The American Board of Clinical Neuropsychology (ABCN) and American Academy of Clinical Neuropsychology (AACN): Recent milestones and future goals 2014-2023.

Objective: The American Board of Clinical Neuropsychology (ABCN) and the American Academy of Clinical Neuropsychology (AACN) have become leading organizations in the credentialing of clinical neuropsychologists and promotion of the field, respectively. This paper updates the literature by summarizing the activities and growth of ABCN and AACN during the period 2014 through 2023. Method: Prior papers have reviewed the history of these organizations up to 2014. In this paper, the authors describe milestones that each organization has reached, provide an update reflecting improved functions and new initiatives, and describe how the organizations have responded to numerous challenges. Conclusions: The past decade has witnessed substantial societal and technological evolution, as well as wrenching events including a global pandemic and public outcry over continued racial injustice. ABCN and AACN have evolved in the face of these changes, positioning each organization well to take on future challenges.

Postdoctoral training in clinical neuropsychology in America: how did we get here and where do recent applicants suggest we go next?

OBJECTIVE: The United States appears to be the only country which typically requires completion of a two-year postdoctoral fellowship for one to be considered competent to practice clinical neuropsychology. We review the history of how this came to be in the United States. Further, we describe obstacles that postdoctoral trainees face during this stage of training. METHOD: We first describe the most significant events leading to the requirement of a two-year fellowship in clinical neuropsychology. Next, we describe factors that trainees face when selecting and completing postdoctoral training. Finally, we review the results of the most recent annual survey of applicants for postdoctoral training to measure their experiences. RESULTS: Postdoctoral training in the United States is a relatively recent requirement in neuropsychology. Trainees face many obstacles when obtaining a postdoctoral position some of which can be addressed by the field. CONCLUSIONS: Training in Clinical Neuropsychology in the United States has evolved considerably over at least the last 45 or so years to the point that a two-year postdoctoral fellowship is now required for one to be a candidate for board certification through the American Board of Clinical Neuropsychology. We review many of the challenges that postdoctoral trainees face and provide survey data to describe their experiences and preferences.

[Formula: see text]Education, training and practice of clinical neuropsychologists in the United States of America.

OBJECTIVE: This invited paper is intended to give an overview regarding the education and training pathways for the practice of neuropsychology in the United States. It is also meant to describe the types of activities engaged in by neuropsychologists, a description of their work settings and the amounts/ways in which they are compensated for their work. METHOD: The authors reviewed the literature and relied on their professional and organizational experiences to collect the necessary data. RESULTS: The United States has well-defined pathways for one to follow to gain the experiences and knowledge necessary to practice clinical neuropsychology in a competent way. Compensation varies widely among workplace settings but overall neuropsychologists appear to be well-paid. Challenges now and in the foreseeable future include a need to develop tests that have better ecological validity and that better reflect the demographics of a changing population, and an increasing need for neuropsychologists to identify key roles as members of integrated care teams. CONCLUSIONS: The United States has played an important role in the development of the practice and science of neuropsychology. Its continued success will, at least in part, depend on innovations in test development and application, and further demonstration of its relevance to health care and academic settings.

Commentary: the postdoctoral residency match in clinical neuropsychology.

Postdoctoral recruitment in clinical neuropsychology has evolved significantly over the past two decades. Prior to 1994, there were no organized recruitment guidelines for the specialty. From 1994 to 2001, the Association of Postdoctoral Programs in Clinical Neuropsychology (APPCN) facilitated a uniform notification date where member programs agreed to not make offers prior to a specified date. In 2001, APPCN partnered with National Matching Services to administer a computerized match recruitment system. Presently, not all programs participate in the match. This often results in students applying to 'match' and 'non-match' programs which can lead to significant stress on the part of applicants and program directors. This issue has recently become the focus of journal articles and public discussions. The goals of this paper were to review the history of postdoctoral recruitment in clinical neuropsychology, review the benefits of coordinated recruitment systems, review the structure and function of the computerized match, and explain why the computerized match for postdoctoral recruitment in clinical neuropsychology is beneficial for the specialty of clinical neuropsychology.

Rebuttal to Nelson et al. 'Response to Bodin and Grote regarding postdoctoral recruitment in clinical neuropsychology'.

Nelson et al. provided a response to our commentary on the postdoctoral match in clinical neuropsychology. In this brief rebuttal, we will focus on statements from Nelson et al. that we believe are factual inaccuracies or misunderstandings of some of the points we made in our commentary. In addition, we will comment briefly on the proposed guidelines offered in their response.

The relationship between suboptimal effort and post-concussion symptoms in children and adolescents with mild traumatic brain injury.

This retrospective chart review study explored the relationship between suboptimal effort and post-concussion symptoms in pediatric mild traumatic brain injury (mTBI). Participants were 382 clinically referred children and adolescents between 8 and 16 years of age who sustained an mTBI. Suboptimal effort was identified using reliable digit span and age-corrected scaled scores from the Numbers subtest of the Children's Memory Scale (CMS); 20% of the sample were classified as non-credible performers. Chi-square analyses and t-tests were used to examine differences in post-concussion symptoms and neuropsychological test performance between credible and non-credible performers. Linear regression was used to examine whether CMS Numbers performance predicted post-concussion symptoms after controlling for baseline symptoms and other relevant demographic- and injury-related factors. We found that non-credible performers presented with a greater number of post-concussion symptoms as compared with credible performers. Additionally, non-credible performers demonstrated comparatively poorer performance on neuropsychological tests of focused attention and processing speed. These results suggest that children and adolescents with mTBI who fail effort testing might have a greater tendency to exaggerate post-concussion symptoms and cognitive impairment. The clinical implications of these findings are discussed.

Postdoctoral recruitment in neuropsychology: a review and call for inter-organizational action.

The history of centralized matches for postgraduate selection is briefly discussed with a focus on the match instituted by the Association of Postdoctoral Programs in Clinical Neuropsychology (APPCN) in 2001] Survey data, conducted both by APPCN and independently, are summarized. In general, despite incomplete participation and an estimated 30% rate of "exploding offers", applicants are somewhat satisfied with the match according to recent surveys (although satisfaction varies depending on whether an applicant matched). Given the high rate of withdrawal, the history of other specialties with suboptimal participation, and the concerns most commonly expressed by participants about this issue in survey data, there is cause for concern. We assert that incomplete participation in the match hurts applicants and programs. We propose that focused efforts are needed involving multiple organizations to enhance the match, including the Clinical Neuropsychology Synarchy (CNS) as our specialty council and the multiple organizations represented on the CNS.

Higher order factor structure of the WISC-IV in a clinical neuropsychological sample.

A confirmatory factor analysis was conducted examining the higher order factor structure of the WISC-IV scores for 344 children who participated in neuropsychological evaluations at a large children's hospital. The WISC-IV factor structure mirrored that of the standardization sample. The second order general intelligence factor (g) accounted for the largest proportion of variance in the first-order latent factors and in the individual subtests, especially for the working memory index. The first-order processing speed factor exhibited the most unique variance beyond the influence of g. The results suggest that clinicians should not ignore the contribution of g when interpreting the first-order factors.

A survey of parent satisfaction with pediatric neuropsychological evaluations.

Satisfaction with pediatric neuropsychological evaluations was surveyed by asking parents or guardians of children who completed pediatric neuropsychological evaluations at a large children's hospital over a 2-year period to complete a 30-item rating scale. The scale included items drawn from published measures of consumer satisfaction, and incorporated a well-validated measure of general satisfaction. A total of 338 surveys were distributed, with 117 completed, for a return rate of 35%. Respondents were generally similar to non-respondents, except that respondents had a higher average level of maternal education and were more likely to have been referred for neuropsychological evaluations by sources outside the hospital. Parents were generally satisfied with pediatric neuropsychological evaluations, although some parents indicated that the evaluations did not provide as much help as expected. A factor analysis of the survey instrument revealed four dimensions of satisfaction: General Satisfaction, Clinician Acceptance/Empathy, Provision of Help, and Facilities/Administrative Assistance. Maternal education was negatively correlated with all four factors, but no other demographic, patient, or clinician variables were significantly related to satisfaction. Future studies could survey physicians and educators to provide a more complete understanding of satisfaction with pediatric neuropsychological evaluations.