Agreement, reliability, feasibility, and acceptability of home-based telehealth versus face-to-face pediatric neuropsychological testing: A within-person crossover study.

Abstract

Objective: It is unclear whether pediatric telehealth-delivered neuropsychology test results are comparable to those obtained face-to-face. This study reports results on (a) the agreement/reliability and (b) the feasibility and acceptability of telehealth neuropsychology testing in Australian children and adolescents.

Method: Using a quasiprospective repeated-measures A followed by B:B followed by A crossover design, participants (N = 36), children with neurofibromatosis type 1, autism, and from the general population underwent face-to-face and telehealth testing using a trained parent facilitator. Measures included Full Scale IQ from the Wechsler Intelligence Scale for Children-Australian and New Zealand Standardised Fifth Edition; Word Reading, Spelling, and Numerical Operations subtests from the Wechsler Individual Achievement Test-Australian and New Zealand Standardised Third Edition; Comprehension of Instructions; Score!; Formulated Sentences; Rey Complex Figure Test; and the California Verbal Learning Test. Children, parents, and clinicians also completed a feasibility and acceptability survey.

Results: Predominantly high agreement between face-to-face and telehealth intelligence and academic scores were identified from intraclass correlation coefficients, independent of age and retest period. Intraclass correlation coefficient values were excellent for Full Scale IQ, Spelling and Numerical Operations (0.91-0.95), good for all intelligence index scores, reading, verbal learning and expressive language (range, 0.76-0.89), moderate for verbal recall, comprehension of instructions and copy accuracy (range, 0.63-0.74), and poor for sustained attention (0.23). Reliable change indices revealed stable test scores across most neuropsychological tests. Telehealth-delivered neuropsychology testing was satisfactory according to children, parents, and clinicians, although in-person was slightly preferred over telehealth.

Conclusions: Findings support the use of home-based telehealth testing in pediatric populations. (PsycInfo Database Record (c) 2025 APA, all rights reserved).