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Sexuality is a fundamental part of human existence and it encompasses thoughts, desires, behaviors, relationships, as well as neuropsychological and physiological components. However, sexuality in older adults is under-researched from the neuropsychological and psychophysiological perspectives and is often neglected by healthcare providers in the clinical practice. This article aims to explore the state of the art on the neuropsychology and psychophysiology of older adults' sexuality, proposing future research directions and emphasizing its significance. By summarizing current knowledge on the sexuality of younger individuals, it was possible to lay the groundwork for formulating research questions about older adults' sexuality. The implications proposed in this article will potentially impact both the scientific and also the clinical field. In fact, gaining insights on the neuropsychological and psychophysiological aspects of sexuality in healthy older adults can also shed light into those with neurocognitive disorders., Competing Interests: Declarations Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Individuals with neurologic illness/injury often experience changes in their daily functioning. Clinical providers caring for these individuals are frequently called upon for input as patients and their families navigate challenging decisions to ensure safety. This article reviews 3 areas in which recommendations from clinicians are often requested: medical decision-making, home safety, and driving. Strategies for making recommendations in these areas is offered including discussion of how neuropsychology evaluations can provide useful information to aid in making recommendations., Competing Interests: Disclosure The authors have nothing to disclose., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Research regarding the delivery of neuropsychological feedback (NF) has grown in recent years to include specific models and strategies for working with patients with diverse medical conditions across the lifespan, and is now considered a core competency for neuropsychologists. NF is an individualized therapeutic intervention designed to maximize the patient's understanding of assessment results and catalyze follow through with treatment recommendations. This article summarizes research on NF and its strategic goals, as well as the potential impact/outcomes of these therapeutic interventions. One specific model (Therapeutic Assessment) is described in detail and illustrated through a clinical vignette., Competing Interests: Disclosure K. Armstrong, Royalties—Feedback that Sticks: The art of effectively communicating neuropsychological assessment results (referenced in this article). J.B. Sheer. No Disclosures to report. M. Lanca. No Disclosures to report. K. Kovacs. No Disclosures to report., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Neuropsychology is an integral component of health care assessment for persons with vascular contributions to cognitive impairment and dementia. Since syndromes of vascular cognitive decline have multiple and varying pathophysiologies, anatomic brain locations, and levels of severity, neuropsychological assessment can be critical to clarify the cognitive manifestations of the disease, potential consequences for the patient and family, as well as the prognosis for future life planning. Cognitive profiles of vascular cognitive declines and relevant neuropsychological literature are reviewed here to provide the practicing physician with guidance for best clinical care practices., Competing Interests: Disclosure Preparation of this manuscript was supported in part by a grant from NIH, United States to J.S. Paulsen (RF1AG074608)., (Copyright © 2024 Elsevier Inc. All rights reserved.)

In the ever-evolving field of clinical neuropsychology, significant methodological and conceptual limitations hinder progress. To ensure the continued relevance of this discipline amidst remarkable advancements in neuroscience, medicine, and methodology, these obstacles must be addressed. This opinion article identifies inherent limitations within current clinical neuropsychology, including issues such as multi-collinearity in neuropsychological assessments, lack of validated tools reflecting contemporary cognitive function models, and the use of divergent theoretical frameworks in evaluations, leading to a gap between theory and practice. The disconnect between behavior and biomarkers, particularly evident in neurodegenerative diseases but also relevant for other pathologies, together with the rise of genetic analyses, necessitate change. Methodological improvements are crucial for ensuring the discipline's future relevance. Looking ahead, key perspectives and challenges are outlined, emphasizing the need for a holistic approach to cognitive functioning and congruent tools, patient engagement in experimental studies, rectification of biases, and exploration of variables like personality. Training professionals to bridge the gap between practice and research is essential. By addressing these challenges, clinical neuropsychology can not only adapt to the evolving landscape but also shape it, ensuring a brighter future for the field., (Copyright © 2024. Published by Elsevier Ltd.)

Equivalent Scores (ES) represent a statistical gold standard to obtain thresholds for clinical inference from normative data. The procedure to obtain ES requires a preliminary mandatory step: to perform a regression model selection to obtain adjusted scores that take into account age, education, and sex. The current article, starting from theoretical considerations, focuses on this step and proposes a new and improved regression model selection method. Results from data simulation show that the newly proposed method outperforms the current one on a wide range of simulation parameters and conditions, leading to better performance in classifying impaired or unimpaired performances, and more precise ES. The article is associated with an online app and R code to allow to easily apply the method to other normative data. This new model selection procedure can be easily incorporated also with other regression-based norm approaches., Competing Interests: Declarations Ethical statement The study was conducted under the principles of the Declaration of Helsinki. Since the study relies solely on data simulation, no approval from the ethics committee was asked. A pre-print of the article is available on PsyArXiv at the following link: https://osf.io/sw4hu. Informed consent This study used publicly available open data and simulated data, for which informed consent was either not required or not applicable. Conflict of interest The author declares no conflict of interest regarding the publication of this paper., (© 2024. Fondazione Società Italiana di Neurologia.)

Semantic dementia is a kind of neurodegenerative disorder, characterized by prominent semantic impairments and anterior temporal lobe atrophy. Since 2010, more studies have devoted to this rare disorder, revealing that it is more complex than we think. Clinical advances include more specific findings of semantic impairments and other higher order cognitive deficits. Neuroimaging techniques can help revealing the different brain networks affected (both structurally and functionally) in this condition. Pathological and genetic studies have also found more complex situations of semantic dementia, which might explain the huge variance existing in semantic dementia. Moreover, the current diagnosis criteria mainly focus on semantic dementia's classical prototype. We further delineated the features of three subtypes of semantic dementia based on atrophy lateralization with three severity stages. In a broader background, as a part of the continuum of neurodegenerative disorders, semantic dementia is commonly compared with other resembling conditions. Therefore, we summarized the differential diagnosis between semantic dementia and them. Finally, we introduced the challenges and achievements of its diagnosis, treatment, care and cross cultural comparison. By providing a comprehensive picture of semantic dementia on different aspects of advances, we hope to deepen the understanding of semantic dementia and promote more inspirations on both clinical and theoretical studies about it., Competing Interests: Declaration of Competing Interest The authors declare no competing interest., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: The rod and frame test (RFT), a measure of field dependence-independence, recently has reemerged as a measure of research interest and potential diagnostic value in neuropsychology. In the standard RFT, the subject experiences offsetting visual cues from a frame surrounding an embedded rod, while the subject's postural/vestibular cues provide the sense of verticality as the subject attempts to set the rod to vertical. The paper shows that RFTs not adhering to RFT parameters can reduce the test's visual framework impact experienced by the subject. Comparisons of neuropsychological studies will highlight that correct adherence to RFT testing conditions can strengthen RFT effects., Method: This review presents the parameters that have been studied which impact on subject performance on the RFT. It identifies how computer administered RFTs have been applied to enhance the study of the RFT parameters and make the RFT more accessible to the study of different diagnostic groups. The article also critiques studies by identifying how the RFT's parameters, study's design and statistical analysis may have diminished identifying the full effects of the RFT experience., Results: Parameters impacting judgments of verticality of the rod can include: perceived size of rod and frame, the gap between the ends of the rod and surrounding frame, presentation of the rod within an encompassing 3D visual framework that visually blocks out the surrounding environment, a dark room, instructions stressing egocentric vs allocentric strategies, double frame surrounding the rod to assess global perception effects, etc. Details are presented how gap size likely affected results in neuropsychology studies. Potentially, these and other experiments may be studied using computer administered RFTs., Conclusions: Based on the descriptions of computer administered RFTs, this article suggested that incorporating these technologies can provide better understanding underlying the RFT, and in turn, understanding neuropsychology processes.

Background: Innovative digital solutions are shaping a new concept of dementia care, opening additional venues for prevention, diagnosis, monitoring and treatment. Hereby, we report the development of a tablet-based teleneuropsychology platform (Tenèpsia®), from concept to certification as Medical Device (MD) Class IIA, as per new MD regulation 745/2017., Methods: The platform was designed for the remote cognitive evaluation and created thanks to the effort of a collaborative working group including experts from three Italian scientific societies and Biogen Italia S.r.l. (hereafter "Biogen"), and developers from Xenia Reply and Inside AI. The development strategy was guided by converting traditional paper-and-pencil tests into digital versions while maintaining comparable neuropsychological features and optimizing patient accessibility and user experience. The experts focused on the choice and adaptation of traditional neuropsychology measures for a 45-min teleneuropsychology assessment., Results: The developers created a web and a mobile interface, respectively, for the professional (neuropsychologist) and non-professional (patient and caregiver) use. Recording of voice, drawing and typing information was enabled. Instant dashboards provide a quick overview of the patient's condition. Simulation activities were performed to obtain MD certification, valid across Europe., Conclusion: Neuropsychology services will benefit from the implementation in clinics of harmonized digital tools with adequate scientific and technological standards. The use of digital cognitive testing for the diagnosis of mild cognitive impairment is expected to enhance patient and clinician outcomes through simplified, digital objective data collection, sparing of time and resources, with a positive impact on healthcare costs and access to treatments, reducing inequalities and delays in diagnosis and cure., (© 2024. Fondazione Società Italiana di Neurologia.)

Much attention in the field of clinical neuropsychology has focused on adapting to the modern healthcare environment by advancing telehealth and promoting technological innovation in assessment. Perhaps as important (but less discussed) are advances in the development and interpretation of normative neuropsychological test data. These techniques can yield improvement in diagnostic decision-making and treatment planning with little additional cost. Brooks and colleagues (Can Psychol 50: 196-209, 2009) eloquently summarized best practices in normative data creation and interpretation, providing a practical overview of norm development, measurement error, the base rates of low scores, and methods for assessing change. Since the publication of this seminal work, there have been several important advances in research on development and interpretation of normative neuropsychological test data, which may be less familiar to the practicing clinician. Specifically, we provide a review of the literature on regression-based normed scores, item response theory, multivariate base rates, summary/factor scores, cognitive intraindividual variability, and measuring change over time. For each topic, we include (1) an overview of the method, (2) a rapid review of the recent literature, (3) a relevant case example, and (4) a discussion of limitations and controversies. Our goal was to provide a primer for use of normative neuropsychological test data in neuropsychological practice., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objective: The COVID-19 pandemic resulted in educational disruption of historic breadth and duration. The impact of school closures and remote learning have been evaluated in recent studies and reflect critical data for neuropsychologists who routinely assess brain development as it relates to diagnosis, recommendations, and informing public policy., Method: Pre-pandemic and contemporaneous literature was summarized, including data on educational disruption and child and adolescent mental health challenges reported during the pandemic, and research on the impact of stress, social isolation, educational achievement, and other factors on brain development during critical developmental windows., Results: Studies indicate that prolonged educational disruption has resulted in attenuated learning gains, most remarkably for those already at risk for educational disparities. Studies have shown increased mental health challenges for youth during the pandemic, with higher rates of mood and eating disorders, and suicidal ideation. Given that some skills develop optimally within specific time periods, pandemic-related disruption has likely contributed to altered developmental trajectories., Conclusion: Trajectory of neuropsychological development of children and adolescents, especially marginalized students, may be affected by effects on learning and mental health due to prolonged educational disruption and psychological stressors. Evaluation and treatment may be delayed due to backlog and increased demand. Clinical neuropsychological practice recommendations are presented with a call to action for the field in moving forward flexibly to increase access to evaluation services., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permission@oup.com.)

Compared with other health disciplines, there is a stagnation in technological innovation in the field of clinical neuropsychology. Traditional paper-and-pencil tests have a number of shortcomings, such as low-frequency data collection and limitations in ecological validity. While computerized cognitive assessment may help overcome some of these issues, current computerized paradigms do not address the majority of these limitations. In this paper, we review recent literature on the applications of novel digital health approaches, including ecological momentary assessment, smartphone-based assessment and sensors, wearable devices, passive driving sensors, smart homes, voice biomarkers, and electronic health record mining, in neurological populations. We describe how each digital tool may be applied to neurologic care and overcome limitations of traditional neuropsychological assessment. Ethical considerations, limitations of current research, as well as our proposed future of neuropsychological practice are also discussed., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permission@oup.com.)

Background and Objectives : The study aims to provide a comprehensive neuropsychological analysis of psychotic spectrum disorders, including schizophrenia, bipolar disorder, and depression. It focuses on the critical aspects of cognitive impairments, diagnostic tools, intervention efficacy, and the roles of genetic and environmental factors in these disorders. The paper emphasizes the diagnostic significance of neuropsychological tests in identifying cognitive deficiencies and their predictive value in the early management of psychosis. Materials and Methods : The study involved a systematic literature review following the PRISMA guidelines. The search was conducted in significant databases like Scopus, PsycINFO, PubMed, and Web of Science using keywords relevant to clinical neuropsychology and psychotic spectrum disorders. The inclusion criteria required articles to be in English, published between 2018 and 2023, and pertinent to clinical neuropsychology's application in these disorders. A total of 153 articles were identified, with 44 ultimately included for detailed analysis based on relevance and publication status after screening. Results: The review highlights several key findings, including the diagnostic and prognostic significance of mismatch negativity, neuroprogressive trajectories, cortical thinning in familial high-risk individuals, and distinct illness trajectories within psychosis subgroups. The studies evaluated underline the role of neuropsychological tests in diagnosing psychiatric disorders and emphasize early detection and the effectiveness of intervention strategies based on cognitive and neurobiological markers. Conclusions : The systematic review underscores the importance of investigating the neuropsychological components of psychotic spectrum disorders. It identifies significant cognitive impairments in attention, memory, and executive function, correlating with structural and functional brain abnormalities. The paper stresses the need for precise diagnoses and personalized treatment modalities, highlighting the complex interplay between genetic, environmental, and psychosocial factors. It calls for a deeper understanding of these neuropsychological processes to enhance diagnostic accuracy and therapeutic outcomes.

Objective: Feedback on neuropsychological assessment is a critical part of clinical practice, but there are few empirical papers on neuropsychological feedback practices. We sought to fill this gap in the literature by surveying practicing neuropsychologists in the United States. Questions addressed how they provide verbal and written feedback to patients and referral sources. Survey questions also addressed billing practices and training in the provision of feedback., Methods: A survey was developed using Qualtrics XM to survey currently licensed, independently practicing clinical neuropsychologists in the United States about their feedback practices. The survey was completed by 184 individuals., Results: Nearly all respondents reported that they provide verbal feedback to patients, most often in-person, within three weeks following testing. Typically, verbal feedback sessions with patients last 45 min. Verbal feedback was provided to referrals by about half of our sample, typically via a brief phone call. Most participants also reported providing written feedback to both the patient and referring provider, most commonly via the written report within three weeks after testing. Regarding billing, most respondents use neuropsychological testing evaluation codes. The COVID-19 pandemic appeared to have had a limited impact on the perceived effectiveness and quality of verbal feedback sessions. Finally, respondents reported that across major stages of professional development, training in the provision of feedback gradually increased but was considered inadequate by many participants., Conclusions: Results provide an empirical summary of the "state of current practice" for providing neuropsychological assessment feedback. Further experimental research is needed to develop an evidence-base for effective feedback practices.

Obsessive-compulsive disorder (OCD), a highly prevalent and debilitating disorder, is incompletely understood in terms of underpinning behavioural, psychological, and neural mechanisms. This is attributable to high symptomatic heterogeneity; cardinal features comprise obsessions and compulsions, including clinical subcategories. While obsessive and intrusive thoughts are arguably unique to humans, dysfunctional behaviours analogous to those seen in clinical OCD have been examined in nonhuman animals. Genetic, ethological, pharmacological, and neurobehavioural approaches all contribute to understanding the emergence and persistence of compulsive behaviour. One behaviour of particular interest is maladaptive checking, whereby human patients excessively perform checking rituals despite these serving no purpose. Dysfunctional and excessive checking is the most common symptom associated with OCD and can be readily operationalised in rodents. This review considers animal models of OCD, the neural circuitries associated with impairments in habit-based and goal-directed behaviour, and how these may link to the compulsions observed in OCD. We further review the Observing Response Task (ORT), an appetitive instrumental learning procedure that distinguishes between functional and dysfunctional checking, with translational application in humans and rodents. By shedding light on the psychological and neural bases of compulsive-like checking, the ORT has potential to offer translational insights into the underlying mechanisms of OCD, in addition to being a platform for testing psychological and neurochemical treatment approaches., (© 2024. The Author(s).)

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., (© The Author(s) 2023. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permission@oup.com.)

Objective: Parental and other caregiving leave is important to postdoctoral fellows, yet there is no field-wide recommendation for leave policies among clinical neuropsychology postdoctoral training programs, which is of particular relevance given the two-year requirement for eligibility for board certification. The aims of this manuscript are to (a) discuss general guidelines and recommendations for leave policies, both informed by prior empirical evidence as well as relevant existing policy guidelines from various academic and healthcare organizations, and (b) use vignettes to provide possible solutions for potential leave scenarios. Method: A critical review of literature on family leave from public policy and political science, industrial-organizational psychology, academic medicine, and psychology was conducted and findings were synthesized. Results and Conclusions: Fellowship training programs are encouraged to adopt a competency-based model that permits flexibility in leave during training without necessarily requiring an extended end date. Programs should adopt clear policies and make this information readily available to trainees and think flexibly about training options that best meet the training needs and goals of each individual. We also encourage neuropsychologists at all levels to engage in advocacy for broader systemic supports of trainees seeking equitable family leave.

The chapter explores the role of neuropsychology in understanding brain fog as a subjective complaint in the context of COVID-19. It discusses the historical and medical significance of the term "brain fog" and its psychological and neurological aspects. The chapter identifies the cognitive domains commonly affected by brain fog, such as attention, executive function, memory, and language. Additionally, it emphasizes the impact of societal changes during the COVID-19 pandemic on the general population as a crucial backdrop for understanding the issue. The chapter also highlights the important role of clinical and research neuropsychologists in gaining clarity on grouped data and individual patients' cognitive and emotional difficulties after COVID-19 infection. It discusses indications for neuropsychological rehabilitation and therapy and describes typical therapy phases and methods, including new approaches like telemedicine, virtual reality, and mobile app-based rehabilitation and self-tracking. The chapter underscores that experiences of brain fog can vary among COVID-19 patients and may change over time. It provides clinicians and interested parties with an in-depth understanding of brain fog and its manifestations, concomitant subtypes, and concrete strategies for addressing it. The chapter emphasizes the critical role of neuropsychology in scientifically examining brain fog and advocating for personalized approaches to cognitive rehabilitation., (© 2024. The Author(s), under exclusive license to Springer Nature Switzerland AG.)

The present review attempts to discuss how some of the central concepts from the Lurian corpus of theories are relevant to the modern neuropsychology of epilepsy and epilepsy surgery. Through the lenses of the main Lurian concepts (such as the qualitative syndrome analysis), we discuss the barriers to clinical reasoning imposed by quadrant-based views of the brain, or even atheoretical, statistically-based and data-driven approaches. We further advice towards a systemic view inspired by Luria's clinical work and theorizing, given their importance towards our clinical practice, by contrasting it to the modular views when appropriate. Luria provided theory-guided methods of assessment and rehabilitation of higher cortical functions. Although his work did not specifically address epilepsy, his theory and clinical approaches actually apply to the whole neuropathology spectrum and accounting for the whole panorama of neurocognition. This holistic and systemic approach to the brain is consistent with the network approach of the neuroimaging era. As to epilepsy, the logic of cognitive functions organized into complex functional systems, contrary to modular views of the brain, heralds current knowledge of epilepsy as a network disease, as well as the concept of the functional deficit zone., Competing Interests: The authors have no conflict of interest to declare., (Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/).)

Objective: Recent teleneuropsychology (TeleNP) models provide some degree of guidance in the application of telecommunication technologies toward the practice of neuropsychology. However, there remains a paucity of peer-reviewed data on TeleNP practices with culturally diverse patients, including Asian patients. This manuscript describes the challenges related to TeleNP practices with Asian patients and offers practical recommendations to complement existing TeleNP guidelines., Method: Based on extant literature on multicultural applications of neuropsychology, weprovide recommendations for TeleNP services with Asian patients that pertain to specific components of a TeleNP evaluation, such as a) pre-evaluation preparation, b) determining the appropriateness of the referral, c) determining language proficiency, d) working with interpreters, e) informed consent and confidentiality issues, f) conducting a culturally sensitive clinical interview, g) behavioral observations and communication, h) test selection, and i) interpreting data and writing reports., Conclusions: Our recommendations for TeleNP services with Asian patients highlight the need for flexibility to accommodate cultural differences and commitment to the complex nature of working with patients requiring interpretation services, while also recognizing the importance of preserving the validity of neuropsychological methods. Moving forward, it is imperative that the field of neuropsychology increases the training and accessibility of neuropsychologists who are knowledgeable in providing TeleNP services to Asian patients, and promotes research on the validation of TeleNP for Asian and other ethnic minority groups.

Neuropsychology is a fast-growing specialty in Greece. This study surveyed the status of neuropsychologists in Greece investigating several aspects of the profession. An online-based questionnaire collected data from December 2019 to February 2020. A total of 133 participants specialized in neuropsychology were included in the final sample: 81% of the participants were women with a mean age of 35 years. In the total sample, 25.8% of the participants reported working in the hospital system, 18.5% in the university or college, and 17.7% in a private practice job. Greek professionals cited to engage actively in assessment (87.9%), in research (65.1%), in rehabilitation (47.7%), and teaching (30.2%). Professionals primarily declared to assess individuals with dementia (80.3%), depression (47.7%), and stroke (44.0%), and they reported neurologists, psychiatrists and psychologists as their leading sources of referrals. The top five perceived barriers to the field include the lack of recognized specialty (75.9%), the lack of clinical training opportunities (63.9%), the lack of strong professional associations (57.9%), the lack of access to neuropsychological instruments (57.9%) and the lack of willingness to collaborate between professionals (48.9%). The average monthly income of professionals represents a ratio of 0.76 in comparison to that of other scientists in the country and is the lowest reported among other countries. Despite the significant development of the profession, it is essential to create more clinical training opportunities, apply practices systematically to diverse populations, redefine the specialty of neuropsychology in the national health system of the country, and advocate for the profession.

Professional challenges have been documented in broad surveys of neuropsychologists. While previous surveyors have included pediatric neuropsychologists, few, if any, have specifically examined practices among those who primarily work in pediatric inpatient rehabilitation settings. Therefore, the aim of this study was to survey neuropsychologists in this setting. Thirty neuropsychologists from the U.S. and one from Canada that work in inpatient pediatric rehabilitation participated in an online survey. Most respondents (83.3%) billed for their inpatient time. Sixty-four percent indicated that payor type (private vs. public) affected services a moderate amount to a lot; this was primarily due to payor's influence on length of stay. Most providers had productivity expectations (66.7%). Among those that had productivity expectations, three-quarters used "hours billed;" 37.5% were solely or additionally tracked by relative value units (RVUs). The majority of respondents conducted some type of clinical data collection, usually for research purposes. With respect to professional identity, most respondents indicated positivity about their role. The top challenges endorsed were related to workload/ability to meet the patients' needs and billing/productivity. Issues related to billing and payor may influence aspects of pediatric inpatient rehabilitation neuropsychological care. Managing challenges related to billing and the time demands associated with providing inpatient services were top concerns for many respondents. Most sites surveyed were involved in data collection, usually for research purposes; increased data collection efforts are needed to aid with program development and evaluation and to demonstrate the added value of neuropsychological services from a patient care perspective.

This article summarizes selected presentations from a session titled "Cognition and Sensory Systems in Healthy and Diseased Subjects", held to highlight and honor the work of Dr. Marilyn Jones-Gotman. The session was part of a two-day symposium, "Neurophysiology, Neuropsychology, Epilepsy, 2022: Hills We Have Climbed and the Hills Ahead". The session presented research on epilepsy and sensory systems by colleagues and former trainees of Dr. Jones-Gotman. The extended summaries provide an overview of historical and current work in the neuropsychology of epilepsy, neuropsychological and neuroimaging approaches to understanding brain organization, sex differences in brain mechanisms underlying neurological disorders, dietary influences on brain function and cognition, and expertise in olfactory training and language experiences and their implications for brain organization and structure., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Objective: The objective of this study is to propose a TeleNP model for remote assessment and offer practical recommendations for clinical practice with patients in Mexico and Latin America, based on a systematic literature review and clinical experience., Method: A systematic review of studies from 2011 to 2021 in English and Spanish used TeleNP, teleneuropsychology, telepsychology, online, assessment, teleneuropsicología, and evaluación for the search; the databases examined included PubMed, BiDi UNAM, ScienceDirect, Google Scholar, and Wiley One Library; the Oxford Centre for Evidence-Based Medicine system was used to grade the levels of evidence. The experience of the last two years of students and faculty in the Master's and Doctoral Programs in Psychology, Clinical Neuropsychology Residency Program, was also used as a basis for this guide., Results: We propose a clinical model for TeleNP assessment in Mexico and Latin America based on the review of 31 articles and the practice of professors and students of clinical neuropsychology., Conclusion: The proposed model describes a procedure and adaptations for home-to-home clinical practice in the neuropsychological assessment of Mexican patients that could also be used in other Latin American countries. Its reliability remains to be assessed, but this model and the suggestions proposed could be used in future studies and clinical trials for Mexican and Latin American populations., (© The Author(s) 2022. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Clinical neuropsychology has been a valuable asset to neurologic surgery, contributing to lateralization and localization of pathologic brain tissue, identification of eloquent cortex, and evaluation of postoperative neuropsychological functioning. Moreover, neuropsychologists provide empirically driven interventions aimed at supporting preparation and/or recovery of neurosurgery patients. Nonetheless, several challenges may limit the reliability, validity, and generalizability of the assessment data obtained and reduce the usefulness of other neuropsychological services provided. Specifically, linguistic, cultural, educational, and other biases associated with demographic characteristics can lead to a narrowed view of an individual's life experiences, which must be confronted to fulfill the mission of ensuring that all patients have access to care that is appropriate to their needs. Instead of perceiving these challenges as insurmountable barriers, such issues can be viewed as opportunities to catalyze change and foster innovation for the future of neuropsychological care in neurosurgical settings. In addition to reviewing the possible mechanisms of these obstacles, the current article offers tangible solutions at both a macro level (e.g., discipline-wide transformations) and micro level (e.g., individualized patient-centric approaches). Outlined are practical techniques to potentially improve consensus and standardization of methods, advance and globalize research, expand representativeness of measures and practices to serve diverse individuals, and increase treatment adherence through engagement of patients and their families., (Copyright © 2022. Published by Elsevier Inc.)

Objective: Identify factors influencing service delivery changes during COVID-19 and examine barriers and provider satisfaction with teleneuropsychology (teleNP)., Method: Licensed clinical neuropsychologists within the United States recruited via neuropsychology-specific listservs (July-August 2020) to complete an online survey., Results: A total of 261 individuals completed the survey. Most (76%) reported delivering in-person testing in some capacity at the time of our survey. Relatively more private practitioners identified concerns with privacy/confidentiality (45.2% vs. 17.9%; χ 2 (2) = 6.99, p  < 0.05), legal issues (47.6% vs. 17.9%; χ 2 (2) = 8.06, p  < 0.05), and an undesirable precedent for legal/forensic cases (59.5% vs. 15.4%; χ 2 (2) = 17.54, p  < 0.001) compared to hospital or other medical (non-VA) practitioners. Multiple resources informed teleNP protocols, such as organization guidelines (87.6%), literature review (75.9%), webinars (72.4%), and consultation (68%). Several factors influenced test selection, including availability of normative data (70.1%), test familiarity (66.4%), administration time (63.5%), and evidence base (60.6%). Reported barriers to continuing teleNP after COVID-19 included need for improved teleNP norms (85.9%), domain coverage (84.7%), improved patient access to technology (74.1%) and further validation studies (84.1%)., Conclusion: TeleNP may not be feasible in all settings and/or referrals. Respondents employed multiple resources in aggregating teleNP protocols and considered several factors when selecting tests. Results highlight the complex and varied decision-making processes utilized by respondents to adapt to service delivery changes. Considering the many benefits of teleNP, future research addressing some of the potentially modifiable factors (e.g., technology access, attitudes regarding teleNP) and significant development needs for teleNP itself (i.e., improved teleNP norms, further validation studies, etc.) is warranted.

Objective: Clinical neuropsychology has been slow in adopting novelties in psychometrics, statistics, and technology. Researchers have indicated that the stationary nature of clinical neuropsychology endangers its evidence-based character. In addition to a technological crisis, there may be a statistical crisis affecting clinical neuropsychology. That is, the frequentist null hypothesis significance testing framework remains the dominant approach in clinical practice, despite a recent surge in critique on this framework. While the Bayesian framework has been put forward as a viable alternative in psychology in general, the possibilities it offers to clinical neuropsychology have not received much attention., Method: In the current position paper, we discuss and reflect on the value of Bayesian methods for the advancement of evidence-based clinical neuropsychology., Results: We aim to familiarize clinical neuropsychologists and neuropsychological researchers to Bayesian methods of inference and provide a clear rationale for why these methods are valuable for clinical neuropsychology., Conclusion: We argue that Bayesian methods allow for a more intuitive answer to our diagnostic questions and form a more solid foundation for sequential and adaptive diagnostic testing, representing uncertainty about patients' observed test scores and cognitive modeling of test results.

Objective: The population aged 65 and over is growing rapidly and with it are increased demands for integrative care and management of cognitive health issues. Such care models often do not include neuropsychologists or other psychology specialties., Methods: In this study, 72 medical charts of VA patients diagnosed with neurocognitive disorders were reviewed using best practice guidelines for diagnosing and managing neurocognitive disorders, adapted from Downs et al. (2006)., Results: Results indicated that physicians typically used clinical judgment through review of medications, blood work within the past year, and a history of symptoms to make diagnostic conclusions. Cognitive assessment and consideration of other reversible causes of cognitive decline (e.g., depression) were less commonly considered., Conclusions: The results are discussed in terms of potential implications for neuropsychologists and the integration of neuropsychology and primary care.

This article highlights ethical issues that may arise in the relationship between curatorship applications and neuropsychology. In South Africa (SA), curatorship applications for the elderly diagnosed with dementia require substantiation from two medical professionals, one of whom should be a practising psychiatrist deemed competent to provide this. Concurrently, there is often a request for a psychologist to conduct a neuropsychological assessment and to produce a relevant report. The process may result in ethical issues at various stages of the assessment. The balance between protecting the patient's rights v. freedom of autonomy becomes a central issue. Psychiatrists and psychologists are cautioned to adhere to best practices throughout the assessment, maintaining a critical and reflective stance. The limitations of cognitive assessment as a predictor of functionality should be considered. Furthermore, neuropsychological training in SA differs across institutions, resulting in variable practitioner competency. 'Competency' itself is an ambiguous legal term that may be interpreted variably. This article outlines the definitions and requirements of the curatorship process, as well as the role and limitations of neuropsychology, with emphasis on the ethical dilemmas that may arise.

Objective: Teleneuropsychology (teleNP) could potentially expand access to services for patients who are confined, have limited personal access to healthcare, or live in remote areas. The emergence of the COVID-19 pandemic has significantly increased the use of teleNP for cognitive assessments. The main objective of these recommendations is to identify which procedures can be potentially best adapted to the practice of teleNP in Latin America, and thereby facilitate professional decision-making in the region., Method: Steps taken to develop these recommendations included (1) formation of an international working group with representatives from 12 Latin American countries; (2) assessment of rationale, scope, and objectives; (3) formulation of clinical questions; (4) evidence search and selection; (5) evaluation of existing evidence and summary; and (6) formulation of recommendations. Levels of evidence were graded following the Oxford Centre for Evidence-Based Medicine system. Databases examined included PubMed, WHO-IRIS, WHO and PAHO-IRIS, Índice Bibliográfico Español en Ciencias de la Salud (IBCS), and LILACS., Results: Working group members reviewed 18,400 titles and 422 abstracts and identified 19 articles meeting the criteria for level of evidence, categorization, and elaboration of recommendations. The vast majority of the literature included teleNP tests in the English language. The working group proposed a series of recommendations that can be potentially best adapted to the practice of teleNP in Latin America., Conclusions: There is currently sufficient evidence to support the use of videoconferencing technology for remote neuropsychological assessments. These recommendations will likely contribute to the advancement of teleNP research and practice in the region., (© The Author(s) 2021. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

In "network neuropsychology", network modelling and graph theory is applied to the neuropsychological test scores of patients with neurological disorders to investigate cognitive functioning. This review identifies the emerging literature on several disorders before focusing on the assumptions about cognition underlying the studies; specifically, that cognition can be thought of as a network of interrelated variables and that changes in these interrelationships, or cognitive rearrangement, can occur in neurological disorders. Next the review appraises how well network models can provide a "map" of this cognitive "territory". In particular, the review considers the lack of correspondence between the variables and properties of network models and cognitive functioning. The challenges of explicitly accounting for latent cognitive constructs and making inferences about cognition based on associative, as opposed to dissociative, methods are also discussed. It is concluded that the validity of network neuropsychological models is yet to be established and that cognitive theory and experiments, as well as network models, are needed to develop and interpret better maps., (Crown Copyright © 2021. Published by Elsevier Ltd. All rights reserved.)

Background: Despite numerous calls throughout the years for an increase in ethnic, cultural, and racial diversity within the field of psychology, it remains an elusive reality for Hispanic neuropsychology practitioners in the United States (U.S.)., Objective: 1. Determine the background and current work situation of Hispanic clinical neuropsychologists in the U.S. (e.g., professional training, assessment and diagnostic procedures used, rehabilitation techniques employed, populations targeted, teaching responsibilities, and research activities), and 2. Examine issues related to perceived discrimination in the field of neuropsychology and what this means for our profession., Methods: The sample consisted of 107 Hispanic neuropsychologists residing among the 50 United States, District of Columbia, and Puerto Rico who took a survey of professional practices and experiences in clinical neuropsychology., Results: Our findings confirm that Hispanic neuropsychologists in the U.S. are culturally diverse, present with varied levels of bilingualism, have been faced with discrimination during training and in their workplace, and compare favorably with non-Hispanic neuropsychologists in terms of education and clinical training., Conclusions: Transforming neuropsychology into a diverse and inclusive field requires intentional, strategic, and systematic interventions in education, academia, training, professional organizations and in research.

Objective: Telehealth offers the opportunity to address a growing need to improve access to specialty services, such as neuropsychology, particularly for older adults and those in rural areas. Initial research has examined the validity and acceptability of teleneuropsychology (teleNP) in research settings, but there is less information about teleNP implementation in clinical practice. Here we describe the development of a teleNP clinic and compare patient satisfaction to those completing in-person neuropsychological evaluations. Method: A teleNP clinic was developed at the VA Bedford Healthcare System to serve older Veterans with referral questions focused on cognitive aging concerns. Patients presented to affiliated VA satellite clinics and were connected to neuropsychology clinicians at the main hospital campus through synchronous video. An evaluation battery was compiled to closely approximate in-person evaluations. Trained staff members at the satellite clinic assisted with administration of select tasks. Patient satisfaction was evaluated using a self-report questionnaire and responses were compared to a group undergoing in-person neuropsychological evaluations. Results: Self-reported satisfaction was high for all aspects of the patient experience, with no significant difference found between teleNP (n = 67) and in-person (n = 64) groups. In particular, 90% of patients in the teleNP group and 98% of patients in the in-person group agreed or strongly agreed with the statement, "I was overall satisfied with this visit.". Conclusions: TeleNP is a feasible and acceptable alternative to traditional in-person neuropsychological evaluations in clinical practice focused on older adults. Future research should continue to validate evaluation measures used in telehealth settings, identify the populations that would benefit most from teleNP services, and explore the expansion of teleNP services.

This paper aims to provide pediatric neuropsychologists with suggested processes and procedures to continue to provide neuropsychology services during the COVID-19 global pandemic. Our practice is located within an academic medical center/children's hospital, and setting-specific recommendations may not extend to all practices, though our hope is that others find guidance from our approach to providing pediatric neuropsychology evaluations when physical distancing is required. With consideration of ethics, equity, and assessment validity, we provide suggestions for a) modifying practices around seeing patients during COVID-19, b) tele-health for the pediatric neuropsychologist, c) safety standards and requirements, and d) working with special populations (e.g., Autism Spectrum Disorder, bilingual populations, immunocompromised patients, and acute inpatient assessment).

Recent events such as the global pandemic of COVID-19 have challenged neuropsychologists to scale up their capacity to conduct portions of their assessment remotely. While more complex patients will likely continue to require on-site, office-based interaction and assessment, the current emergency-based expansion of online and telehealth evaluation practices may ultimately lay the groundwork for more routine, online assessment of patients with less complex presentations in the future. To this end, the current study evaluated a pre-appointment, online methodology for differentiating referred pediatric patients based upon the scope and severity of their caregiver-reported adaptive, academic, attentional, behavioral, and emotional impairment. Prior to on-site assessment, parents/caregivers of 2197 children (Mean age = 10.0y, range = 4-19y, 62% male) completed an online developmental history form screening for symptoms of adaptive, attentional, learning, affective, and behavioral impairment; 71% of those children eventually underwent assessment. Using latent class analysis, the data supported a reproducible 4-class model consisting of groups of children at increased risk for: 1) severe multi-domain dysfunction; the "High Complexity" group, 30%, 2) behavioral-affective (but not academic) dysregulation; the "Behavioral Focus" group, 13%, 3) academic (but not behavioral-affective) problems; the "Academic and Inattention" group, 37%, and 4) patients with minimal clinical complexity; the "Low Complexity" group, 20%. Comparison of pre-visit classification with day-of-assessment standardized test scores supported the validity of patient subtypes. Moving forward, pre-appointment clarification of patient complexity may support efficient patient triage with regard to assessment modality (e.g., on-site or online) and length of appointment (e.g., comprehensive or targeted).

Neuropsychologists in the digital age have increasing access to emerging technologies. The National Institutes of Health (NIH) initiatives for behavioral and social sciences have emphasized these developing scientific and technological potentials (eg, novel sensors) for augmented characterization of neurocognitive, behavioral, affective, and social processes. Perhaps these innovative technologies will lead to a paradigm shift from disintegrated and data-poor behavioral science to cohesive and data-rich science that permits improved translation from bench to bedside. The 4 main advances influencing the scientific priorities of a recent NIH Office of Behavioral and Social Sciences Research strategic plan include the following: integration of neuroscience into behavioral and social sciences, transformational advances in measurement science, digital intervention platforms, and large-scale population cohorts and data integration. This paper reviews these opportunities for novel brain-behavior characterizations. Emphasis is placed on the increasing concern of neuropsychology with these topics and the need for development in these areas to maintain relevance as a scientific discipline and advance scientific developments. Furthermore, the effects of such advancements necessitate discussion and modification of training as well as ethical and legal mandates for neuropsychological research and praxes., (©Thomas Parsons, Tyler Duffield. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 16.12.2020.)

This is the second of two narrative reviews on cognitive disorders in epilepsy (companion manuscript: Cognitive disorders in epilepsy I: Clinical experience, real-world evidence and recommendations). Its focus is on the clinical targets, indications, and the selection of neuropsychological test instruments. Cognitive assessment has become an essential tool for the diagnosis and outcome control in the clinical management of epilepsy. The diagnostics of basic and higher brain functions can provide valuable information on lateralized and localized brain dysfunctions associated with epilepsy, its underlying pathologies and treatment. In addition to the detection or verification of deficits, neuropsychology reveals the patient's cognitive strengths and, thus, information about the patient reserve capacities for functional restitution and compensation. Neuropsychology is an integral part of diagnostic evaluations mainly in the context of epilepsy surgery to avoid new or additional damage to preexisting neurocognitive impairments. In addition and increasingly, neuropsychology is being used as a tool for monitoring of the disease and its underlying pathologies, and it is suited for the quality and outcome control of pharmacological or other non-invasive medical intervention. This narrative review summarizes the present state of neuropsychological assessments in epilepsy, reveals diagnostic gaps, and shows the great need for education, homogenization, translation and standardization of instruments., (Copyright © 2020 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.)

Purpose: Traditional neuropsychological testing carries elevated COVID-19 risk for both examinee and examiner. Here we describe how the pilot study of the Australian Epilepsy Project (AEP) has transitioned to tele-neuropsychology (teleNP), enabling continued safe operations during the pandemic., Methods: The AEP includes adults (age 18-60) with a first unprovoked seizure, new diagnosis of epilepsy or drug resistant focal epilepsy. Shortly after launching the study, COVID-related restrictions necessitated adaptation to teleNP, including delivery of verbal tasks via videoconference; visual stimulus delivery via document camera; use of web-hosted, computerised assessment; substitution of oral versions for written tests; online delivery of questionnaires; and discontinuation of telehealth incompatible tasks., Results: To date, we have completed 24 teleNP assessments: 18 remotely (participant in own home) and six on-site (participant using equipment at research facility). Five face-to-face assessments were conducted prior to the transition to teleNP. Eight of 408 tests administered via teleNP (1.9 %) have been invalidated, for a variety of reasons (technical, procedural, environmental). Data confirm typical patterns of epilepsy-related deficits (p < .05) affecting processing speed, executive function, language and memory. Questionnaire responses indicate elevated rates of patients at high risk of mood (34 %) and anxiety disorder (38 %)., Conclusion: Research teleNP assessments reveal a typical pattern of impairments in epilepsy. A range of issues must be considered when introducing teleNP, such as technical and administrative set up, test selection and delivery, and cohort suitability. TeleNP enables large-scale neuropsychological research during periods of social distancing (and beyond), and offers an opportunity to expand the reach and breadth of neuropsychological services., (Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Objectives: Emory University has modified its clinical practices across specialties in response to the 2020 COVID-19 pandemic to provide service delivery while maintaining patient, staff, and faculty safety. This report shares current solutions and workarounds associated with telehealth neuropsychology (teleNP) while also recognizing teleNP opportunities. Results: We modified many measures from our traditional assessment protocols so they could be administered through Zoom. To maximize quality control, formal how-to coversheets and manuals were developed for both training and task administration (i.e. navigating Zoom assessment interfaces, practicing adapted test instructions, and troubleshooting). Conclusions: TeleNP has been successfully used to answer referral questions regarding deep brain stimulation (DBS) candidacy in Parkinson's disease patients and presence of mild neurocognitive impairment in patients with subjective memory decline. Our current protocols will continue to evolve with greater experience and are not considered to be a finished product. Nevertheless, development of robust teleNP protocols should expand availability of neuropsychology in both clinical and research applications while simultaneously decreasing assessment burden associated with traveling - sometimes long distances - for diagnostic neuropsychological evaluation.

Objective: To describe the challenges related to COVID-19 affecting pediatric neuropsychologists practicing in inpatient brain injury rehabilitation settings, and offer solutions focused on face-to-face care and telehealth. Methods: A group of pediatric neuropsychologists from 12 pediatric rehabilitation units in North America and 2 in South America have met regularly since COVID-19 stay-at-home orders were initiated in many parts of the world. This group discussed challenges to clinical care and collaboratively problem-solvedsolutions. Results: Three primary challenges to usual care were identified, these include difficulty providing 1) neurobehavioral and cognitive assessments; 2) psychoeducation for caregivers and rapport building; and 3) return to academic instruction and home. Solutions during the pandemic for the first two areas focus on the varying service provision models that include 1) face-to-face care with personal protective equipment (PPE) and social distancing and 2) provision of care via remote methods, with a focus on telehealth. During the pandemic,neuropsychologists generally combine components of both the face-to-face and remote care models. Solutions to the final challenge focus on issues specific to returning to academic instruction and home after an inpatient stay. Conclusions: By considering components of in-person and telehealth models of patient care during the pandemic, neuropsychologists successfully serve patients within the rehabilitation setting, as well as the patient's family who may be limited in their ability to be physically present due to childcare, illness, work-related demands, or hospital restrictions.

Objective: The illness resulting from Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), better known as COVID-19, has quickly escalated to a worldwide pandemic. Although understanding of the short and long-term manifestations of COVID-19 remains incomplete, there is a preponderance of respiratory pathology in COVID-19 and potential for chronic loss of pulmonary function in recovered patients, raising concerns for associated cognitive impacts. Method: We conducted a narrative review of the existing literature on neuropsychological variables in acute/severe respiratory disease and various forms of chronic pulmonary disease to inform expectations about potential cognitive manifestations of COVID-19. Results: Cognitive dysfunction is common but not inevitable in acute and chronic pulmonary disease, although unique predictors and symptom trajectories appear to be associated with each. Conclusions: Although the full scope of neuropathophysiology associated with COVID-19 remains to be established, pulmonary insults associated with the disease are likely to produce cognitive dysfunction in a substantial percentage of patients.

Objective: As the coronavirus pandemic extends across the globe, the impacts have been felt across domains of industry. Neuropsychology services are no exception. Methods for neuropsychological assessments, which typically require an in-person visit, must be modified in order to adhere to social distancing and isolation standards enacted in an effort to slow the pandemic. How can providers continue to meet the needs of patients referred for neuropsychology evaluations, while respecting federal and state guidelines for safety and ethical mandates? We offer a novel, tiered model of care, successfully implemented in response to mandated social distancing, in a large, pediatric neuropsychology program. Method: We describe the considerations and challenges to be addressed in transitioning a large neuropsychology department to a new model of care, including triaging referrals, developing -or rediscovering - types of services to meet the needs of a virtual patient population, and helping patients, parents, and providers to adjust to these new models. Conclusions: Lessons learned as a function of rapid changes in care models have implications for the field of neuropsychology as a whole as well as for future flexibility in meeting the needs of pediatric patients and their families.

Objective: The COVID-19 pandemic is a global health crisis that has created sudden and unique challenges within the field of clinical neuropsychology. Adapting neuropsychology services using teleneuropsychology models (e.g. video or telephone assessments) may not always be a viable option for all providers and settings. Based on the existing teleneuropsychology literature, we propose a "contactless" evidence-based inpatient test battery to be used for in-person assessments amenable to physical distancing. Method: In addition to the proposed test battery, we suggest a decision-making workflow process to help readers determine the appropriateness of the proposed methods given their patients' needs. Considerations for special populations (i.e. seniors, patients with brain injury, psychiatric patients), feedback, limitations of the proposed physical distancing approach, and future directions are also discussed. Conclusions: Our aim is that the suggested teleneuropsychology-informed battery and model may inform safe and practical neuropsychological inpatient assessments during the COVID-19 pandemic and other situations requiring contact precautions for infection prevention and control.

Objective: In light of the COVID-19 pandemic, a majority of clinicians have had to quickly and dramatically alter their clinical practices. Two surveys were administered on 3/26/2020 and 3/30/2020, respectively, to document immediate changes and challenges in clinical practice. Method: Two surveys were administered between 3/26/2020 and 3/30/2020, via SurveyMonkey and Google Forms, asking clinicians questions pertaining to practice issues during the early stages of the COVID-19 pandemic. Quantitative responses from the second survey were stratified by clinical setting (Medical Hospital vs. Private Practice) prior to analysis. Qualitative, free-response items were coded by the authors to better understand immediate changes in practice and other concerns. Results: 266 neuropsychologists completed Survey 1 and 230 completed Survey 2. Results suggest that practices immediately moved towards remote service provision. A meaningful proportion of clinicians and their staff were immediately affected economically by the pandemic, with clinicians in private practice differentially affected. Furthermore, a small but significant minority of respondents faced ethical dilemmas related to service provision and expressed concerns with initial communication from their employment organizations. Respondents requested clear best-practice guidelines from neuropsychological practice organizations. Conclusions: It is clear that field of neuropsychology has drastically shifted clinical practices in response to COVID-19 and is likely to continue to evolve. While these responses were collected in the early stages of stay-at-home orders, policy changes continue to occur and it is paramount that practice organizations consider the initial challenges expressed by clinicians when formulating practice recommendations and evaluating the clinical utility of telehealth services.

Objective: Due to the recent COVID-19 pandemic, the field of neuropsychology must rapidly evolve to incorporate assessments delivered via telehealth, or teleneuropsychology (TNP). Given the increasing demand to deliver services electronically due to public health concerns, it is important to review available TNP validity studies. This systematic review builds upon the work of Brearly and colleagues' (2017) meta-analysis and provides an updated review of the literature, with special emphasis on test-level validity data. Method: Using similar methodology as Brearly and colleagues (2017) three internet databases (PubMed, EBSCOhost, PsycINFO) were searched for relevant articles published since 2016. Studies with older adults (aged 65+) who underwent face-to-face and TNP assessments in a counterbalanced cross-over design were included. After review, 10 articles were retained. Combined with nine articles from Brearly's analysis, a total of 19 studies were included in the systematic review. Results: Retained studies included samples from 5 different countries, various ethnic/cultural backgrounds, and diverse diagnostic populations. Test-level analysis suggests there are cognitive screeners (MMSE, MoCA), language tests (BNT, Letter Fluency), attention/working memory tasks (Digit Span Total), and memory tests (HVLT-R) with strong support for TNP validity. Other measures are promising but lack sufficient support at this time. Few TNP studies have done in-home assessments and most studies rely on a PC or laptop. Conclusions: Overall, there appears to be good support for TNP assessments in older adults. Challenges to TNP in the current climate are discussed. Finally, a provisional outline of viable TNP procedures used in our clinic is provided.

Objectives: In response to the 2020 COVID-19 pandemic, traditional, in-person neuropsychological assessment services paused in most settings. Neuropsychologists have sought to establish new guidelines and care models using telehealth neuropsychology (teleNP) services. The need to adapt to remote technology became the most difficult challenge to date for existing practice models. Results: Primary considerations for transitioning to teleNP include scope and limitations of the telehealth modality, informed consent for telehealth services, patient privacy and confidentiality, test security, and validity of telehealth assessments. Given timelines for fully re-opening clinical settings, access to traditional models of neuropsychological care remains unclear. These considerations will remain relevant even upon return to an in-office practice, as many assessment models will likely continue with teleNP to some extent. Specialists will need to consider the unique needs of their populations in ensuring quality care, as diagnostic differences and patient age will impact participation in teleNP. Conclusions: As the COVID-19 pandemic lingers, teleNP presents an opportunity as well as a challenge for neuropsychologists looking to provide patient care in the context of social distancing and stay-at-home restrictions. In this transformative time, the field of neuropsychology has opportunities to advance beyond traditional settings and focus on alternative delivery of patient care.

Objective: Despite expansion of telecommunication strategies across health services and data supporting feasibility of videoconference-based neuropsychological assessment, relatively little is known about teleneuropsychology (TeleNP) use in practice. The current COVID-19 pandemic provides an opportunity for greater use of TeleNP and understanding of neuropsychologists' experience with this unique assessment medium. Methods: During the course of a no-cost global webinar related to practical/ethical considerations of TeleNP practice, attendees were invited to engage in a 26-question survey about their TeleNP use and related COVID-19 concerns. TeleNP practices before the COVID-19 pandemic and early on during the global outbreak were queried among survey participants, along with examination of TeleNP intentions following COVID-19. Results: Multiple countries were represented across five continents, with two-thirds of respondents being from the United States. Approximately one-fourth of respondents reported using TeleNP for clinical interview, feedback, and intervention prior to the onset of the COVID-19 pandemic, and approximately one-tenth of individuals used TeleNP for testadministration. Increased use of TeleNP for clinical interview, feedback, and intervention was reported within the first few weeks of the global COVID-19 outbreak, though the use of TeleNP for testing remained relatively unchanged. Most respondents indicated an intention for future use of TeleNP. Conclusions: Our findings suggest the use of TeleNP is increasing, although use of remote TeleNP testing is still developing. Findings also illustrate increasing use of TeleNP in the context of the COVID-19 pandemic and encourage follow-up investigation in future studies to understand the changing practices and rates of TeleNP provision over time.