Objective: Assess the effects of videoconferencing-based counseling on the psychosocial functioning of rural teenagers with epilepsy. Setting: University and rural communities. Participants: Twenty-two teenagers with epilepsy and their parents. Interventions: Six sessions of home-based video counseling, homebased speakerphone counseling, or office-based counseling. Main Outcome Measures: Problem severity and frequency, Social Skills Rating System, modified Working Alliance Inventory, and treatment adherence. Results: Teenagers and parents reported significant reductions in both problem severity and frequency across all 3 conditions from pre-to post-6th session to the 6-month follow-up. Parents reported significant increases in prosocial behaviors from pre-to post-6th session to follow-up. In contrast, both parents and teachers reported no change in problem behaviors over time. No differences in adherence were found across the 3 modalities. Overall therapeutic alliance was high but varied as a function of family member and treatment. Conclusions: Mode of delivery did not influence initial treatment outcomes or adherence.
Individuals with dementia frequently demonstrate decreased awareness of their cognitive difficulties. Empirical research examining this phenomenon has addressed a number of aspects of unawareness in Alzheimer's disease and other dementias, including occurrence in various disorders; possible neuroanatomical substrates; relationship to general cognitive functioning, executive functioning, and psychiatric symptomatology; and progression over time and across cognitive domains. Limitations of the current research literature are discussed, particularly issues surrounding operational definitions of unawareness and the current limited understanding of the role of the frontal lobes. A number of conclusions regarding unawareness that appear to be supported by the current body of empirical research and possible future directions are discussed.
To provide a critical review of studies on the impact of telecommunication-based interventions for persons with chronic disabilities. Design: Only those studies that focused on specific health care or clinical interview outcomes and included at least 1 comparison condition were selected for review. Ten studies met these criteria. Results: Overall, the results of initial studies suggest that telecommunication-based interventions may be an efficient and effective way of providing services for chronically disabled populations, even for those who have no previous experience with the technologies. Conclusions: The number of controlled trials examining telecommunication-based interventions for those with chronic disabilities remains small. Future research should endeavor to increase sample size, use conceptually meaningful control groups, focus on cost utility, and investigate which types of telecommunication-based interventions provide the best match with specific populations.One of the most exciting developments in health care and rehabilitation today is the growing use of telecommunication technologies to provide health informa-
Objective: To perform a preliminary evaluation of a questionnaire designed to assess functional outcomes of treatment for aphasia. Methods: The Functional Outcome Questionnaire for Aphasia (FOQ-A) is an inventory consisting of 32 caregiver-completed items rating the person with stroke's ability to perform various communication behaviors on a 5-point scale. The total score for the FOQ-A is reported as a mean of all completed items. The FOQ-A was administered by research assistants to caregivers of patients with left hemisphere stroke (n = 18). Results: The FOQ-A showed acceptable initial reliability and validity properties. As predicted, the FOQ-A displayed high positive correlations with standardized functional communication measures. The FOQ-A also showed only weak associations with other measures (health-related quality of life, caregiver strain). Conclusions: Overall results of our preliminary psychometric examination of the FOQ-A were promising. The findings suggested that the FOQ-A may be a sensitive measure of functional communication abilities and does not appear to be biased heavily by caregiver strain. Plans for further evaluation of the FOQ-A are discussed.
Objective Teleneuropsychology (TNP) has been shown to be a valid assessment method compared with in-person neuropsychological evaluations. Interest in delivering TNP directly to patients’ homes has arisen in response to the coronavirus disease 2019 (COVID-19) pandemic. However, prior research has typically involved patients tested in clinical settings, and the validity of in-home TNP testing has not yet been established. The present study aims to explore the validity and clinical utility of in-home TNP testing in a mixed clinical sample in the wake of COVID-19. Methods Test profiles for 111 in-home TNP patients were retrospectively compared with 120 patients who completed in-person evaluations. The TNP test battery consisted of tests measuring attention/processing speed, verbal memory, naming, verbal fluency, and visuoconstruction. TNP scores of cognitively normal (CN) patients were compared with patients with neurocognitive disorders (NCD), and score profiles were examined among suspected diagnostic groups of Alzheimer’s disease (AD), Parkinson’s disease (PD), and vascular disease (VaD). Results TNP test scores did not significantly differ from in-person testing across all tests except the Hopkins Verbal Learning Test-Revised Discrimination Index. Within the TNP group, significant differences between the CN and NCD groups were found for all tests, and the memory and semantic fluency tests yielded large effect sizes (d ≥ 0.8). Score profiles among the AD, PD, and VaD groups were explored. Conclusions These findings support the validity of in-home TNP testing compared with in-person neuropsychological testing. Practice considerations, limitations, and future directions are discussed.
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