Teleneuropsychology for Monolingual and Bilingual Spanish-Speaking Adults in the Time of COVID-19: Rationale, Professional Considerations, and Resources

Abstract

Objective Neuropsychological assessments with monolingual Spanish and bilingual Spanish/English-speaking adults present unique challenges. Barriers include, but are not limited to, the paucity of test norms, uncertainty about the equivalence of translated neuropsychological tests, and limited proficiency in the provision of culturally competent services. Similar issues generalize to telephone- and video-based administration of neuropsychological tests or teleneuropsychology (TeleNP) with Hispanics/Latinos (as), and few studies have examined its feasibility and validity in this group. The sudden onset of the COVID-19 pandemic prompted neuropsychologists to identify alternative ways to provide equitable care. Clinicians providing TeleNP to this population during (and after) the pandemic must consider safety, professional factors, and systemic barriers to accessing and benefitting from virtual modalities. Method This clinical process manuscript describes how cross-cultural neuropsychologists across five U.S. academic institutions serving Hispanics/Latinos (as) developed TeleNP models of care during the pandemic. Results Workflows, test batteries, and resources for TeleNP assessment with monolingual and bilingual Spanish-speaking patients are included. Factors guiding model development and informing decisions to incorporate virtual administration of neuropsychological tests into their practice are also discussed. Conclusions Provision of TeleNP is a promising modality. Additional research in this area is warranted with focus on cultural and contextual factors that support or limit the use of TeleNP with this community.

The Application of e-Mental Health in Response to COVID-19: Scoping Review and Bibliometric Analysis

“…At the broader system level, several articles pointed to changes in regulation and reimbursements that have enabled clinicians practicing in a wide range of settings to quickly adopt e-mental health solutions for both existing and new patients struggling with the pandemic’s impact [ 29 - 31 , 52 , 67 ]. Patel et al identified a number of local and national collaborative approaches to care that have been developed since COVID-19, such as “Webinars for Nursing Homes” that have linked palliative care, geriatrics, and psychiatric old-age services in Ireland through Project ECHO AIIHPC (Extension for Community Healthcare Outcomes, All Ireland Institute of Hospice and Palliative Care) to help nursing home staff improve their knowledge of e-mental health tools [ 51 ].…”

Clinical utility of Phototest via teleneuropsychology in Chilean rural older adults

“…The low resolution of the screens can affect the discrimination of colors present in the tests. Finally, the quality of the audio can lead to loss of information or interruption 18 . These situations were addressed through the recording of the assessments and subsequent reviews.…”

“…However, the development of TNP in Latin America (LA) is still in its incipient, and the assessment of CD with the brief instruments through telehealth formats in rural seniors has not been conducted in the region 17 . Few studies have analyzed the reliability and validity of neuropsychological tests in the telehealth context among Latin or Hispanic people 18 ; mainly in preclinical phases of dementia, such as mild cognitive impairment (MCI).…”

Working Group Recommendations for the Practice of Teleneuropsychology in Latin America

“…Another significant limitation of our work is that the studies from which we based our recommendations were mostly written in the English language. This is due to the lack of studies on Spanish-speaking populations from Latin America ( Arias et al., 2020 ). However, studies on Spanish-speaking populations in the United States and in Spain support the applicability of teleNP in Spanish ( Franco, Bernardo-Ramos, & Soto-Pérez, 2012 ).…”