Remote Neuropsychological Assessment: A Proof-of-Concept Test

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DESCRIPTION (provided by applicant): Stroke is a leading cause of adult disability with a large portion of stroke survivors confronting a communication disorder that significantly diminishes the quality of their lives. Clinical and basic researchers rely upon neuropsychological testing to evaluate the neurologic and behavioral status of stroke survivors. The difficulties involved in obtaining neuropsychological data hinder basic and clinical research involving this population. This proposal responds to the need for innovative approaches to neuropsychological testing. Standard neuropsychological test administration relies upon face-to-face (F2F) interactions. This imposes geographic constraints and data acquisition burdens that reduce research efficiency and lead to disparities in research involvement. To overcome these barriers, we will develop tools and protocols that will allow stroke survivors to complete neuropsychological tests in their own homes, through the virtual support of a geographically distant investigator. We will use wireless collaborative videoconferencing software and easy-to-operate tablet computers (iPads). Our test battery will probe core language functions and our participants will have left-hemisphere lesions. This initial direction was chosen because the personal and societal burden of post-stroke aphasia is significant, many tasks used for aphasia research are straightforward, prior data permits predictions about expected results, and there is a clear need for tools that can monitor aphasia status and treatment outcomes. Formative usability tests of our technology and protocols will be used to optimize the administration of our battery under three different conditions: 1) a virtual, investigator-guided protocol that is designd to emulate standard F2F neuropsychological testing, 2) a virtual, self- administered protocol that is designed to emulate computerized approaches to test administration, and 3) a standard face-to-face protocol that is intended as a performance benchmark. Once our protocols are in place, data will be acquired from three groups of participants with focal left-hemisphere lesions. Each group will complete our battery of language tasks in their home, via one of our two virtual protocols or a standard F2F protocol. All groups will complete a standard F2F protocol in our research laboratory. A variety of usability metrics will be used to evaluate participant and researcher satisfaction, confidence, and success with our virtual protocols. The behavioral data will be used to test whether comparable results are obtained when our tasks are administered under versus F2F testing conditions. Measures of efficiency and equipment reliability will provide a practical perspective on the benefits and limitations of home-based remote neuropsychological assessment. Overall, we aim to develop an innovative method for home-based remote neuropsychological testing that can be readily adapted and adopted by other investigators to meet a diverse set of research needs.