Integrating Telehealth Into Neurodevelopmental Assessment: A Model From the Cardiac Neurodevelopmental Outcome Collaborative

Stephany M Cox; Jennifer L Butcher; Anjali Sadhwani; Renee Sananes; Jacqueline H Sanz; Elizabeth Blumenfeld; Adam R Cassidy; Jessica C Cowin; Dawn Ilardi; Nadine A Kasparian; Joslyn Kenowitz; Kristin Kroll; Thomas A Miller; Kelly R Wolfe; from the Telehealth Task Force of the Cardiac Neurodevelopmental Outcome Collaborative

doi:10.1093/jpepsy/jsac003

Integrating Telehealth Into Neurodevelopmental Assessment: A Model From the Cardiac Neurodevelopmental Outcome Collaborative

J Pediatr Psychol. 2022 Jun 7;47(6):707-713. doi: 10.1093/jpepsy/jsac003.

Authors

Stephany M Cox¹, Jennifer L Butcher², Anjali Sadhwani³, Renee Sananes⁴, Jacqueline H Sanz⁵, Elizabeth Blumenfeld⁶, Adam R Cassidy^{7

8}, Jessica C Cowin⁹, Dawn Ilardi¹⁰, Nadine A Kasparian^{11

12}, Joslyn Kenowitz^{13

14}, Kristin Kroll¹⁵, Thomas A Miller¹⁶, Kelly R Wolfe¹⁷; from the Telehealth Task Force of the Cardiac Neurodevelopmental Outcome Collaborative

Affiliations

¹ Department of Pediatrics, Division of Developmental Medicine, Benioff Children's Hospital, University of California-San Francisco, USA.
² Department of Pediatrics, University of Michigan School of Medicine & C.S. Mott Children's Hospital, USA.
³ Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Harvard Medical School, USA.
⁴ Labatt Family Heart Centre, Hospital for Sick Children and Department of Pediatrics, University of Toronto, Canada.
⁵ Division of Neuropsychology, Children's National Hospital, Departments of Psychiatry and Behavioral Sciences & Pediatrics, George Washington University School of Medicine, USA.
⁶ Mended Little Hearts, USA.
⁷ Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Harvard Medical School, USA.
⁸ Department of Psychiatry and Psychology, Mayo Clinic, USA.
⁹ The Children's Heart Foundation, USA.
¹⁰ Department of Neuropsychology, Children's Healthcare of Atlanta, and Department of Rehabilitation Medicine, Emory University, USA.
¹¹ Cincinnati Children's Center for Heart Disease and Mental Health, Heart Institute and the Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital, USA.
¹² Department of Pediatrics, University of Cincinnati College of Medicine, USA.
¹³ Nemours Cardiac Center, Alfred I. duPont Hospital for Children, USA.
¹⁴ Department of Pediatrics, Thomas Jefferson University, USA.
¹⁵ Department of Pediatrics, Division of Pediatric Psychology and Developmental Medicine, Medical College of Wisconsin, USA.
¹⁶ Division of Pediatric Cardiology, Maine Medical Center, USA.
¹⁷ Department of Pediatrics, University of Colorado School of Medicine, Anschutz Medical Campus, USA.

Abstract

Objective: In the wake of the COVID-19 pandemic, psychologists were pushed to look beyond traditional in-person models of neurodevelopmental assessment to maintain continuity of care. A wealth of data demonstrates that telehealth is efficacious for pediatric behavioral intervention; however, best practices for incorporating telehealth into neurodevelopmental assessment are yet to be developed. In this topical review, we propose a conceptual model to demonstrate how telehealth can be incorporated into various components of neurodevelopmental assessment.

Methods: Harnessing existing literature and expertise from a multidisciplinary task force comprised of clinicians, researchers, and patient/parent representatives from the subspecialty of cardiac neurodevelopmental care, a conceptual framework for telehealth neurodevelopmental assessment was developed. Considerations for health equity and access to care are discussed, as well as general guidelines for clinical implementation and gaps in existing literature.

Results: There are opportunities to integrate telehealth within each stage of neurodevelopmental assessment, from intake to testing, through to follow-up care. Further research is needed to determine whether telehealth mitigates or exacerbates disparities in access to care for vulnerable populations as well as to provide evidence of validity for a wider range of neurodevelopmental measures to be administered via telehealth.

Conclusions: While many practices are returning to traditional, face-to-face neurodevelopmental assessment services, psychologists have a unique opportunity to harness the momentum for telehealth care initiated during the pandemic to optimize the use of clinical resources, broaden service delivery, and increase access to care for pediatric neurodevelopmental assessment.

Keywords: adolescents; cardiology; eHealth/mHealth; neuropsychology; preschool children; school-age children.

MeSH terms

COVID-19*
Child
Humans
Pandemics
SARS-CoV-2
Telemedicine*