The preservation of the field of neuropsychology as an evidenced-based discipline requires immediate, disruptive, organization-level actions to place assessment methods and research paradigms that reflect the racial, cultural, and linguistic diversity of our society at the heart of our education, training and practice models. In this comment on the Cory article on white privilege, three such concrete organizational level actions are articualted, including adoption of Relevance 2050 learning objectives, a revision of the Houston Conference Guidelines to integrate multiracial/multilingual/multiculturalism within every training experience and competency area, and a pledge from every major national neuropsychology organization to dedicate a percentage of our yearly budgets to directly fund multicultural/multiracial/multilingual norms and cultural competence development.

Objective The Inter Organizational Practice Committee (IOPC) convened a workgroup to develop guidance on models to provide neuropsychological (NP) care during the COVID-19 pandemic while minimizing risks of novel coronavirus transmission as lockdown orders are lifted and ambulatory clinical services resume. Method A collaborative panel of experts from major professional organizations developed provisional guidance for models of neuropsychological practice during the pandemic. The stakeholders included the American Academy of Clinical Neuropsychology/American Board of Clinical Neuropsychology, the National Academy of Neuropsychology, Society of Clinical neuropsychology (Division 40) of the American Psychological Association, the American Board of Professional Neuropsychology, and the American Psychological Association Services, Inc. Results This guidance reviews the risks and benefits of conducting NP exams in several ways, including standard in-person, mitigated in-person, in-clinic teleneuropsychology (TeleNP), and in-home TeleNP. Strategies are provided for selecting the most appropriate model for a given patient, taking into account four levels of patient risk stratification, level of community risk, and the concept of stepped models of care. Links are provided to governmental agency and professional organization resources as well as an outline and discussion of essential infection mitigation processes based on commonalities across recommendations from diverse federal, state, local, and professional organization recommendations. Conclusion This document provides recommendations and guidance with analysis of the risks relative to the benefits of various models of NP care during the COVID-19 pandemic. These recommendations may be revised as circumstances evolve, with updates posted continuously on the IOPC website (https://iopc.online/).

espanolObjetivos: el Comite de Practica Inter Organizacional (IOPC) convoco a un grupo de trabajo para brindar una guia rapida sobre teleneuropsicologia (TeleNP) en respuesta a la pandemia de COVID-19. Metodos: un panel colaborativo de expertos de las principales organizaciones profesionales de USA desarrollo una guia provisional para la practica de neuropsicologia clinica durante la pandemia. Dicho panel incluyo la Academia Americana de Neuropsicologia Clinica/Junta Americana de Neuropsicologia Clinica, la Academia Nacional de Neuropsicologia, la Division 40 de la Asociacion Americana de Psicologia, la Junta Americana de Neuropsicologia Profesional y la Asociacion Americana de Servicios de Psicologia. El grupo hizo una revision de la literatura disponible, recopilo las regulaciones federales, regionales y estatales, informacion de las aseguradoras y encuesto a los profesionales para identificar las mejores practicas para la TeleNP. Resultados: la literatura indica que la TeleNP puede ofrecer evaluaciones confiables y validas. Sin embargo, los clinicos deben tener en cuenta sus limitaciones, desarrollar nuevos procedimientos de consentimiento informado, reportar las modificaciones que realicen a los procedimientos estandarizados y establecer limitaciones a las conclusiones diagnosticas y recomendaciones. Limitaciones especificas afectan las evaluaciones de TeleNP en poblacion adulta mayor, ninos pequenos, personas con acceso limitado a la tecnologia y personas de contextos culturales y/o linguisticos diversos. La TeleNP puede no ser recomendada o derechamente inviable dependiendo de las caracteristicas especificas del paciente, las circunstancias y el motivo de derivacion. Se ofrecen consideraciones para la facturacion de los servicios de TeleNP con la observacion de que cada clinico verifique los procedimientos de manera independiente. Adicionalmente, se proporciona orientacion sobre aspectos tecnicos y consejos para los procedimientos de TeleNP. Conclusiones: este documento ofrece una guia provisional con enlaces a recursos y pautas establecidas para la telepsicologia. Las recomendaciones especificas se extienden para la practica de la TeleNP. Estas recomendaciones pueden ser revisadas conforme evolucionen las circunstancias mediante actualizaciones publicadas continuamente en OPC.online. EnglishObjective: The Inter Organizational Practice Committee (IOPC) convened a workgroup to provide rapid guidance about teleneuropsychology (TeleNP) in response to the COVID-19 pandemic. Method: A collaborative panel of experts from major professional organizations developed provisional guidance for neuropsychological practice during the pandemic. The stakeholders included the American Academy of Clinical Neuropsychology/American Board of Clinical Neuropsychology, the National Academy of Neuropsychology, Division 40 of the American Psychological Association, the American Board of Professional Neuropsychology, and the American Psychological Association Services, Inc. The group reviewed literature, collated federal, regional and state regulations and information from insurers, and surveyed practitioners to identify best practices. Results: Literature indicates that TeleNP may offer reliable and valid assessments, but clinicians need to consider limitations, develop new informed consent procedures, report modifications of standard procedures, and state limitations to diagnostic conclusions and recommendations. Specific limitations affect TeleNP assessments of older adults, younger children, individuals with limited access to technology, and individuals with other individual, cultural, and/or linguistic differences. TeleNP may be contraindicated or infeasible given specific patient characteristics, circumstances, and referral questions. Considerations for billing TeleNP services are offered with reservations that clinicians must verify procedures independently. Guidance about technical issues and “tips” for TeleNP procedures are provided. Conclusion: This document provides provisional guidance with links to resources and established guidelines for telepsychology. Specific recommendations extend these practices to TeleNP. These recommendations may be revised as circumstances evolve, with updates posted continuously at OPC.online.

OBJECTIVE:The Inter Organizational Practice Committee convened a workgroup to provide rapid guidance about teleneuropsychology (TeleNP) in response to the COVID-19 pandemic.METHOD:A collaborative panel of experts from major professional organizations developed provisional guidance for neuropsychological practice during the pandemic. The stakeholders included the American Academy of Clinical Neuropsychology/American Board of Clinical Neuropsychology, the National Academy of Neuropsychology, Division 40 of the American Psychological Association, the American Board of Professional Neuropsychology, and the American Psychological Association Services, Inc. The group reviewed literature; collated federal, regional, and state regulations and information from insurers; and surveyed practitioners to identify best practices.RESULTS:Literature indicates that TeleNP may offer reliable and valid assessments, but clinicians need to consider limitations, develop new informed consent procedures, report modifications of standard procedures, and state limitations to diagnostic conclusions and recommendations. Specific limitations affect TeleNP assessments of older adults, younger children, individuals with limited access to technology, and individuals with other individual, cultural, and/or linguistic differences. TeleNP may be contraindicated or infeasible given specific patient characteristics, circumstances, and referral questions. Considerations for billing TeleNP services are offered with reservations that clinicians must verify procedures independently. Guidance about technical issues and "tips" for TeleNP procedures are provided.CONCLUSION:This document provides provisional guidance with links to resources and established guidelines for telepsychology. Specific recommendations extend these practices to TeleNP. These recommendations may be revised as circumstances evolve, with updates posted continuously at IOPC.online.

Position papers from the American Academy of Clinical Neuropsychology and the National Academy of Neuropsychology define assessment of symptom and performance validity, using well-validated assessment tools, as a critical component of a competent neuropsychological assessment. The ability to provide information to the court about whether defendants/plaintiffs are providing accurate information about their symptoms and abilities is a unique and valuable contribution that our field brings to the forensic table. This chapter addresses strategies to assist jurors and other triers of fact in their understanding of concepts of effort and exaggeration, through evaluation of noncredible symptom patterns and performance validity and symptom validity testing.

As scientists and clinicians, we have grown up in an academic tradition that tells us to communicate with jargon-filled, technical language and to be so fearful of making an error that reading from slides verbatim at a conference appears to be a sane communication choice. Our years of scientific training may actually result in a net loss of our ability to communicate clearly and simply about the neuroscience we love. Use of an academic communication style interferes with jurors’ ability to access our messages and also reduces our credibility, as we may unwittingly appear distant and condescending. This chapter shares how principles of improvisation can help us disrupt the inaccessible academic communication style we all learned in graduate school. Shedding jargon, giving ourselves permission to allow emotion to creep back into our language, freeing up our body language, and using vivid, clear language allows us to create moments of genuine, productive communication with jurors and other triers of fact. At its heart, improv challenges us to be human, connect with others in ways that are meaningful to others, not take ourselves so seriously, and share the joy/fun we experience in the field we chose.

Pediatric trauma, medical malpractice, teen criminal cases and capital cases often require explanations of normal and abnormal cognitive development; and almost any case we see as forensic neuropsychologists requires some level of communication about how we assess “premorbid” intellectual or cognitive function. This chapter shares clear, vivid strategies to explain concepts of cognitive development, premorbid intellectual function, and current intellectual abilities. Topics covered include the developing brain, problems that might emerge later in a child’s development, prenatal injuries, and intellectual disability. Because in many forensic contexts, a defendant/plaintiff’s IQ number can have very profound consequences, experts should be prepared when IQ is discussed in court.

Jurors may have no idea how our assessment tools and procedures work. Professionals are so used to speaking and thinking with the basic assumptions of our professions that those assumptions become invisible to us. Standardized testing and normative interpretation are a great example of this concept. After years of graduate school and clinical practice, when a neuropsychologist uses the word testing we have a very precise image in our thought bubbles of a battery of valid and reliably constructed instruments, normed on appropriate populations, administered in a standardized fashion, and interpreted in the context of the larger assessment. But very few jurors will have been exposed to the concept of normative interpretation. To ensure that jurors and triers of fact have access to our broader message regarding assessment results, we need to begin our testimony with a clear, accessible, and engaging description of our assessment tools and process. This chapter addresses strategies for explaining psychological and neuropsychological assessment procedures, as well as specific tests like the MMPI, in a clear, accessible manner.

When experts discuss psychological or neurological syndromes, jurors will bring to the courtroom their own background knowledge and understanding of those disorders. The challenge for the expert is that the jurors’ information may or may not be accurate. This chapter shares vivid, succinct strategies to explain psychiatric illness, intellectual disability, cognitive effects of illness, neurological disorders, and chronic pain to jurors and other triers of fact. Seasoned forensic psychologists and neuropsychologists were asked to share what they actually say in court to describe the most common clinical phenomena that are the subject of criminal and civil cases, including PTSD and depression.

Objective: Though some neuropsychological groups have proposed criteria and suggestions for clinical report writing there has never been professional consensus or accepted published guidelines on how to write reports. Given the paucity of guidelines and the evolving practice climate, we sought to survey neuropsychologists and referral source stakeholders to understand current report writing practices. Method: The data were collected in two SurveyMonkey surveys via professional list servs, email, and LinkedIn clinical interest groups. Results: Results of the survey indicate many neuropsychologists spend multiple hours writing reports that they believe will not be read completely by stakeholders. A striking 73% of referral sources reported slow turnaround time of neuropsychological reports negatively affected their patient care. Referral sources reported they value the diagnosis/impression and recommendations sections the most; in contrast, they did not find the history, behavioral observations, emotional functioning, or descriptions of cognitive domains sections as useful. Conclusions: The survey findings highlight the disjuncture between what neuropsychologists typically do in their practice of report writing versus what they believe is useful for patients and referral sources. The survey also highlights differences between writing practices of neuropsychologists and what referral sources identify as the most valuable aspects of reports to assist them in caring for their patients.

In an era of rapid changes in the healthcare marketplace the specialty of clinical neuropsychology faces a substantial increase in advocacy challenges. These include maintaining both access to services and a favorable practice climate as new healthcare structures and payment models evolve. The issue of regional variability complicates an effective response to these challenges from national professional organizations. One response to the challenge of regional variability is to strengthen our national organizations' capacity to engage in coordinated and effective advocacy, and to partner with state and regional neuro/psychological associations. The Inter-Organizational Practice Committee (IOPC) was formed in 2012 to meet this need. The IOPC has developed a model of 360 Degree Advocacy that coordinates local, regional, and national resources for high-impact, efficient advocacy. This paper describes the 360 Degree Advocacy model, and walks readers through an example of the model in action, successfully responding to a threat to patient access and practice climate with a regional Medicare carrier.

The general public is way ahead of us on positive neuropsychology. Beginning at the first signs of pregnancy, parents spend millions on toys, music, and devices that claim to stimulate neural conne...

Toward a Neuropsychology of Healthy Aging - Nurturing the Older Brain and Mind, by Pamela M. Greenwood and Raja Parasuraman. 2012. Cambridge, MA: The MIT Press, 326 pp., $40.00 (PB). - Volume 19 Issue 8