INS NYC 2024 Program

Symposium	Symposia 3 Program Schedule 02/15/2024 09:00 am - 10:30 am Room: West Side Ballroom - Salon 4 Symposia 3: Current Trends and Future Frontiers in Neuropsychology and Digital Technologies Simposium #2 Comparing Telehealth and In-Person Administration of Neuropsychological Assessment Measures in an Outpatient Pediatric Sample during the COVID-19 Pandemic Madeline Manning, Massachusetts General Hospital, Boston, United States Pieter Vuijk, Massachusetts General Hospital, Boston, United States Eline Laurent, Massachusetts General Hospital, Boston, United States Emmaline Cook, Massachusetts General Hospital, Boston, United States Ellen Braaten, Massachusetts General Hospital, Boston, United States Alysa Doyle, Massachusetts General Hospital, Boston, United States Mary Colvin, Massachusetts General Hospital, Boston, United States Category: Assessment/Psychometrics/Methods (Child) Keyword 1: teleneuropsychology Keyword 2: pediatric neuropsychology Objective: In response to the COVID-19 pandemic, neuropsychologists adopted virtual assessments to meet patient care demands. While the need for remote test administration during the pandemic was pressing, equivalence of in-person and virtual assessment remains an open and critical question for neuropsychologists to adapt for future care. In the current analyses, we compared virtual versus in-person performances on twelve measures commonly administered in the child clinical setting. Participants and Methods: Participants were 475 youth (422 index children and 53 siblings) ages 6 through 17 (M_age 11.4 ± 3.0; 37.1% girls) consecutively referred for clinical neuropsychiatric evaluation and enrolled in the Longitudinal Study of Genetic Influences on Cognition. To be included, children were evaluated during the first or second year of the COVID-19 pandemic (i.e., 03/14/20 – 03/13/22) and completed at least one of the following 12 measures (M_{number of measures}= 8.2± 2.7): Similarities, Vocabulary, Matrix Reasoning, Figure Weights, and/or Digit Span from the Wechsler Adult Intelligence Scale – Fourth Edition (WAIS-IV) or Wechsler Intelligence Scale for Children – Fifth Edition (WISC-V); WISC-V Picture Span; Word Reading (WR), Decoding (DC) and/or Reading Comprehension (RC) from Wechsler Individual Achievement Test – Third or Fourth Edition (WIAT-III or WIAT-IV); Letter Fluency and Category Fluency of the Verbal Fluency (VF) test, and/or Inhibition from the Color Word Interference (CWI) test, both from the Delis-Kaplan Executive Function System (D-KEFS). Multilevel mixed-effects modeling was used to analyze the data to account for observations that are not independent. There were 2 levels, where participants (level 1) are nested in families (level 2). Detailed data about the type of assessment (i.e., virtual or in-person) was available for each measure and was the independent variable of interest. Control variables were age, sex, psychotropic medication, number of days between the start of the pandemic and assessment date, and, when relevant, the Wechsler or WIAT version. Analyses were performed with STATA 14. We used the Benjamini-Hochberg false discovery rate, with a critical value of .05 to correct for multiple testing. Results: Of the twelve tests examined, only three Wechsler verbal subtests yielded a significant effect of virtual/in-person assessment. On Similarities, the virtual assessment group scored 1.14 standard score points higher than the in-person group (z = 2.81, p = .0050). Similar benefits of virtual assessment were found for Vocabulary (b = 1.12, z = 2.55, p = .0107) and Digit Span (b = 1.04, z = 2.67, p = .0077). No significant effects were found on the measures of academic and executive functioning after correction for multiple testing. Post-hoc analysis suggested performance in both pandemic groups (virtual and in-person) was comparable to a pre-pandemic cohort. Conclusions: Results suggest relatively consistent performances across measures regardless of test modality. Three Wechsler verbal subtests (Similarities, Vocabulary, Digit Span) were exceptions in that virtual patients outperformed in-person patients. This interesting finding warrants further investigation. In sum, the current study offers promising data supporting the use of virtual administration of some common pediatric neuropsychological measures.

Symposium

02/15/2024
09:00 am - 10:30 am
Room: West Side Ballroom - Salon 4

Symposia 3: Current Trends and Future Frontiers in Neuropsychology and Digital Technologies

Simposium #2

Comparing Telehealth and In-Person Administration of Neuropsychological Assessment Measures in an Outpatient Pediatric Sample during the COVID-19 Pandemic

Madeline Manning, Massachusetts General Hospital, Boston, United States
Pieter Vuijk, Massachusetts General Hospital, Boston, United States
Eline Laurent, Massachusetts General Hospital, Boston, United States
Emmaline Cook, Massachusetts General Hospital, Boston, United States
Ellen Braaten, Massachusetts General Hospital, Boston, United States
Alysa Doyle, Massachusetts General Hospital, Boston, United States
Mary Colvin, Massachusetts General Hospital, Boston, United States

Category: Assessment/Psychometrics/Methods (Child)

Keyword 1: teleneuropsychology
Keyword 2: pediatric neuropsychology

Objective:

In response to the COVID-19 pandemic, neuropsychologists adopted virtual assessments to meet patient care demands. While the need for remote test administration during the pandemic was pressing, equivalence of in-person and virtual assessment remains an open and critical question for neuropsychologists to adapt for future care. In the current analyses, we compared virtual versus in-person performances on twelve measures commonly administered in the child clinical setting.

Participants and Methods:

Participants were 475 youth (422 index children and 53 siblings) ages 6 through 17 (M_age 11.4 ± 3.0; 37.1% girls) consecutively referred for clinical neuropsychiatric evaluation and enrolled in the Longitudinal Study of Genetic Influences on Cognition. To be included, children were evaluated during the first or second year of the COVID-19 pandemic (i.e., 03/14/20 – 03/13/22) and completed at least one of the following 12 measures (M_{number of measures}= 8.2± 2.7): Similarities, Vocabulary, Matrix Reasoning, Figure Weights, and/or Digit Span from the Wechsler Adult Intelligence Scale – Fourth Edition (WAIS-IV) or Wechsler Intelligence Scale for Children – Fifth Edition (WISC-V); WISC-V Picture Span; Word Reading (WR), Decoding (DC) and/or Reading Comprehension (RC) from Wechsler Individual Achievement Test – Third or Fourth Edition (WIAT-III or WIAT-IV); Letter Fluency and Category Fluency of the Verbal Fluency (VF) test, and/or Inhibition from the Color Word Interference (CWI) test, both from the Delis-Kaplan Executive Function System (D-KEFS).

Multilevel mixed-effects modeling was used to analyze the data to account for observations that are not independent. There were 2 levels, where participants (level 1) are nested in families (level 2). Detailed data about the type of assessment (i.e., virtual or in-person) was available for each measure and was the independent variable of interest. Control variables were age, sex, psychotropic medication, number of days between the start of the pandemic and assessment date, and, when relevant, the Wechsler or WIAT version. Analyses were performed with STATA 14. We used the Benjamini-Hochberg false discovery rate, with a critical value of .05 to correct for multiple testing.

Results:

Of the twelve tests examined, only three Wechsler verbal subtests yielded a significant effect of virtual/in-person assessment. On Similarities, the virtual assessment group scored 1.14 standard score points higher than the in-person group (z = 2.81, p = .0050). Similar benefits of virtual assessment were found for Vocabulary (b = 1.12, z = 2.55, p = .0107) and Digit Span (b = 1.04, z = 2.67, p = .0077). No significant effects were found on the measures of academic and executive functioning after correction for multiple testing. Post-hoc analysis suggested performance in both pandemic groups (virtual and in-person) was comparable to a pre-pandemic cohort.

Conclusions:

Results suggest relatively consistent performances across measures regardless of test modality. Three Wechsler verbal subtests (Similarities, Vocabulary, Digit Span) were exceptions in that virtual patients outperformed in-person patients. This interesting finding warrants further investigation. In sum, the current study offers promising data supporting the use of virtual administration of some common pediatric neuropsychological measures.