Pediatric Neuropsychology: Toward Subspecialty Designation

The Role of Speech-Language Pathologists in Expanding Delivery of Teen Online Problem Solving for Adolescents With Acquired Brain Injury: A Quality Improvement Project

PURPOSE

Teen Online Problem Solving (TOPS) is an evidence-based teletherapy program designed to promote neurocognitive, behavioral, and psychosocial recovery following brain injury through family-centered training. To date, TOPS has been primarily administered by neuropsychologists and clinical psychologists. This clinical focus article discusses a quality improvement project to adapt the TOPS training and manual for use by speech-language pathologists (SLPs) and reports feedback from SLPs following TOPS training and after delivering the program with adolescents who experienced neurological insults.

METHOD

SLPs were invited to participate in TOPS training. Trainees were asked to complete posttraining surveys, active therapist questionnaires, and follow-up surveys directed to SLPs who had completed the intervention with at least one patient.

RESULTS

To date, a total of 38 SLPs completed TOPS training, 13 have implemented TOPS with at least one adolescent. Eight SLPs and 16 psychologists/trainees responded to follow-up surveys to share their perspectives on the program. Perceptions of clinicians delivering the program did not differ significantly in most respects. SLPs rated the ease of understanding nonverbal communication higher than psychologists. Seven SLPs responded to an SLP-specific survey about their experiences administering TOPS, noting a range of advantages and some limitations in their open-ended responses.

CONCLUSION

Training SLPs to deliver TOPS has the potential to increase service provision to adolescents with acquired brain injury who have cognitive communication difficulties and their families.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.22357327.

Forensic neuropsychology: History and current status

Objective:This review provides a summary of historical details and current practice activities related to Forensic Neuropsychology (FN). Under the auspices of the American Board of Clinical Neuropsychology (ABCN), the Forensic Neuropsychology Special Interest Group (FNSIG) views the FN as a subspecialty, which has developed over time as the straightforward result of more than 20 years of numerous publications, extensive continuing education, focused research and growth of forensic practice within neuropsychology. In this article, the FNSIG core work group documents and integrates information that is the basis of efforts to consolidate practice knowledge and facilitate attainment of forensic practice competencies by clinical neuropsychologists. Method:Overview of continuing education topics at professional conferences, search results that identify relevant books and peer-reviewed publications, as well as pertinent findings across years of large-scale national survey results. Results:Relevant evidence has shown for decades that FN is prominent within Clinical Neuropsychology as practiced in the United States and Canada. A majority of U.S. neuropsychologists have received FN training and provide forensic evaluation services. FN practice time per week is considerable for many practitioners, and across survey epochs has been shown to be increasing. Conclusion:The present review leads to the conclusion that in the interest of promoting the acquisition of competence, FN practice should remain a focal point of training and continuing education. Alternate routes to attain competence are discussed, as are ongoing professional activities that undoubtedly will ensure continued growth of, and interest in, the subspecialty of FN.

Professional practices, beliefs, and incomes of U.S. neuropsychologists: The AACN, NAN, SCN 2020 practice and "salary survey"

OBJECTIVE

This portion of the 2020 survey updates practice information, beliefs, and income data of clinical neuropsychologists who practice within the United States. Methods: Doctoral-level neuropsychology practitioners were invited via numerous methods, with multiple reminders, to participate in a web-based survey from January 17 through April 2, 2020. The useable U.S. sample of 1677 doctoral-level practitioners was 6.2% larger than the comparable group in the prior 2015 practice survey. Results: Whereas women practitioners predominate, which continues a steeply increasing trend across time, increases in overall ethnic/racial diversity continue at a slow pace. Median age has remained very similar over the last 30 years, reflecting a continuous influx of young practitioners. A relatively small minority of neuropsychologists work part time. The proportion of board-certified neuropsychologists continues to show meaningful increase; interest in subspecialization certification is relatively high. Reliance on technicians remains popular, especially for neuropsychologists who work in institutions or are board certified. Although implementation of new CPT codes in 2019 and related payor policies appear to have had more negative than positive effects, psychology-related annual incomes of neuropsychologists have again increased compared to prior surveys. Variables such as specific work setting, state, region, years in practice, forensic practice hours, board certification, and basis for determining income (e.g. hours billed, revenue collected, relative value units) have an impact on income. More than half of practitioners engage in forensic neuropsychology, with the number of related practice hours per week again increasing. There is very high agreement regarding the use of response validity measures in clinical practice and forensic practice. Neurologists remain the number one referral source whether working in an institution, private practice, or a combination of both, and regardless of maintaining a pediatric, adult, or lifespan practice. Career satisfaction ratings for income, job, and work-life balance remain high, with the majority of ratings regarding the future of the specialty in the positive range. Additional data summaries related to a wide range of professional and practice topics are provided. Conclusions: Updating and comparing survey information at five-year intervals continues to provide insights and perspectives regarding relative stabilities and changes in practice activities, beliefs, and incomes of U.S. clinical neuropsychologists. Such information also provides guidance regarding the future of the specialty.

The Speech-Language Pathologists' Role in Mild Traumatic Brain Injury for Early Childhood-, Preschool-, and Elementary School-Age Children: Viewpoints on Guidelines From the Centers for Disease Control and Prevention

Purpose Traumatic brain injury (TBI) impacts millions of children each year, with those between birth and 4 years of age being 1 of the highest incidence groups. To address gaps in service provision specifically for children with mild TBI (mTBI), the Centers for Disease Control and Prevention (CDC) recently released guidelines for providers. Method The goal of this commentary is to deliver viewpoints on the application of the CDC guidelines directly to speech-language pathology clinical practice, with special attention paid to assessment, symptom monitoring, and intervention using a family-centered approach to care for infants, toddlers, preschoolers, and early elementary students with mTBI. Results In all pediatric practice settings, speech-language pathologists (SLPs) are a critical component of the care team for children who experience mTBI and should participate in symptom monitoring, assessment, intervention, education, and advocacy for this population. Conclusions SLPs can use the CDC guidelines to advocate for their role in the care of young children with mTBI. In addition, SLPs can use the guidelines to create a framework for clinical care provision when working with young children with mTBI. Much work is needed to advance evidence-based practices for this population, and dissemination of current clinical practices could help to close this gap.

Neupsilin-Inf em um Modelo de Avaliação Neuropsicológica Breve para Centros de Saúde

Resumo Este estudo teve como objetivo analisar o uso do NEUPSILIN-Inf num modelo de avaliação neuropsicológica breve em crianças atendidas em um serviço assistencial. As etapas seguidas no modelo de avaliação neuropsicológica breve são: sala de espera, grupo de crianças e avaliação neuropsicológica individual. A análise da aplicabilidade do NEUPSILIN-Inf na detecção de déficits cognitivos foi realizada comparando o desempenho de 171 crianças com possíveis transtornos do neurodesenvolvimento a 358 crianças da amostra de normatização, tendo a média marginal do escore ajustado pela idade. Em todas as tarefas do NEUPSILIN-Inf, o grupo clínico mostrou desempenho inferior. O conjunto de dados do modelo de avaliação pode gerar hipóteses diagnósticas, como deficiência intelectual, possíveis quadros de transtornos da aprendizagem ou específicos de linguagem. Frente à alta escassez de atendimento público para crianças com possíveis transtornos do neurodesenvolvimento, este pode ser um modelo economicamente eficiente para centros de saúde em diversas regiões do Brasil.