psychometric properties reported, the sensitivity ranged from 0.70 to 1, and the specificity ranged from 0.38 to 1. The present study highlights the strengths and weaknesses of current telemedicine approaches and provides a basis for future research. More rigorous empirical studies with larger sample sizes are needed to understand the feasibility, strengths, and limitations of telehealth technologies for screening, assessing, and diagnosing ASD.
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Affiliation(s)
- Liu Meimei
- grid.12380.380000 0004 1754 9227Vrije University Amsterdam, Amsterdam, The Netherlands
| | - Ma Zenghui
- Beijing ALSOABA Technology Co. LTD, ALSOLIFE, Beijing, China
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13
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Cox SM, Butcher JL, Sadhwani A, Sananes R, Sanz JH, Blumenfeld E, Cassidy AR, Cowin JC, Ilardi D, Kasparian NA, Kenowitz J, Kroll K, Miller TA, Wolfe KR. Integrating Telehealth Into Neurodevelopmental Assessment: A Model From the Cardiac Neurodevelopmental Outcome Collaborative. J Pediatr Psychol 2022; 47:707-713. [PMID: 35146508 PMCID: PMC9383469 DOI: 10.1093/jpepsy/jsac003] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 01/07/2022] [Accepted: 01/21/2022] [Indexed: 11/14/2022] Open
Abstract
Objective In the wake of the COVID-19 pandemic, psychologists were pushed to look beyond traditional in-person models of neurodevelopmental assessment to maintain continuity of care. A wealth of data demonstrates that telehealth is efficacious for pediatric behavioral intervention; however, best practices for incorporating telehealth into neurodevelopmental assessment are yet to be developed. In this topical review, we propose a conceptual model to demonstrate how telehealth can be incorporated into various components of neurodevelopmental assessment. Methods Harnessing existing literature and expertise from a multidisciplinary task force comprised of clinicians, researchers, and patient/parent representatives from the subspecialty of cardiac neurodevelopmental care, a conceptual framework for telehealth neurodevelopmental assessment was developed. Considerations for health equity and access to care are discussed, as well as general guidelines for clinical implementation and gaps in existing literature. Results There are opportunities to integrate telehealth within each stage of neurodevelopmental assessment, from intake to testing, through to follow-up care. Further research is needed to determine whether telehealth mitigates or exacerbates disparities in access to care for vulnerable populations as well as to provide evidence of validity for a wider range of neurodevelopmental measures to be administered via telehealth. Conclusions While many practices are returning to traditional, face-to-face neurodevelopmental assessment services, psychologists have a unique opportunity to harness the momentum for telehealth care initiated during the pandemic to optimize the use of clinical resources, broaden service delivery, and increase access to care for pediatric neurodevelopmental assessment.
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Affiliation(s)
- Stephany M Cox
- Department of Pediatrics, Division of Developmental Medicine, Benioff Children's Hospital, University of California-San Francisco, USA
| | - Jennifer L Butcher
- Department of Pediatrics, University of Michigan School of Medicine & C.S. Mott Children's Hospital, USA
| | - Anjali Sadhwani
- Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Harvard Medical School, USA
| | - Renee Sananes
- Labatt Family Heart Centre, Hospital for Sick Children and Department of Pediatrics, University of Toronto, Canada
| | - Jacqueline H Sanz
- Division of Neuropsychology, Children's National Hospital, Departments of Psychiatry and Behavioral Sciences & Pediatrics, George Washington University School of Medicine, USA
| | | | - Adam R Cassidy
- Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Harvard Medical School, USA.,Department of Psychiatry and Psychology, Mayo Clinic, USA
| | | | - Dawn Ilardi
- Department of Neuropsychology, Children's Healthcare of Atlanta, and Department of Rehabilitation Medicine, Emory University, USA
| | - Nadine A Kasparian
- Cincinnati Children's Center for Heart Disease and Mental Health, Heart Institute and the Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, USA
| | - Joslyn Kenowitz
- Nemours Cardiac Center, Alfred I. duPont Hospital for Children, USA.,Department of Pediatrics, Thomas Jefferson University, USA
| | - Kristin Kroll
- Department of Pediatrics, Division of Pediatric Psychology and Developmental Medicine, Medical College of Wisconsin, USA
| | | | - Kelly R Wolfe
- Department of Pediatrics, University of Colorado School of Medicine, Anschutz Medical Campus, USA
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14
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Hewitt KC, Block C, Bellone JA, Dawson EL, Garcia P, Gerstenecker A, Grabyan JM, Howard C, Kamath V, LeMonda BC, Margolis SA, McBride WF, Salinas CM, Tam DM, Walker KA, Del Bene VA. Diverse experiences and approaches to tele neuropsychology: Commentary and reflections over the past year of COVID-19. Clin Neuropsychol 2022; 36:790-805. [DOI: 10.1080/13854046.2022.2027022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Kelsey C. Hewitt
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Cady Block
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - John A. Bellone
- Perspectives Psychological Services, Fullerton, California, USA
| | - Erica L. Dawson
- Department of Neurology, The Ohio State University, Columbus, Ohio, USA
| | - Patricia Garcia
- Department of Rehabilitation Neuropsychology, Rehabilitation Hospital of Indiana, Indianapolis, Indiana, USA
- Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Adam Gerstenecker
- Department of Neurology, University of Alabama at Birmingham, UAB Heersink School of Medicine, Birmingham, Alabama, USA
| | - Jonathan M. Grabyan
- Michael E. DeBakey VA Medical Center, Behavioral Health Program, Houston, Texas, USA
| | - Christopher Howard
- Psychology Department, Utah State Hospital, Provo, Utah, USA
- Department of Psychology, Brigham Young University, Provo, Utah, USA
| | - Vidyulata Kamath
- Perspectives Psychological Services, Fullerton, California, USA
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Brittany C. LeMonda
- Perspectives Psychological Services, Fullerton, California, USA
- Department of Psychiatry, NYU Langone, NYU Psychiatry Associates, New York, New York, USA
| | - Seth A. Margolis
- Perspectives Psychological Services, Fullerton, California, USA
- Department of Psychiatry & Human Behavior, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island, USA
| | - Willie F. McBride
- Perspectives Psychological Services, Fullerton, California, USA
- Department of Neurology, University of Virginia Health, Charlottesville, Virginia, USA
| | - Christine M. Salinas
- Perspectives Psychological Services, Fullerton, California, USA
- Neuropsychology Concierge®, Indialantic, Florida, USA
| | - Danny M. Tam
- VA NY Harbor Healthcare System, Division of Psychology, Mental Health Service, New York, New York, USA
| | - Keenan A. Walker
- Perspectives Psychological Services, Fullerton, California, USA
- National Institute on Aging, Laboratory of Behavioral Neuroscience, Baltimore, Maryland, USA
| | - Victor A. Del Bene
- Department of Neurology, University of Alabama at Birmingham, UAB Heersink School of Medicine, Birmingham, Alabama, USA
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15
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Ruffini C, Tarchi C, Morini M, Giuliano G, Pecini C. Tele-assessment of cognitive functions in children: a systematic review. Child Neuropsychol 2021; 28:709-745. [PMID: 34856882 DOI: 10.1080/09297049.2021.2005011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Cognitive Tele-Assessment approach (CTA) has been widely used in adults for clinical, research, and screening purposes. In the last decades, it has been considered a useful tool for evaluating child development in both clinical and educational settings and new instruments for CTA in children have been developed. In comparison to In Person Assessment (IPA), CTA can have several advantages, such as increasing accessibility, cutting waiting lists, reducing time and travel costs, and assisting with infection control by minimizing face-to-face contact in times of pandemic. Nevertheless, several issues related to the feasibility and reliability of using CTA to evaluate cognitive development are still open. The present systematic review has a twofold aim: 1. to describe the cognitive functions that are most frequently measured by CTA in children, the procedures used, and the characteristics of the samples investigated; 2. to investigate the agreement between CTA and IPA scores in children.In the present systematic review, 23 studies using CTA in children, with typical or atypical development, have been selected and analyzed. Results support the similarities in performance scores between IPA and CTA and good compliance by children and their families in participating in CTA. Nonetheless, most studies suggest that several methodological precautions must be taken to manage technical and procedural characteristics that may represent challenges for CTA of children. Suggestions for a correct use of CTA, factors affecting the validity of the results and directions for future research are discussed.
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Affiliation(s)
- Costanza Ruffini
- Department of Education, Languages, Intercultures, Literatures and Psychology (FORLIPSI), University of Florence, Firenze, Italy
| | - Christian Tarchi
- Department of Education, Languages, Intercultures, Literatures and Psychology (FORLIPSI), University of Florence, Firenze, Italy
| | - Monica Morini
- Department of Education, Languages, Intercultures, Literatures and Psychology (FORLIPSI), University of Florence, Firenze, Italy
| | - Gabriella Giuliano
- Department of Education, Languages, Intercultures, Literatures and Psychology (FORLIPSI), University of Florence, Firenze, Italy
| | - Chiara Pecini
- Department of Education, Languages, Intercultures, Literatures and Psychology (FORLIPSI), University of Florence, Firenze, Italy
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16
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Hollingdale J, Adamo N, Tierney K. Impact of COVID-19 for people living and working with ADHD: A brief review of the literature. AIMS Public Health 2021; 8:581-597. [PMID: 34786421 PMCID: PMC8568596 DOI: 10.3934/publichealth.2021047] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 08/18/2021] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE COVID-19 lockdowns have changed the social and environmental context. Those with ADHD are more vulnerable to experiencing difficulties than their non-ADHD peers. This paper attempts to provide a brief summary of the literature that has emerged during the COVID-19 pandemic. METHOD A literature search was completed using the following databases; Embase, Ovid Medline, APA PsycInfo. A total of 36 papers were identified as relevant to the topic. RESULTS The pandemic has exacerbated the core symptoms of ADHD and co-occurring difficulties. Services have adapted their assessment and intervention protocols for tele-health working and findings suggest that tele-interventions present a viable alternative. However, much of this research utilises small sample sizes and a restricted number of population groups. CONCLUSIONS More research is required to determine the effectiveness of ADHD care during the pandemic and whether adaptations will be retained post-pandemic.
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Affiliation(s)
| | - Nicoletta Adamo
- SCAAND Department, Michael Rutter Centre, South London and Maudsley NHS Trust, London, UK
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Kevin Tierney
- SCAAND Department, Michael Rutter Centre, South London and Maudsley NHS Trust, London, UK
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17
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Lichtenstein JD, Amato JT, Holding EZ, Grodner KD, Pollock EN, Marschall KP, Scull S. How We Work Now: Preliminary Review of a Pediatric Neuropsychology Hybrid Model in the Era of COVID-19 and Beyond. Arch Clin Neuropsychol 2021; 37:40-49. [PMID: 34050361 PMCID: PMC8194792 DOI: 10.1093/arclin/acab041] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 04/05/2021] [Accepted: 05/11/2021] [Indexed: 12/28/2022] Open
Abstract
Objective Although telehealth has become a central component of medical care in response to the coronavirus disease 2019 (COVID-19) pandemic, comprehensive pediatric neuropsychological assessment over virtual platforms lacks empirical efficacy. This paper presents: a) the results of a quality improvement project examining the feasibility of in-person evaluation in the context of safety measures that alter test standardization, b) the impact such changes had upon neuropsychological test scores, and c) how using a hybrid model of clinical service delivery affected access to care. Method We compared demographic and outcome variables between patients seen during the pandemic (N = 87) to a group of patients seen in our service immediately prior to COVID-19 (N = 87). A subset of those patients were case-matched for age and diagnosis (N = 39 per group). Children seen for neuropsychological re-evaluation during the pandemic (N = 10) were examined using pairwise comparison. Results Groups did not differ on age, sex, or FSIQ. Despite changes to standardized administration, no group differences were found for any selected neuropsychological test variables in the larger sample or subsamples. In fact, all variables were moderately to highly correlated in the re-evaluation subgroup. The hybrid model expedited feedback sessions and increased face-to-face (telehealth) feedbacks. Conclusions A hybrid model incorporating modified in-person testing and intake and feedback encounters via telehealth may be a feasible and effective way to provide pediatric neuropsychological services. These preliminary findings suggest such novel aspects of neuropsychological evaluation could represent an improvement over pre-COVID models, especially in rural settings.
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Affiliation(s)
- Jonathan D Lichtenstein
- Dartmouth-Hitchcock Medical Center, Pediatric Neuropsychology Program, Lebanon, NH, USA.,Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Jennifer T Amato
- Dartmouth-Hitchcock Medical Center, Pediatric Neuropsychology Program, Lebanon, NH, USA.,Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Emily Z Holding
- Dartmouth-Hitchcock Medical Center, Pediatric Neuropsychology Program, Lebanon, NH, USA
| | - Kelsey D Grodner
- Dartmouth-Hitchcock Medical Center, Pediatric Neuropsychology Program, Lebanon, NH, USA
| | - Erica N Pollock
- Dartmouth-Hitchcock Medical Center, Pediatric Neuropsychology Program, Lebanon, NH, USA
| | - Kelsea P Marschall
- Dartmouth-Hitchcock Medical Center, Pediatric Neuropsychology Program, Lebanon, NH, USA
| | - Sara Scull
- Dartmouth-Hitchcock Medical Center, Pediatric Neuropsychology Program, Lebanon, NH, USA
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18
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Children and Adolescents with Disabilities and Exposure to Disasters, Terrorism, and the COVID-19 Pandemic: a Scoping Review. Curr Psychiatry Rep 2021; 23:80. [PMID: 34643813 PMCID: PMC8511280 DOI: 10.1007/s11920-021-01295-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/11/2021] [Indexed: 01/15/2023]
Abstract
PURPOSE OF REVIEW This paper reviews the empirical literature on exposures to disaster or terrorism and their impacts on the health and well-being of children with disabilities and their families since the last published update in 2017. We also review the literature on studies examining the mental health and functioning of children with disabilities during the COVID-19 pandemic. RECENT FINDINGS Few studies have examined the effects of disaster or terrorism on children with disabilities. Research shows that children with disabilities and their families have higher levels of disaster exposure, lower levels of disaster preparedness, and less recovery support due to longstanding discriminatory practices. Similarly, many reports of the COVID-19 pandemic have documented its negative and disproportionate impacts on children with disabilities and their families. In the setting of climate change, environmental disasters are expected to increase in frequency and severity. Future studies identifying mitigating factors to disasters, including COVID-19; increasing preparedness on an individual, community, and global level; and evaluating post-disaster trauma-informed treatment practices are imperative to support the health and well-being of children with disabilities and their families.
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