A comparison of traditional face-to-face and remote administration of auditory attention and executive functioning measures in a cohort of clinically-referred pediatric patients.

Objective: During the COVID-19 pandemic, teleneuropsychology (teleNP) practice was quickly adopted to afford continuity of clinical care, however, the teleNP literature in children remains limited and focused on specific clinical populations and/or select test measures. Notably, attention and executive functioning are commonly assessed in neuropsychological assessments of patients with medical conditions, psychological, or educational concerns, yet few studies have offered support for teleNP administration of measures targeting these cognitive domains in children. Method: This cross-sectional study involved a retrospective chart review of pediatric patients who underwent an in-person neuropsychological evaluation at an academic medical center before the pandemic (N = 287) or videoconference teleNP assessment during the pandemic (N = 277). The assessment battery included a test of intellectual functioning and measures indexing sustained attention or executive functioning (inhibition, set-shifting, concept formation). Results: No effect of test modality was seen across measures of sustained attention, shifting, and abstract reasoning. TeleNP testing yielded lower inhibition, switching, and divided attention scores than in-person testing, a pattern that was observed among those with anxiety. In contrast, no effect of test modality was seen in those without anxiety. Conclusions: Although findings provide evidence of equivalence between remote and in-person testing for select auditory and executive functioning measures, results highlight the importance of considering anxiety. TeleNP can be an important assessment modality to expand accessibility for youth with medical and psychological concerns, however, more research is necessary to determine specific tools that are diagnostically sensitive across test modalities.