Teleneuropsychology in the time of COVID-19: the experience of the Australian Epilepsy Project

Purpose Traditional neuropsychological testing carries elevated COVID-19 risk for both examinee and examiner Here we describe how the pilot study of the Australian Epilepsy Project (AEP) has transitioned to tele-neuropsychology (teleNP), enabling continued safe operations during the pandemic Methods The AEP includes adults (age 18-60) with a first unprovoked seizure, new diagnosis of epilepsy or drug resistant focal epilepsy Shortly after launching the study, COVID-related restrictions necessitated adaptation to teleNP, including delivery of verbal tasks via videoconference;visual stimulus delivery via document camera;use of web-hosted, computerised assessment;substitution of oral versions for written tests;online delivery of questionnaires;and discontinuation of telehealth incompatible tasks Results To date, we have completed 24 teleNP assessments: 18 remotely (participant in own home) and six on-site (participant using equipment at research facility) Five face-to-face assessments were conducted prior to the transition to teleNP Eight of 408 tests administered via teleNP (1 9%) have been invalidated, for a variety of reasons (technical, procedural, environmental) Data confirm typical patterns of epilepsy-related deficits (p <  05) affecting processing speed, executive function, language and memory Questionnaire responses indicate elevated rates of patients at high risk of mood (34%) and anxiety disorder (38%) Conclusion Research teleNP assessments reveal a typical pattern of impairments in epilepsy A range of issues must be considered when introducing teleNP, such as technical and administrative set up, test selection and delivery, and cohort suitability TeleNP enables large-scale neuropsychological research during periods of social distancing (and beyond), and offers an opportunity to expand the reach and breadth of neuropsychological services