Pediatric Teleneuropsychology: Feasibility and Recommendations.

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.

Intraindividual variability in attentional vigilance in children with epilepsy.

Attentional vigilance, the ability to maintain focus over time, is frequently impaired in childhood epilepsy. Typically, indices of Omissions (failure to detect a target) and Commissions (responding to a nontarget) are considered primary indices of attentional vigilance. Recently, the concept of intraindividual variability (IIV) has been identified as an important measure of attentional vigilance in several pediatric and adult clinical populations, but has not yet been systematically examined in childhood epilepsy. Here, we examined IIV on the Connors Continuous Performance Task-II (CCPT-II) for 144 newly diagnosed children with epilepsy (age 8-18years) and a matched age group of healthy children (n=82). Intraindividual variability showed a large effect size difference (d=0.68) between groups. In addition, IIV significantly predicted both intellectual functioning and academic achievement. These findings support the utility of examining IIV in the assessment of attentional ability in childhood epilepsy.