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Objectives: A number of commonly used performance validity tests (PVTs) may be prone to high failure rates when used for individuals with severe neurocognitive deficits. This study investigated the validity of 10 PVT scores in justice-involved adults with fetal alcohol spectrum disorder (FASD), a neurodevelopmental disability stemming from prenatal alcohol exposure and linked with severe neurocognitive deficits. Method: The sample comprised 80 justice-involved adults (ages 19–40) including 25 with confirmed or possible FASD and 55 where FASD was ruled out. Ten PVT scores were calculated, derived from Word Memory Test, Genuine Memory Impairment Profile, Advanced Clinical Solutions (Word Choice), the Wechsler Adult Intelligence Scale – Fourth Edition (Reliable Digit Span and age-corrected scaled scores (ACSS) from Digit Span, Coding, Symbol Search, Coding – Symbol Search, Vocabulary – Digit Span), and the Wechsler Memory Scale – Fourth Edition (Logical Memory II Recognition). Results: Participants with diagnosed/possible FASD were more likely to fail any single PVT, and failed a greater number of PVTs overall, compared to those without FASD. They were also more likely to fail based on Word Memory Test, Digit Span ACSS, Coding ACSS, Symbol Search ACSS, and Logical Memory II Recognition, compared to controls (35–76%). Across both groups, substantially more participants with IQ <70 failed two or more PVTs (90%), compared to those with an IQ ≥70 (44%). Conclusions: Results highlight the need for additional research examining the use of PVTs in justice-involved populations with FASD.

Objective: The COVID-19 pandemic is a global health crisis that has created sudden and unique challenges within the field of clinical neuropsychology. Adapting neuropsychology services using teleneuropsychology models (e.g. video or telephone assessments) may not always be a viable option for all providers and settings. Based on the existing teleneuropsychology literature, we propose a "contactless" evidence-based inpatient test battery to be used for in-person assessments amenable to physical distancing. Method: In addition to the proposed test battery, we suggest a decision-making workflow process to help readers determine the appropriateness of the proposed methods given their patients' needs. Considerations for special populations (i.e. seniors, patients with brain injury, psychiatric patients), feedback, limitations of the proposed physical distancing approach, and future directions are also discussed. Conclusions: Our aim is that the suggested teleneuropsychology-informed battery and model may inform safe and practical neuropsychological inpatient assessments during the COVID-19 pandemic and other situations requiring contact precautions for infection prevention and control.

BackgroundHigh rates of substance misuse during emerging adulthood require developmentally appropriate clinical programs.ObjectivesThis work outlines the development of an evidence-informed emerging adult outpatient substance use program, quality improvement process and protocol, and 1-year program insights.MethodsLiterature reviews, program reviews, environmental scans, and stakeholder consultations (including lived expertise) were used to develop the program. A 12-week emerging adult (17-25) measurement-based care program was developed including: 1) individual measurement-based care and motivational enhancement therapy sessions; 2) group programming focused on cognitive behavioural therapy, mindfulness, distress tolerance, and emotional regulation; 3) consults for diagnostic clarification and/or medication review; and 4) a separate education group for loved ones. A measurement system was concurrently created to collect clinical and program evaluation data at 6 time points.ResultsIn the first year of the program, 96 young adults fully enrolled in the program (Mean age = 21 years old, 48% female gender) primarily reporting treatment targets of alcohol (70%) and cannabis (59%). Almost all patients (97%) surpassed at least one clinical threshold for co-occurring mental health disorder, with the median/mode of positive psychiatric screens being for 5 conditions.ConclusionsThis program demonstrates that developing an integrative evidence-informed measurement-based care young adult substance use program is feasible, though requires flexibility and ongoing monitoring to meet local needs. Patient characteristics reveal very high rates of concurrent psychiatric disorders in addition to substance use disorders.