The feasibility of remote administration of oral processing speed measures in children with chronic medical conditions.

Objective: Processing speed is an important neuropsychological construct, with weaknesses evident across many pediatric medical conditions. During the COVID-19 pandemic, tele-neuropsychological evaluations were widely utilized in children with various health conditions to examine cognitive functioning as part of standard care or disease surveillance. Although remote testing afforded better access to neuropsychological care for many families, psychometric properties of tele-neuropsychological assessments, and particularly the equivalence of processing speed measures across in-person versus telehealth test modality, remain underexamined. Method: Pediatric patients with a medical condition completed a measure of intellectual functioning and oral processing speed (verbal fluency, speeded object naming, speeded word reading) either in-person prior to the pandemic or via telehealth during the pandemic. T-tests or chi-squared tests examined differences in processing speed outcomes in patients by testing modality. Additionally, the impact of test modality on processing speed performance was examined across individual medical conditions to determine if remote testing may be more appropriate in the monitoring of cognition for select diagnoses. Results: As a whole, patients performed similarly on oral processing speed measures regardless of testing modality. By medical diagnosis, pediatric oncology patients' performance was higher on a measure of speeded color naming but lower on a measure of speeded object naming when administered via tele-testing. Conclusions: Findings suggest that oral processing speed can be assessed remotely in pediatric patients with medical conditions, though assessment in pediatric oncology patients should be further examined. Limitations and implications for practice are discussed.