ADHD Assessments Conducted Via Telehealth May Not Disadvantage Children

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The APSARD study finds that most neuropsychological assessment scores did not differ significantly between both in-person and virtual visit modalities.

Findings from a new study indicate that telehealth services are a valid means of offering neuropsychological assessment in children with ADHD.

The study, presented this weekend at the 2021 American Professional Society of ADHD and Related Disorders (APSARD)Annual Virtual Meeting, was conducted to evaluate the disruptions in healthcare stemming from the coronavirus disease 2019 (COVID-19) pandemic.

“The rapid transition to telehealth services due to the COVID-19 pandemic prompted debate regarding the comparability of neuropsychological assessments administered via teleconference versus those administered in-person, given that norms are based on in-person administration of these measures,” the investigators wrote.

The team, led by Kristie Sweeney, MS, Kennedy Krieger Institute, thus determined whether telehealth systematically disadvantaged children with ADHD.

Telehealth vs. In-Person

They evaluated a total of 365 onsite/in-person testing visits and 142 virtual (Zoom) visits through the Kennedy Krieger Institute clinic.

Further, the in-person sample consisted of all testing visits 4.5 months prior to March 2020, while the virtual visits occurred within 4.5 month following reopening of the clinic.

Patients in the virtual cohort were matched to those in the in-person cohort according to age (mean, 10.45 years), sex (68% male), insurance type (43% medical assistance, 57% commercial insurance).

In both modalities, the WISC-V Matrix Reasoning, Similarities, Vocabulary, Digit Span; KTEA-3 Math Concepts, Letter & Word Recognition; DKEFS Verbal Fluency; and NEPSY-II Word Generation assessments were performed.

The investigators then used 2 sample t-tests to compare the scores obtained from the aforementioned assessments through onsite and virtual visits.

Sweeney and colleagues reported no significant differences between administration modalities for the WISC-V, DKEFS, and NEPSY subtests, in addition to the KTEA-3 Letter/Word subtest (P > .05 for all tests).

Interestingly, the KTEA-3 Math Concepts scores were noted to be significantly higher for telehealth administration (SS = 90.28) than for in-person administration (SS = 85.44; P = .04).

“With the exception of Math Concepts, which requires more investigation, results suggest that modality of neuropsychological evaluation (onsite/in-person vs. telehealth) does not affect performance for children with ADHD, and that telehealth services may be a valid way to assess this population,” the team wrote.

They indicated that improved Math Concepts scores via telehealth may be due to clinicians checking in on patients more often to ensure connectivity and task engagement. As such, this would provide increased redirection and support to aid variability in attention.

Sweeney and her team acknowledged a need to explore further these factors that may have contributed to an improved performance through telehealth service.

Additionally, they believed future research should seek to compare an ADHD cohort with the non-ADHD population.

The study, “Performance on Neuropsychological Assessments Administered in Person Compared to Telehealth for Children With ADHD,” was presented at APSARD 2021.