ABSTRACT Research aims The benefits of parenting interventions for child and family outcomes following pediatric brain injury are well documented. However, training in pediatric neuropsychology largely emphasizes a focus on assessment, as well as syndrome- or disorder-specific interventions. Greater attention to transdiagnostic intervention is warranted, particularly pediatric neurorehabilitation programs that are family-centered and evidence-based. This study evaluated the acceptability of a didactic and skill-based transdiagnostic training model for pediatric neuropsychologists, and its outcomes on their knowledge, behavior, and early fidelity in delivering Interact-North in a pediatric brain injury population. Methods We evaluated a neuropsychologically informed training and supervision model for Interact-North, a virtual transdiagnostic parenting intervention for children with acquired brain injury. Outcomes of training were evaluated, informed by the Kirkpatrick framework, across the last two cohorts of trainees (2023 n = 7; 2025 n = 11), who consisted of PhD level early career and trainee neuropsychologists. Training included a two-day workshop with didactic learning and role-play components. Following training, Interact-North trainees participated in biweekly group and individual supervision, as well as case-shadowing. Training outcomes included trainees’ impressions of training, knowledge, behavior (i.e. skills) for both the 2023 and 2025 cohorts, and results (i.e. treatment fidelity, assessed in clinician checklists after each treatment session) for the 2023 cohort only. Results Overall, participants endorsed highly favorable impressions of training (i.e. 4.91/5.00) and high relevancy to their career/clinical work. Role play was rated highest in utility (i.e. 4.93/5.00). Self-reported competency improved significantly following the training. The focus and value of individual and group supervision were also highly rated. Trainees demonstrated 95% program fidelity in their first case. Implications for the field Findings suggest that this transdiagnostic neuropsychological intervention training model is successful in improving skill and clinician confidence with uniform acceptability in its importance to extend neuropsychological competencies in evidence-based family focused pediatric neurorehabilitation.

Conceptual frameworks for cultural competence are essential in psychological care. The assessment of implementation efforts in pediatric neuropsychological contexts is particularly lacking. This study investigated an adapted training program for the Cultural Formulation Interview (CFI), including impact on provider cultural competence and perspectives on adaptation and implementation. Neuropsychological care providers (N = 16) participated in an adapted, group-based CFI training. The training included review of an online module, supplemented with reflective discussion. Participants completed pre- and post-training measures of perceived cultural competence, as well as a post-training survey assessing acceptability and utility of the CFI and training, facilitators and barriers to implementation, and potential adaptations to the CFI. The CFI and adapted training were rated highly on acceptability and utility. Self-reported confidence and competence in delivering culturally responsive care increased from pre- to post-training (z = −3.4; p = .0007). Key barriers and facilitators to implementation included resource needs, continuing education, and systemic change. Participants identified a theoretical, abbreviated 5-item CFI including alternative wording to fit their clinical needs. Overall, the adapted CFI training enhanced perceived cultural competence among pediatric neuropsychological providers, with strong acceptability and relevance to clinical practice. Recommendations will guide future training and systemic implementation.

ABSTRACT The growing fields of genetics and neurogenetics have brought increased attention to developmental and epileptic encephalopathies (DEEs), a group of rare epilepsy disorders that span genetic and neurological pathology. Among the genetic causes of DEEs, single-gene variants represent a significant and increasingly recognized category. These variants often lead to complex and distinct clinical presentations, including variable seizure types, neurocognitive profiles, and developmental trajectories. Foundational knowledge about these disorders, including their molecular and cellular etiologies, accompanying clinical symptoms, and developmental trajectories, can better inform neuropsychological practice, especially in guiding test selection and recommendations as well as highlighting limitations for evaluation. The primary objective of this paper is to provide an evidence-based primer on single-gene developmental epileptic encephalopathies for pediatric neuropsychologists working with these growing clinical and research populations. The manuscript begins with a broad overview of definitions relevant to the care of those with single-gene epilepsies. The paper then describes the clinical features and neurocognitive outcomes associated with the eight most common single-gene pediatric-onset epilepsies, which is subsequently followed by a brief overview of 13 additional single-gene pediatric-onset epilepsies. The paper concludes with a summary of the treatment landscape and discusses current considerations for neuropsychological assessment with this population.

Interpreter-mediated assessments are increasingly common in paediatric neuropsychology, both globally and within the United Kingdom, due to the rising linguistic and cultural diversity of service users. However, limited research has examined how interpreters and clinicians navigate the complexities of delivering developmentally appropriate, culturally sensitive and psychometrically valid assessments. This qualitative study explored the experiences of 10 paediatric neuropsychologists and nine professional interpreters across NHS services in the United Kingdom. Semi-structured interviews examined the challenges, role expectations and collaborative practices within interpreter-mediated cognitive assessments. Data were analysed using reflexive thematic analysis, with key themes highlighting tensions between access and standardisation, differing interpretations of the interpreter's role and the unique demands of neuropsychological testing in children. Participants consistently emphasised the value of structured collaboration, such as pre-assessment briefings and post-assessment debriefs, though these practices were inconsistently applied. A two-round structured consensus-building exercise, informed by Delphi methodology but adapted for a smaller, profession-specific sample, was subsequently conducted with 13 participants to generate consensus-based recommendations. Nine statements reached an agreement of ≥80%, including the need for joint preparation, interpreter access to sample materials and tailored training for both interpreters and clinicians. These findings underscore the distinct cognitive, relational and linguistic challenges inherent to interpreter-mediated paediatric neuropsychological assessment and call for more explicit guidance and professional development. The study contributes to cross-cultural neuropsychology by providing practice-oriented recommendations to enhance the quality and equity of assessments. Future work should focus on implementation, particularly within resource-constrained or multilingual settings.

Objective: Children admitted to the PICU are at risk for acquiring morbidities from their hospitalization known as post-intensive care syndrome in pediatrics (PICS-p). The objectives of this study were to examine the need for neurocognitive follow-up in evaluating for PICS-p, describe acquired PICS-p morbidities, and characterize recommended interventions. Methods: Children ages 1 day to 18 years admitted to the PICU between January 1, 2016 to December 31, 2023 who were evaluated in the pediatric neuropsychology outpatient clinic within 3–8 months of hospital discharge were included. Results: Among 453 referrals, 343 (76%) children were evaluated by the neuropsychology team. The most common post-discharge morbidities were sleep disturbances (63%), developmental/functional concerns (60%), and coping difficulties (56%). 289 children (84%) received interventions as a result of their neurocognitive evaluations. Medical interventions including referrals to physical, occupational, and speech therapy, psychiatry, psychotherapy, and neurology were recommended for 73.8% of children. Home interventions to address sleep and mood disturbances were recommended for 73.2% of children. Academic interventions including recommendations for educational services and provision of additional time to complete tasks were provided for 76.1% of children. Conclusions: The majority of children received recommendations for interventions as a result of their evaluations suggesting that neurocognitive follow-up has a role following pediatric critical illness. The high uptake of neuropsychology services among children referred for follow-up suggests that many PICU survivors experience significant functional and psychosocial morbidities after hospital discharge and are willing to seek support.

Cross-cultural paediatric neuropsychology faces important challenges in ensuring assessments are fair and valid across diverse cultural, linguistic, and socioeconomic backgrounds. This article aims to highlight key considerations and gaps in current practice, with a focus on supporting equitable neuropsychological assessment practices in increasingly diverse populations. This perspective article draws on a structured narrative review of key literature and explores core themes in the cross-cultural neuropsychological assessment of children, including test adaptation, developmental considerations, and interpreter-mediated assessment. Three main areas are discussed: (1) the inconsistent adaptation of paediatric-specific cognitive assessment tools across cultures, (2) the influence of cultural and educational factors on child development and test performance, and (3) the complexities of interpreter-mediated neuropsychological assessment in paediatric settings. Although there are established tools and emerging guidance in adult neuropsychology, systematic, child-focused cross-cultural assessment frameworks remain underdeveloped. Further research is needed to develop culturally responsive, developmentally appropriate, and standardised frameworks for paediatric neuropsychological assessment. This includes improving normative data sets, refining cross-cultural adaptation processes, and developing interpreter protocols tailored to child assessments. These efforts are essential to ensure that assessments are equitable, accurate, and clinically useful across diverse populations.

ObjectiveThis study aims to address the gap in standardized neurodevelopmental screening for children with craniosynostosis following surgical intervention. It proposes a structured timeline for assessments to identify developmental delays and cognitive deficits, facilitating early intervention and improved outcomes.DesignTwo neurodevelopmental expert consensus meetings were held virtually with pediatric neuropsychologists and psychologists to review existing literature and identify screening tools, timelines, and implementation strategies. The proposed protocol was then presented to multidisciplinary members of the SynRG research group, including surgeons and craniofacial specialists, to refine recommendations.SettingThe protocol is intended for implementation in multidisciplinary craniosynostosis clinics at tertiary care institutions across the United States.Patients, ParticipantsThe study involved pediatric neuropsychologists and psychologists with expertise in neurodevelopment, as well as neurosurgeons and craniofacial specialists of the SynRG research group.InterventionsThe proposed screening schedule spans infancy through adolescence, incorporating tools such as the Ages and Stages Questionnaire, NIH Toolbox, and PROMIS measures. Screening intervals align with developmental milestones and academic transitions.Main Outcome MeasuresThe study focused on feasibility, clinical utility, and the ability of the proposal to detect developmental concerns among craniosynostosis patients early.ResultsThe panel recommended a screening protocol tailored to key developmental stages, integrating caregiver input and direct assessments. Feedback from the SynRG group supported the protocol's feasibility but highlighted barriers such as neuropsychologist availability and insurance challenges.ConclusionsThe proposal offers a scalable protocol to neurodevelopmental screening in craniosynostosis care. Implementation in clinical practice could enhance early identification and intervention, improving long-term outcomes.

Neuropsychology's Role in Multidisciplinary Follow-Up Care of Neurologically Complex Infants and Toddlers.

Objective: We conducted a project to manage a high volume of referrals to pediatric neuropsychology. We aimed to manage referrals for children and adolescents without known medical risk factors. We proposed that a clinical neurodevelopmental interview conducted via telehealth would reduce the number of patients on the waitlist and identify those who do not need neuropsychological evaluation. Method: We conducted clinical neurodevelopmental interviews via telehealth to assess patients’ need and urgency for neuropsychological testing. These patients had no or unclear risk factors and non-specific concerns with learning, attention, and/or behavior. We monitored our waitlist over a 2-year period to determine if this service could reduce our waitlist. We measured the time to initial consultation before and after this new service. We surveyed referring providers to assess their satisfaction of this service. Results: Using this new triage consultation service, we found that 1 in 4 children did not require a neuropsychological evaluation. This reduced our waitlist by about 5 months, even while we had an increase in referrals during the same period. After implementation, patients were seen for consultation within a month of the referral. Referring providers were generally satisfied with this service. Conclusions: Implementing telehealth clinical interviews was effective in triaging healthy children with non-specific learning, attention, and/or behavior concerns. This new service effectively reduced our waitlist and offered quick access to neuropsychological consultation and recommendations. Referring providers appreciated efforts to increase access to pediatric neuropsychology services for those who were anticipated to benefit the most from such services.

Supplemental Material for Agreement, Reliability, Feasibility, and Acceptability of Home-Based Telehealth Versus Face-to-Face Pediatric Neuropsychological Testing: A Within-Person Crossover Study

Juan is a 5-year-old boy who has been followed by a developmental-behavioral pediatrician and pediatric neuropsychologist since being diagnosed with language delay and autism spectrum disorder at age 2 years. He is otherwise healthy and was born at term after a healthy pregnancy. His primary language is Spanish, and he has minimal interactions in English. His first words were at 20 months; they were not functional but rather words related to his interests such as "train." He began using 2 to 3-word phrases shortly after but only to request needs. He began speaking in complete sentences at age 4 years.A neuropsychological evaluation was conducted at age 2 years during which Juan demonstrated repetitive behaviors such as hand-flapping, toe-walking, body rocking, and head banging. He displayed sensory seeking behaviors such as rubbing items on his face and close visual inspection. He did not respond to his name and his use of eye contact was inconsistent. He demonstrated rigidity and difficulty transitioning between activities. He did not engage in social reciprocity, and his facial expressions were limited. Minimal spontaneous language was observed, and expressive language largely consisted of echolalia in both languages. Juan was diagnosed with autism spectrum disorder and applied behavior analysis, speech and language therapy, and occupational therapy were recommended.Developmental-behavioral follow-up over the next 2 years noted improvements in behavior, transitions, and social interactions. He participated in early childhood intervention and early childhood special education with significant advances for speech and language in English and Spanish, demonstrating a large vocabulary. At 4 years, parents noted Juan to have reluctance to speak in English. He stopped speaking in English entirely for 3 weeks, though he continued to speak in Spanish. When he resumed speaking in English, it was only with people he knew well (e.g., parents, teachers, babysitter). In clinic, he did not speak to the English-speaking developmental-behavioral pediatrician but spoke in short sentences to the Spanish-speaking neuropsychologist.A repeat neuropsychological evaluation completed at age 5 years revealed that Juan had stopped speaking in English completely, even among those previously deemed "safe." Results were consistent with average cognitive abilities with a strength in verbal skills. Juan's single-word vocabulary in Spanish was exceptionally high. He did not provide expressive responses in English, but his receptive English vocabulary was high average. He responded to English language with nonverbal gestures or spoken language in Spanish. Parents reported Juan to display increased anxiety accompanied by extreme school refusal, behavioral difficulties, and reluctance to leave the home.Given this information, what are your diagnostic considerations and treatment recommendations?

Transdiagnostic Attentional Deficits Are Associated with Depressive and Externalizing Symptoms in Children and Adolescents with Neuropsychiatric Disorders.

Pediatric neuropsychological assessment in Southeast Asia: Current status and future directions with Vietnam as a scoping review case example.

Pediatric-onset multiple sclerosis (POMS) accounts for approximately 2 to 5% of all individuals with MS and is associated with an increased risk for cognitive impairment. In recent years, neuropsychological screening questionnaires have been increasingly utilized for pediatric populations in multidisciplinary settings. This study examines the clinical utility of the Colorado Learning Difficulties Questionnaire (CLDQ) and Pediatric Perceived Cognitive Functioning (Peds PCF) screening measures for identifying cognitive impairment in persons with POMS during a target neuropsychological evaluation. Retrospective data was gathered from electronic medical records at a single pediatric hospital. Forty-nine participants were included (69% female; 43% Hispanic/Latinx; mean age = 16.1 years old, range = 9.9 to 20.6 years old). Correlation analyses demonstrated strong interrelatedness between caregiver ratings on screening measures and performance on traditional neuropsychological measures. Effect sizes were medium across comparisons (CLDQ: Spearman's rho = -.321 to -.563; PedsPCF: Spearman's rho = .308 to .444). Exploratory cut-points using receiver operating characteristic analysis and Youden indices are also discussed. Comparison of scores across caregiver rating questionnaires and on a targeted neuropsychological battery suggests that the screening surveys alone may not be sensitive enough to identify children with cognitive impairments, but ratings may provide qualitatively meaningful information along with neuropsychological testing. This study illustrates how pediatric neuropsychologists can leverage screening tools to focus consultative interviews and effectively triage referrals for evaluation within an academic medical setting.

An Examination of the Impact of Single Errors on Performance Validity Testing on Neuropsychological Performance: a Youth Athlete Cohort Study

Objective: The pediatric patient populations in the United States are becoming increasingly diverse in culture. In addition to medical factors, a variety of sociocultural factors (including educational systems, language, immigration status, etc.) can impact a child’s cognitive development, performance on traditional neuropsychological measures, provider interactions, differential diagnosis, and recommendations. A culturally-informed neuropsychological evaluation aims to understand the impact of sociocultural factors and integrate them into the assessment approach. Fujii’s ECLECTIC framework (acronym for Education & Literacy, Culture/Acculturation, Language, Economic Issues, Communication Style, Testing Situation, Intelligence Conceptualization, and Context of Immigration) can be used to guide culturally-informed neuropsychological evaluations of children with complex medical conditions. Method: Using the ECLECTIC framework, this paper describes clinical considerations and offers practical solutions for providing culturally-informed pediatric neuropsychology evaluations. Four diverse patients with spina bifida are reviewed. Results: The case presentations highlight the application of the ECLECTIC framework within a medically complex pediatric patient population. Conclusions: Spina bifida is one example of a pediatric medical population in which both medical and sociocultural factors can impact cognitive development and the evaluation process. The ECLECTIC framework defines a variety of sociocultural factors that can influence cognitive development and multiple aspects of a pediatric neuropsychological evaluation. Pediatric neuropsychologists should use the ECLECTIC framework to provide culturally-informed evaluations for our increasingly diverse patient populations.

Objective: Despite varying opinions, little research has examined how to best write pediatric neuropsychology reports. Method: This study gathered input from 230 parents on how text difficulty (reading level) and visual emphasis (bullets, underline, italics) affect report readability and utility. We focused on the most-read report section: summary/impressions. Each parent rated the readability and usefulness of a generic summary/impressions section written in four different styles. The four styles crossed text difficulty (high school-vs-collegiate) with use of visual emphasis (absent-vs-present). Results: Parents found versions with easier text to be more clearly written, easier to follow, and easier to find information (p<.001). Parents rated those with harder text to be overly detailed, complex, hard to understand, and hard to read (p<.001). Visual emphasis made it easier to find key information and the text easier to follow and understand – but primarily for versions that were written in difficult text (interaction p≤.026). After rating all four styles, parents picked their preference. They most often picked versions written in easier text with visual emphasis (p<.001). Conclusions: Findings support writing styles that use easier text difficulty and visual emphasis.

In clinical neuropsychology, the phenomenon of accelerated long-term forgetting (ALF) has advanced to be a marker for subtle but clinically relevant memory problems associated with a range of neurological conditions. The normal developmental trajectory of long-term memory, in this case, memory recall after 1 week, and the influence of cognitive variables such as intelligence have not extensively been described, which is a drawback for the use of accelerated long-term forgetting measures in pediatric neuropsychology. In this clinical observation study, we analyzed the normal developmental trajectory of verbal memory recall after 1 week in healthy children and adolescents. We hypothesized that 1-week recall and 1-week forgetting would be age-dependent and correlate with other cognitive functions such as intelligence and working memory. Sixty-three healthy participants between the ages of 8 and 16 years completed a newly developed auditory verbal learning test (WoMBAT) and the WISC-V intelligence test (General Ability Index, GAI). Using these tests, 1 week recall and 1 week forgetting have been studied in relation to GAI, verbal learning performance, and verbal working memory. Neither 1-week recall nor 1-week forgetting seems to be age-dependent. They are also not significantly predicted by other cognitive functions such as GAI or working memory. Instead, the ability to recall a previously memorized word list after 7 days seems to depend solely on the initial learning capacity. In the clinical setting, this finding can help interpret difficulties in free recall after 7 days or more since they can probably not be attributed to young age or low intelligence.

Teacher Perspectives of Pediatric Neuropsychology and Supporting Children With Chronic Health Conditions.

Children with neurologic disorders face increased risks for mental health and neurodevelopmental conditions, with information often limited to parent report. To better understand mental health and neurodevelopmental needs in this population, a retrospective chart review of a convenience sample of children with neurologic disorders referred for a neuropsychological evaluation was conducted in the present study to explore interrater agreement between care team members (referring providers, parents, pediatric neuropsychologist). Qualitative and quantitative data were collected from the evaluation reports of 129 youth (9:0–17:11 years old; 51.2% of female sex) with neurologic disorders (i.e., 38.0% traumatic brain injury, 27.1% epilepsy, 14.7% premature birth, 7.8% pediatric cancer, 3.9% prenatal substance exposure, and 14.7% other) who completed an evaluation in 2019. Over half the youth were flagged for unmet neurodevelopmental and mental health concerns and analyses revealed low interrater agreement for mental health concerns (κ = .324), better agreement for neurodevelopmental concerns (κ = .511), and low sensitivity of referring providers (Se = .326) and parents (Se = .366). One-way analyses of variance uncovered important factors (e.g., symptom severity, adaptive skills) that may account for missed concerns. Findings guide recommendations to strengthen methods for understanding mental health and/or neurodevelopmental concerns in children with neurologic disorders.