Cox Stephany M, Butcher Jennifer L, Sadhwani Anjali, Sananes Renee, Sanz Jacqueline H, Blumenfeld Elizabeth, Cassidy Adam R, Cowin Jessica C, Ilardi Dawn, Kasparian Nadine A, Kenowitz Joslyn, Kroll Kristin, Miller Thomas A, Wolfe Kelly R
Department of Pediatrics, Division of Developmental Medicine, Benioff Children's Hospital, University of California-San Francisco, USA.
Department of Pediatrics, University of Michigan School of Medicine & C.S. Mott Children's Hospital, USA.
J Pediatr Psychol. 2022 Jun 7;47(6):707-713. doi: 10.1093/jpepsy/jsac003.
In the wake of the COVID-19 pandemic, psychologists were pushed to look beyond traditional in-person models of neurodevelopmental assessment to maintain continuity of care. A wealth of data demonstrates that telehealth is efficacious for pediatric behavioral intervention; however, best practices for incorporating telehealth into neurodevelopmental assessment are yet to be developed. In this topical review, we propose a conceptual model to demonstrate how telehealth can be incorporated into various components of neurodevelopmental assessment.
Harnessing existing literature and expertise from a multidisciplinary task force comprised of clinicians, researchers, and patient/parent representatives from the subspecialty of cardiac neurodevelopmental care, a conceptual framework for telehealth neurodevelopmental assessment was developed. Considerations for health equity and access to care are discussed, as well as general guidelines for clinical implementation and gaps in existing literature.
There are opportunities to integrate telehealth within each stage of neurodevelopmental assessment, from intake to testing, through to follow-up care. Further research is needed to determine whether telehealth mitigates or exacerbates disparities in access to care for vulnerable populations as well as to provide evidence of validity for a wider range of neurodevelopmental measures to be administered via telehealth.
While many practices are returning to traditional, face-to-face neurodevelopmental assessment services, psychologists have a unique opportunity to harness the momentum for telehealth care initiated during the pandemic to optimize the use of clinical resources, broaden service delivery, and increase access to care for pediatric neurodevelopmental assessment.
在新冠疫情之后,心理学家被迫超越传统的面对面神经发育评估模式,以维持护理的连续性。大量数据表明,远程医疗对于儿科行为干预是有效的;然而,将远程医疗纳入神经发育评估的最佳实践尚未形成。在这篇专题综述中,我们提出一个概念模型,以展示如何将远程医疗纳入神经发育评估的各个环节。
利用由心脏神经发育护理亚专业的临床医生、研究人员以及患者/家长代表组成的多学科特别工作组的现有文献和专业知识,制定了远程医疗神经发育评估的概念框架。讨论了健康公平性和医疗服务可及性的相关考量,以及临床实施的一般指南和现有文献中的空白。
在神经发育评估的各个阶段,从接诊到测试,再到后续护理,都有将远程医疗整合进来的机会。需要进一步研究以确定远程医疗是减轻还是加剧了弱势群体获得医疗服务的差距,以及为通过远程医疗实施的更广泛的神经发育测量方法提供有效性证据。
虽然许多医疗机构正在回归传统的面对面神经发育评估服务,但心理学家有一个独特的机会,利用疫情期间启动的远程医疗护理的势头,优化临床资源的使用,扩大服务范围,并增加儿科神经发育评估的医疗服务可及性。