Tricia S Williams, Marin M Taylor, Rivka R Green, Rachael Lyon, Bianca C Bondi, Naddley Désiré
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引用次数: 0
Abstract
Objective: Neuropsychological care benefits children with neonatal brain conditions by monitoring brain health and directing supports to optimize learning and psychosocial growth. Conventional assessments often are time and resource intensive; innovative, precise, and efficient assessment models are needed. This study examined 1) feasibility and acceptability of a tiered assessment protocol and 2) preliminary predictive validity of screening measures.
Method: Children aged 4-18 years and their caregivers were referred for neuropsychological evaluation. A tiered protocol was co-designed with family advisors and included 3 steps: 1) invitation to consultation, including psychoeducation; 2) screening measures of cognition, learning, and well-being; and 3) virtual 1:1 consultation with a neuropsychologist/fellow. Collaborative caregiver-clinician discussion led to a) in-person testing, b) deferred assessment, or c) discharge. A portion (22%) of cases were reviewed independently to assess inter-clinician reliability. Caregiver feedback was gathered via survey. Multiple linear regression models assessed relationships between screening measures and 1) consultation outcome, and 2) child full scale intellectual IQ scores (FSIQ).
Results: Of 104 families invited to participate, 98 (94%) responded: 9 (9.2%) declined services and 85 (86.7%) completed screening measures and consultation. After consultation, 50 (59%) proceeded to in-person testing, 17 (20%) deferred assessment, and 18 (21%) were discharged. Inter-clinician agreement on consultation outcome was strong (90%). Caregiver feedback reflected protocol feasibility and acceptability; comments described helpfulness of monitoring, and timeliness of process. Screening measures predicted outcomes of consultation and child FSIQ.
Conclusions: Results illustrate importance of evaluating neuropsychological pathways with precision, efficiency and caregiver-partners in mind.
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