Dataset Information

Pediatric Teleneuropsychology: Feasibility and Recommendations.

ABSTRACT: OBJECTIVE:Teleneuropsychology (TeleNP) is a growing and promising practice within the telemedicine landscape that has been well established within the adult neuropsychology literature. This project aimed to demonstrate the feasibility of TeleNP in a pediatric clinical population and disseminate clinical decision-making procedures to guide best practices for pediatric TeleNP. METHOD:This project conducted during the 2019 coronavirus (COVID-19) pandemic reflects the largest clinical cohort to date of TeleNP in a pediatric population (N = 129). Data were gathered retrospectively from patients who were rescheduled from in-person assessment to TeleNP between March to June 2020. RESULTS:TeleNP was an accessible option for most patients and families, with no differences in demographic variables in patient appointment attendance, whether testing was conducted, and whether the patient was referred for face-to-face follow-up. Patients using laptops/desktops were more likely to undergo remote test administration in comparison with patients using phones/tablets (?2 = 23.83, p < .002). Sixty-three percent of the sample were referred for a face-to-face follow-up assessment. CONCLUSIONS:TeleNP is feasible in a pediatric clinical population ranging to begin the process of differential diagnosis and treatment planning. Pediatric TeleNP may be most efficacious as a screening procedure due to limited measures suited for remote administration and behavioral challenges interfering with testing requiring in-person follow-up. TeleNP screening as standard practice for patients who do not require a full, traditional neuropsychological battery may provide a more efficient care model, with more patients able to be seen using shorter batteries with less wait time.

SUBMITTER: Ransom DM

PROVIDER: S-EPMC7665284 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Publications

Pediatric Teleneuropsychology: Feasibility and Recommendations.

Ransom Danielle M DM Butt Sakina M SM DiVirgilio Emily K EK Cederberg Charles D CD Srnka Kyle D KD Hess Colleen T CT Sy Megan C MC Katzenstein Jennifer M JM

Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists 20201101 8

<h4>Objective</h4>Teleneuropsychology (TeleNP) is a growing and promising practice within the telemedicine landscape that has been well established within the adult neuropsychology literature. This project aimed to demonstrate the feasibility of TeleNP in a pediatric clinical population and disseminate clinical decision-making procedures to guide best practices for pediatric TeleNP.<h4>Method</h4>This project conducted during the 2019 coronavirus (COVID-19) pandemic reflects the largest clinical ...[more]

PMID: 33103715

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Project description:ImportanceThe American Academy of Pediatrics and the Centers for Disease Control and Prevention recommend waiting 3 to 5 days between the introduction of new complementary foods (solid foods introduced to infants <12 months of age), yet with advances in the understanding of infant food diversity, the guidance that pediatric practitioners are providing to parents is unclear.ObjectiveTo characterize pediatric practitioner recommendations regarding complementary food introduction and waiting periods between introducing new foods.Design, setting, and participantsIn this survey study, a 23-item electronic survey on complementary food introduction among infants was administered to pediatric health care professionals from February 1 to April 30, 2019. Responses were described among the total sample and compared among subgroups. Survey invitations were emailed to 2215 members of the Illinois Chapter of the American Academy of Pediatrics and the national American Academy of Pediatrics' Council on Early Childhood. Participants were required to be primary medical practitioners, such as physicians, resident physicians, or nurse practitioners, providing pediatric care to infants 12 months or younger.Main outcomes and measuresThe main outcome measures were recommendations on age of complementary food introduction and waiting periods between the introduction of new foods. Categorical survey items were reported as numbers (percentages) and 95% CIs. Means (SDs) were used to describe continuous survey items.ResultsThe survey was sent to 2215 practitioners and completed by 604 (response rate, 27.3%). Of these respondents, 41 were excluded because they did not provide care for infants or pediatric patients. The final analyses included responses from 563 surveys. Of these, 454 pediatricians (80.6%), 85 resident physicians (15.1%), and 20 nurse practitioners (3.6%) completed the survey. Only 217 practitioners (38.6%; 95% CI, 34.1%-44.6%) recommended waiting 3 days or longer between food introduction; 259 practitioners (66.3%; 95% CI, 61.4%-70.8%) recommended waiting that amount of time for infants at risk for food allergy development (P = .02). A total of 264 practitioners (46.9%; 95% CI, 42.8%-51.0%) recommended infant cereal as the first food, and 226 practitioners (40.1%; 95% CI, 36.1%-44.2%) did not recommend a specific order. A total of 268 practitioners (47.6%; 95% CI, 43.5%-51.7%) recommended food introduction at 6 months for exclusively breastfed (EBF) infants, and 193 (34.3%; 95% CI, 30.5%-38.3%) recommended food introduction at 6 months for non-EBF infants (P < .001); 179 practitioners (31.8%; 95% CI, 28.1%-35.8%) recommended food introduction at 4 months for EBF infants, and 239 practitioners (42.5%; 95% CI, 38.4%-46.6%) recommended food introduction at 4 months for non-EBF infants (P < .001). A need for additional training on complementary food introduction was reported by 310 practitioners (55.1%; 95% CI, 50.9%-59.1%).Conclusions and relevanceIn this survey study, most pediatric practitioners did not counsel families to wait 3 days or longer between introducing foods unless infants were at risk for food allergy development. The findings suggest that the current recommendation limits infant food diversity and may delay early peanut introduction. Because the approach to food allergy prevention has changed, a reevaluation of published feeding guidelines may be necessary.

Dataset Information

Pediatric Teleneuropsychology: Feasibility and Recommendations.

Publications

Pediatric Teleneuropsychology: Feasibility and Recommendations.

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