Date of Award

2024

Document Type

Dissertation

Degree Name

Doctor of Psychology (PsyD)

Department

Graduate Department of Clinical Psychology

First Advisor

Leihua Edstrom, PhD, ABSNP

Second Advisor

Glena Andrews, PhD, ABPP

Third Advisor

Kathleen Gathercoal, PhD

Abstract

The restructuring of clinical service provision during the COVID-19 pandemic prompted neuropsychologists to reconsider telehealth options for patient care. Subsequent advances in teleneuropsychology (Tele-NP) research and practice have demonstrated that virtual assessment is not only practical, but also increases accessibility to neuropsychological services for the elderly, medically at-risk, and rural patients. In order to ensure services are in-line with professional standards of evidence-based practice, it is incumbent on research to demonstrate the validity of virtual assessment, as well as patient acceptability of Tele-NP findings. The objectives of this research project were three-fold. First, I aimed to determine the reliability of a proposed virtual battery of neuropsychological measures commonly used to identify early cognitive decline in older adults. The proposed battery consisted of assessments that already have well-documented validity for in-person clinical settings. Reliability was determined by administering the battery using virtual telecommunication technology to a non-clinical sample of 33 older adults (ages 65 years and older), and then comparing the performance of that sample to a reference standard. Second, I surveyed participants at the conclusion of their participation regarding their confidence that the virtual measures accurately captured their actual level of functioning. Third, I surveyed participants’ subjective perceptions of the Tele-NP experience using the direct to home full teleneuropsychology model (Stolwyk et al., 2020), with specific attention to their comfort using virtual telecommunication technology and their ability to effectively communicate in a virtual space. Participants reported a high degree of confidence in both their ability to use virtual telecommunication technology, as well as in the accuracy of Tele- NP findings. Finally, I compiled a list of recommendations for clinicians considering adding a remote evaluation option for some patients using the direct to home full teleneuropsychology model. These practical considerations were developed in the course of designing and executing this study.

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