Why are neuropsychologists so reluctant to embrace modern assessment techniques?

Schmand, B

doi:10.1080/13854046.2018.1523468

Cited by 38 publications

(30 citation statements)

References 40 publications

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“…This was due to the importance of precision in measuring reaction times and standard deviations for the attention tests. For the other tests, the clinical standard was paper and pencil and better normative data were available for those versions (Schmand 2019). Accordingly, computerized tests (which the basic processes are based on) may be better at predicting performance in other computerized tests (complex attention) than in paper and pencil tests (executive functioning).…”

Section: Discussionmentioning

confidence: 99%

Basic processes as foundations of cognitive impairment in adult ADHD

et al. 2019

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Attention deficit hyperactivity disorder (ADHD) in adulthood is associated with impairment of multiple aspects of cognition which adversely affect the individual’s everyday functioning. However, little is known about how these impairments are intertwined. This study explores whether impairments in basic processes (processing speed and distractibility) in adults with ADHD explain impairments in higher order functions, namely executive functions, memory, and complex attention. Furthermore, it is explored whether pharmacological treatment with methylphenidate (MPH) affects basic processes and higher order functions. A between-subjects design compared patients with ADHD without stimulant drug treatment (N = 55) and patients with ADHD treated with MPH (N = 31) with a healthy control group (N = 80). A neuropsychological test battery assessing basic processes and higher order functions was administered. Hierarchical logistic regression analyses were performed to evaluate the contribution of basic processes to impairments in higher order functions. Patients with ADHD not treated with MPH showed impairments in basic processes and higher order functions compared to controls. The impairments in basic processes explained 41–43% of impairments in executive functions, 27–29% in memory, and 56–74% in complex attention. In patients with ADHD treated with MPH, basic processes were not impaired and did not contribute significantly to impairments of higher order functions. Basic processes may constitute part of the foundation of cognitive impairments in adult ADHD. MPH may improve cognitive performance, presumably through improving basic processes. Applying this information could optimize neuropsychological assessments and inform treatment strategies by targeting basic processes.

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Section: Discussionmentioning

confidence: 99%

Basic processes as foundations of cognitive impairment in adult ADHD

et al. 2019

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“…Much of the extant work has focused on administering existing cognitive screens and neuropsychological tests via tele-conferencing [29,39,66,72,73] rather than exploring updated options, such as using well-validated experimental tasks in a clinical context. Looking into the future, incorporating data collected from wearables, smartphone apps, and/or other sensors may also provide a rich source of data for better detection and monitoring of cognitive [37,74] and mood symptoms in neurodegenerative diseases [75]. For example, if some cognitive domains can be reliably measured using web-based cognitive tasks with acceptable psychometric properties [28,[76][77][78], clinical practice can shift toward more remote monitoring of cognitive changes in memory or executive functioning, given that these domains are key factors in the loss of functional independence in neurodegenerative diseases [79].…”

Section: Principal Findingsmentioning

confidence: 99%

“…There are promising avenues for better detection and monitoring of cognitive impairment using well-established cognitive tasks [33][34][35]. Nevertheless, most clinicians (ie, neurologists, neuropsychologists) continue to rely on paper-and-pencil testing conducted during in-office visits, using technology only sparingly in their assessments [36,37].…”

Section: Introductionmentioning

confidence: 99%

Web-Based Cognitive Testing of Older Adults in Person Versus at Home: Within-Subjects Comparison Study

Cyr¹,

Romero²,

Galin-Corini³

2021

JMIR Aging

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Background Web-based research allows cognitive psychologists to collect high-quality data from a diverse pool of participants with fewer resources. However, web-based testing presents unique challenges for researchers and clinicians working with aging populations. Older adults may be less familiar with computer usage than their younger peers, leading to differences in performance when completing web-based tasks in their home versus in the laboratory under the supervision of an experimenter. Objective This study aimed to use a within-subjects design to compare the performance of healthy older adults on computerized cognitive tasks completed at home and in the laboratory. Familiarity and attitudes surrounding computer use were also examined. Methods In total, 32 community-dwelling healthy adults aged above 65 years completed computerized versions of the word-color Stroop task, paired associates learning, and verbal and matrix reasoning in 2 testing environments: at home (unsupervised) and in the laboratory (supervised). The paper-and-pencil neuropsychological versions of these tasks were also administered, along with questionnaires examining computer attitudes and familiarity. The order of testing environments was counterbalanced across participants. Results Analyses of variance conducted on scores from the computerized cognitive tasks revealed no significant effect of the testing environment and no correlation with computer familiarity or attitudes. These null effects were confirmed with follow-up Bayesian analyses. Moreover, performance on the computerized tasks correlated positively with performance on their paper-and-pencil equivalents. Conclusions Our findings show comparable performance on computerized cognitive tasks in at-home and laboratory testing environments. These findings have implications for researchers and clinicians wishing to harness web-based testing to collect meaningful data from older adult populations.

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“…Examiner contact: Social demands created by the presence of an examiner may affect performance [ 9 ]; examiner contact allows for behavioral observations to assess comprehension, mental state and competency, motivation, and task engagement [ 8 , 10 ]; the examiner can also provide additional explanation regarding tasks where needed [ 11 ], and structured encouragement to support participant motivation.…”

Section: Introductionmentioning

confidence: 99%

Comparing Web-Based and Lab-Based Cognitive Assessment Using the Cambridge Neuropsychological Test Automated Battery: A Within-Subjects Counterbalanced Study

Backx¹,

Skirrow²,

Dente³

et al. 2020

J Med Internet Res

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Background Computerized assessments are already used to derive accurate and reliable measures of cognitive function. Web-based cognitive assessment could improve the accessibility and flexibility of research and clinical assessment, widen participation, and promote research recruitment while simultaneously reducing costs. However, differences in context may influence task performance. Objective This study aims to determine the comparability of an unsupervised, web-based administration of the Cambridge Neuropsychological Test Automated Battery (CANTAB) against a typical in-person lab-based assessment, using a within-subjects counterbalanced design. The study aims to test (1) reliability, quantifying the relationship between measurements across settings using correlational approaches; (2) equivalence, the extent to which test results in different settings produce similar overall results; and (3) agreement, by quantifying acceptable limits to bias and differences between measurement environments. Methods A total of 51 healthy adults (32 women and 19 men; mean age 36.8, SD 15.6 years) completed 2 testing sessions, which were completed on average 1 week apart (SD 4.5 days). Assessments included equivalent tests of emotion recognition (emotion recognition task [ERT]), visual recognition (pattern recognition memory [PRM]), episodic memory (paired associate learning [PAL]), working memory and spatial planning (spatial working memory [SWM] and one touch stockings of Cambridge), and sustained attention (rapid visual information processing [RVP]). Participants were randomly allocated to one of the two groups, either assessed in-person in the laboratory first (n=33) or with unsupervised web-based assessments on their personal computing systems first (n=18). Performance indices (errors, correct trials, and response sensitivity) and median reaction times were extracted. Intraclass and bivariate correlations examined intersetting reliability, linear mixed models and Bayesian paired sample t tests tested for equivalence, and Bland-Altman plots examined agreement. Results Intraclass correlation (ICC) coefficients ranged from ρ=0.23-0.67, with high correlations in 3 performance indices (from PAL, SWM, and RVP tasks; ρ≥0.60). High ICC values were also seen for reaction time measures from 2 tasks (PRM and ERT tasks; ρ≥0.60). However, reaction times were slower during web-based assessments, which undermined both equivalence and agreement for reaction time measures. Performance indices did not differ between assessment settings and generally showed satisfactory agreement. Conclusions Our findings support the comparability of CANTAB performance indices (errors, correct trials, and response sensitivity) in unsupervised, web-based assessments with in-person and laboratory tests. Reaction times are not as easily translatable from in-person to web-based testing, likely due to variations in computer hardware. The results underline the importance of examining more than one index to ascertain comparability, as high correlations can present in the context of systematic differences, which are a product of differences between measurement environments. Further work is now needed to examine web-based assessments in clinical populations and in larger samples to improve sensitivity for detecting subtler differences between test settings.

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Why are neuropsychologists so reluctant to embrace modern assessment techniques?

Cited by 38 publications

References 40 publications

Basic processes as foundations of cognitive impairment in adult ADHD

Basic processes as foundations of cognitive impairment in adult ADHD

Web-Based Cognitive Testing of Older Adults in Person Versus at Home: Within-Subjects Comparison Study

Comparing Web-Based and Lab-Based Cognitive Assessment Using the Cambridge Neuropsychological Test Automated Battery: A Within-Subjects Counterbalanced Study

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