The COVID-19 pandemic is impacting every corner of our world, and neuropsychology is certainly not immune from its effects. In particular, many neuropsychological clinics have temporarily shut down operations in response to the widespread call for social distancing. With this as the backdrop, we speak with Munro Cullum, Ph.D., ABPP-CN, about teleneuropsychology and telemedicine in general. We distinguish between pre-COVID-19 teleneuropsychological evaluations, conducted in clinics and other controlled environments, and the current push for home-to-home teleneuropsychology. We then dive into the details of teleneuropsychology, including topics such as research evidence for feasibility, reliability, and validity of this methodology, patient acceptability, environmental challenges, patient privacy and informed consent, and trainee clinical hours, among others. Throughout the interview, Dr. Cullum summarizes the current literature and provides advice, tips, and guidance for interested researchers and clinicians.
A pdf of the transcript for this episode is available here.
If you’d like to receive APA-approved CE credit for listening to this episode, click here.
Topics covered
- Define basic terminology related to telehealth
- Patient/provider satisfaction with teleneuropsychology as part of typical practice
- Benefits of using telemedicine methodology to complete neuropsychological assessment
- Implementing teleneuropsychology as part of typical practice (e.g., necessary hardware, environment)
- Contemporary research investigating validity and diagnostic accuracy of teleneuropsychological assessment compared to typical neuropsychological assessment
- Utility of shorter test batteries for teleneuropsychological evaluations
- Attempting standardized administration of neuropsychological assessment tools in a virtual environment
- Generalizability of research on teleneuropsychological assessment to clinical populations
- Building rapport virtually
- Feasibility of teleneuropsychological assessment for patients with sensory impairment(s)
- Scoring visuomotor or visuoperceptual tests completed during a teleneuropsychological assessment
- Test security in teleneuropsychological assessment
- Standardized test taking in teleneuropsychological assessment and the use of non-admissible test aids
- Concerns for the completion of teleneuropsychological assessment during the COVID-19 pandemic
- Setting up your test administration environment and minding your screen presence
- Patient safety and other videoconference testing logistics
- Implementing validity testing as part of a teleneuropsychological evaluation
- Breaking standardization: When is it acceptable?
- Considerations for teleneuropsychological evaluation of pediatric populations
- HIPAA-compliant videoconference services to use for teleneuropsychology
- Minding patient safety and security despite relaxed HIPAA regulations
- How does informed consent differ for teleneuropsychological services
- For trainees: supervision for teleneuropsychological services
- For trainees: Training opportunities available during the COVID-19 pandemic
- Computerized testing and teleneuropsychology
- Cultural awareness and responsivity in the implementation of teleneuropsychology
- Bonus questions!
About Munro
Dr. Munro Cullum is a board-certified clinical neuropsychologist who specializes directs the Neuropsychology Program at The University of Texas Southwestern. Dr. Cullum also serves as the Chief of the Division of Psychology and Clinical Core Leader in the UTSW Alzheimer’s Disease Center. He is a past-president of the Society for Clinical Neuropsychology and the National Academy of Neuropsychology and is actively involved in research, teaching, and clinical practice in neuropsychology. In addition to other research areas, he is a pioneer in telemedicine applications of neuropsychology.
Select Academic References
Bilder, R. M., Postal, K. S., Barisa, M., Aase, D. M., Cullum, C. M., Gillaspy, S. R., . . . Woodhouse, J. (2020). InterOrganizational practice committee recommendations/guidance for teleneuropsychology (TeleNP) in response to the COVID-19 pandemic. The Clinical Neuropsychologist, 1-21.
Brearly, T. W., Shura, R. D., Martindale, S. L., Lazowski, R. A., Luxton, D. D., Shenal, B. V., & Rowland, J. A. (2017). Neuropsychological test administration by videoconference: a systematic review and meta-analysis. Neuropsychology review, 27(2), 174-186.
Castanho, T. C., Sousa, N., & Santos, N. C. (2017). When new technology is an answer for old problems: the use of videoconferencing in cognitive aging assessment. Journal of Alzheimer’s disease reports, 1(1), 15-21.
Cullum, C. M., Hynan, L. S., Grosch, M., Parikh, M., & Weiner, M. F. (2014). Teleneuropsychology: Evidence for video teleconference-based neuropsychological assessment. Journal of the International Neuropsychological Society, 20(10), 1028-1033.
Galusha-Glasscock, J. M., Horton, D. K., Weiner, M. F., & Cullum, C. M. (2016). Video teleconference administration of the repeatable battery for the assessment of neuropsychological status. Archives of Clinical Neuropsychology, 31(1), 8-11.
Grosch, M. C., Gottlieb, M. C., & Cullum, C. M. (2011). Initial practice recommendations for teleneuropsychology. The Clinical Neuropsychologist, 25(7), 1119-1133.
Luxton, D. D., Pruitt, L. D., & Osenbach, J. E. (2014). Best practices for remote psychological assessment via telehealth technologies. Professional Psychology: Research and Practice, 45(1), 27-35.
Parikh, M., Grosch, M. C., Graham, L. L., Hynan, L. S., Weiner, M., Shore, J. H., & Cullum, C. M. (2013). Consumer acceptability of brief videoconference-based neuropsychological assessment in older individuals with and without cognitive impairment. The Clinical Neuropsychologist, 27(5), 808-817.
Wadsworth, H. E., Dhima, K., Womack, K. B., Hart Jr, J., Weiner, M. F., Hynan, L. S., & Cullum, C. M. (2018). Validity of teleneuropsychological assessment in older patients with cognitive disorders. Archives of Clinical Neuropsychology, 33(8), 1040-1045.
Select Resources
Inter Organizational Practice Committee
American Academy of Clinical Neuropsychology
APA’s guidance on psychological tele-assessment during the COVID-19 crisis
The APA’s webinar series on telepsychology (free for a limited time)
APA’s explanation of temporary changes to federal Medicare telehealth policies
Dropbox documents, compliments of Dr. Yakeel Quiroz-Gaviria
Bibliography of telemedicine articles
**We are not affiliated with any of these organizations**
Picture of a common teleneuropsychology setup
We are looking to appropriate stands to hold the stimulus books (Boston, WAIS-IV, etc.) and are wondering where you can acquire a couple of these as shown in your slides?
This podcast was excellent and very helpful to getting this up and running. Thank you!
Sorry – looking FOR appropriate stands, not TO.
Hi Wendy,
We’re very glad to hear that you found the episode helpful. Regarding the stands, I’m not sure what Dr. Cullum uses but my prior supervisor had us using music stands, which worked really well. Hope that helps.
Best,
~John
Hi! Thanks. Actually, that was suggested by someone in admin, but I don’t think it will work for us and our proposed setup. We’ll keep searching! 🙂
Sorry for the delayed response- we used binders of different sizes to get the right height- not high tech, but it worked!