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The Current State of Neuropsychological Training and Clinical Practices with Asian American Patient Populations
Sana Arastu, Palo Alto University, Palo Alto, United States
Rayna Hirst, Palo Alto University, Palo Alto, United States
Talamahe'a Tupou, Palo Alto University, Palo Alto, United States
Julius Flowers, Palo Alto University, Palo Alto, United States
Lillian Vang, Palo Alto University, Palo Alto, United States
Alexandra Rousseau, Palo Alto University, Palo Alto, United States
Michael Ellis-Stockley, Palo Alto University, Palo Alto, United States
Asian American populations in the United States account for the fastest growing ethnic group. This diversity illuminates the challenges of addressing culturally sensitive clinical care and need for comprehensive training. The present study aimed to examine the extent of neuropsychologists’ training, considerations, and current practices with Asian American patient populations and identify important advocacy areas.
Neuropsychologists (n = 90, 81% female, mean age = 44.47) completed a survey containing questions about demographic information, professional work and training, and current practices with Asian American populations. Frequencies were calculated for demographics, training, and practices. Nonparametric Friedman’s ANOVA and post hoc tests identified patterns of ranked responses for current practices. A thematic analysis was conducted for open-ended questions about barriers to providing culturally sensitive neuropsychological training and services.
One third (37.7%) of participants received cultural sensitivity training in four or more settings, mainly in clinical contexts (83.3%). Over 86% received little to no training on Asian Americans specifically, yet half had worked with this population in the “past few weeks.” Steps to selecting norms and evaluating for English proficiency often differed from established recommendations. Resource inaccessibility, inconsistent use and lack of normative data, and interpreter use were identified as barriers to providing culturally sensitive services. Most (64.5%) desired increased and improved training quality with Asian Americans.
Findings suggest that neuropsychologists received little training experience with Asian Americans yet commonly worked with various Asian American subgroups in their practices. Results highlighted variability in adherence to guidelines for the interpretation and comparison of test performance, thereby raising ethical concerns and adding costs to their current work environments. Several barriers to providing culturally sensitive services to Asian American patients were reported, including lack of resources and poor accessibility of existing resources. Findings indicate an urgent need for increased accessibility and consensus in guidelines and recommendations for improving neuropsychological training and practices with Asian minorities. This can be achieved by increasing cultural sensitivity training across contexts and activities and by improving the dissemination of knowledge on recent guidelines for culturally informed practices to promote consistency in the neuropsychological assessment of Asian Americans.
Keyword 1: acculturation
Keyword 2: cross-cultural issues
Keyword 3: neuropsychological assessment