Neuropsychologists

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What's the recognized neuropsychology board/agency to go to, to look up the people who have done an actual fellowship and picked up the certification?

My new location I'm in is surrounded with every psychologist, without neuropsych fellowship training, doing testing and training random people to be their psychometrists.

Gotta love seeing reports on a patient who is floridly depressed, with anxiety, and untreated OSA; getting a report that just says ADD 'in my professional opinion' and no background reference to current symptoms of depression and anxiety.

I miss seeing reports from real Neuropsychologists. I need to find the closest real ones.

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I get a lot of these folks who go to psychologists in the area specifically to get "tested for ADHD" and then present to me asking for stimulants. I find they actually have ADHD in my opinion maybe half the time. Is that what is going on?
 
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Rural community, wait time for Psychiatry access, so because PCPs were at a loss of what to do, they errantly leaned into the psychologists for some sort of guidance. This "ADHD testing" market emerged. My theory at least. But now that I'm in the tiny local pond and releasing the pressure on built up psychiatry needs, I need to know what the legit Neuropsych credentials are, so I can google search who gets my referrals. Definitely isn't the local psychologists. Got one group so bold as to do confirmation testing, post pharmacotherapy interventions. Naturally they are charging a premium.
 
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You can search for neuropsychologists who are certified in clinical neuropsychology. There actually aren't that many. As anyone can call themselves a neuropsychologist, most don't have board certification in it. Most of those that do (at least in my area) seem to work in academics or for the VA.
 
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You can search for neuropsychologists who are certified in clinical neuropsychology. There actually aren't that many. As anyone can call themselves a neuropsychologist, most don't have board certification in it. Most of those that do (at least in my area) seem to work in academics or for the VA.

Depends on how you define "not many." There are 58 boarded folks in my state, not a big state, and looking at the list, more than half work in general hospital systems or private practice. You can also check the AACN directory, folks probably keep that updated more often. Also, it has a map feature, so you can visualize more easily than the ABPP directory site.

 
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Also, I'd stick with ABPP, there are a lot of fake boards out there, that sell "board certification" without any credential review or testing. So, even though someone may say that they are board certified, depends on the certifying body. Though, most of the fake boarded people try to get it for legal work.
 
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Are you also looking to refer patients for ADHD purposes or rather trying to figure out who the legit neuropsychologists are for when you have complex R/O cognitive decline (dementia) cases?

If looking to find boarded neuropsychologists who take ADHD referrals, that will be a harder task. I can't name one in my metro who does those evals. We all kick those out other practices.
 
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The number one reason I send a patient to a neuropsychologist is to test for learning disorders after I've been working with a patient (usually child) on their ADHD and it hasn't been successful and I'm suspecting a reading comprehension, intellectual disability, or another cognitive concern.

If they are in school and academically falling behind and I'm not worried as much about a learning disorder, I will have the school do a psychoeducational evaluation to help them identify worthwhile accommodations.

I don't work much with older individuals to evaluate for dementia so I often don't get neuropsych testing for that.

When would other people send patients to a neuropsychologist?
 
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The number one reason I send a patient to a neuropsychologist is to test for learning disorders after I've been working with a patient (usually child) on their ADHD and it hasn't been successful and I'm suspecting a reading comprehension, intellectual disability, or another cognitive concern.

My understanding is that these types of referrals are more in the bucket of general psychological assessment rather than neuropsychological assessment (e.g., schools psychologists can do these).
 
My understanding is that these types of referrals are more in the bucket of general psychological assessment rather than neuropsychological assessment (e.g., schools psychologists can do these).

Depending on the school district and district resources some are veryyy reluctant or just will take forever to do these. Some of the school psychological assessments are also very variable. Benefit of the school though is that it's free. If I have a neuropsych practice that's sent me solid reports in the past and I know they do thorough testing, better to have the family try to go there.

Schools will also very much avoid diagnosing things like ASD, so sometimes better to get it all done in one go if I'm also on the fence about that and want another set of eyes to evaluate and do a formal ADOS.
 
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Depending on the school district and district resources some are veryyy reluctant or just will take forever to do these. Some of the school psychological assessments are also very variable. Benefit of the school though is that it's free. If I have a neuropsych practice that's sent me solid reports in the past and I know they do thorough testing, better to have the family try to go there.

Largely agree, but there's a difference between a school psychologist that works in the schools and a person with a Ph.D. in school psychologist in private practice. Both are trained to offer these types of assessments, IME.

Edit: Assessments you get from the former are more restricted and/or difficult to access. No argument there.
 
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I will say that psychologists do a crap job advertising what they do to both the public as well as other mental health professionals to the point that virtually none of the PCPs know the difference between psychiatry, psychology and neuropsychology and many of us in psychiatry are still confused when to refer to psychology vs neuropsychology vs child psychology (is child neuro psych a separate thing?)
 
I've been more disappointed by school psychological/psychoeducational assessments than by private neuropsychologists although some of the latter have reports that leave much to be desired.

School psychologists are more focused on academic skills such as reading, math, spelling which are tasks at school. Neuropsychologists evaluate for cognitive skills that are used in and out of school and are more relevant for me in my clinical practice.
 
I will say that psychologists do a crap job advertising what they do to both the public as well as other mental health professionals to the point that virtually none of the PCPs know the difference between psychiatry, psychology and neuropsychology and many of us in psychiatry are still confused when to refer to psychology vs neuropsychology vs child psychology (is child neuro psych a separate thing?)
pediatric clinical neuropsychology is a separate board certification
 
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I will say that psychologists do a crap job advertising what they do to both the public as well as other mental health professionals to the point that virtually none of the PCPs know the difference between psychiatry, psychology and neuropsychology and many of us in psychiatry are still confused when to refer to psychology vs neuropsychology vs child psychology (is child neuro psych a separate thing?)

Part of the problem may be that many of us do not need to advertise. It's extremely easy to have a 9 month wait list after calling a few referral sources if you take insurance.
 
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I've been more disappointed by school psychological/psychoeducational assessments than by private neuropsychologists although some of the latter have reports that leave much to be desired.

I mean it kinda depends, right? I've read some terrible neuropsych reports by board-certified people who were grandfathered in. Contrast that person with someone who did a fellowship in neurodevelopmental disorders or has multiple first authored publications in their area, for instance. Maybe a heuristic to adopt could be if they do cognitive testing for uncomplicated cases of ADHD. I wouldn't refer to that person regardless of their credentials.
 
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I mean it kinda depends, right? I've read some terrible neuropsych reports by board-certified people who were grandfathered in. Contrast that person with someone who did a fellowship in neurodevelopmental disorders or has multiple first authored publications in their area, for instance. Maybe a heuristic to adopt could be if they do cognitive testing for uncomplicated cases of ADHD. I wouldn't refer to that person regardless of their credentials.

Like the guy in my area who diagnosed someone they referred to me with schizoaffective disorder, as far as I can tell based entirely on a high-ish score on the Eysenck psychoticism scale. I re-read the report three times, I figured I had to be missing something. Nothing else that spoke to the criteria for SA. The person in question, upon my evaluation, had the most bog standard outpatient MDD you can imagine. I'm sure the discrepancy had nothing to do with the patient being black. Nope nope.
 
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Like the guy in my area who diagnosed someone they referred to me with schizoaffective disorder, as far as I can tell based entirely on a high-ish score on the Eysenck psychoticism scale. I re-read the report three times, I figured I had to be missing something. Nothing else that spoke to the criteria for SA. The person in question, upon my evaluation, had the most bog standard outpatient MDD you can imagine. I'm sure the discrepancy had nothing to do with the patient being black. Nope nope.

A schizoaffective dx off the EPQ? Impressive. A fabricated diagnosis from an instrument likely created with fabricated data.
 
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I did wonder whether this was bad enough to rise to the level of malpractice for y'all. The total lack of any other basis for the dx in the report was shocking.

It's tough when it comes to the weird old school type of assessors. I've seen someone use a Rorschach in an ADHD eval. I don't think many boards would take action after investigation here. Most of our board actions are inappropriate relationships or failure to adhere to minimal documentation standards.
 
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I did wonder whether this was bad enough to rise to the level of malpractice for y'all. The total lack of any other basis for the dx in the report was shocking.
I've seen a lot of psychological reports with bogus psychotic diagnoses. Most psychologists have very little experience with psychosis unless they got training in inpatient settings or an early psychosis program etc I'm not sure if that has anything to do with. But I've read what look like very sensible reports and testing right until you get to the assessment part and these obviously personality disordered individuals are dx with schizophrenia and schizoaffective disorder based on their Rorschach etc without any reference to diagnostic criteria etc. Truly bizarre.
 
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I've seen a lot of psychological reports with bogus psychotic diagnoses. Most psychologists have very little experience with psychosis unless they got training in inpatient settings or an early psychosis program etc I'm not sure if that has anything to do with. But I've read what look like very sensible reports and testing right until you get to the assessment part and these obviously personality disordered individuals are dx with schizophrenia and schizoaffective disorder based on their Rorschach etc without any reference to diagnostic criteria etc. Truly bizarre.

I guess if you haven't had a chance to become attuned to das Praecox-Gefuehl it is much easier to go astray.
 
When would other people send patients to a neuropsychologist?
Assuming we're talking about ADHD still, I think this is going to be most helpful for forensic-esque evaluations. For example, if someone needs accommodations for the Bar exam, USMLE, boards, LSAT, MCAT etc then the request will be more compelling if their is documented impairment on tests of attention, executive function, processing speed etc. Similarly, for some sorts of jobs testing may be helpful to support that they can do it. For pilots, they will need it (the FAA has their own guidelines on what they want). Usually none of this is covered by insurance.

The kinds of cases where it would be deemed medically necessary is attentional issues in someone with a history of TBI, epilepsy, following neurosurgery, MS etc.
 
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I've at least had success writing letters of support for accommodations for LSAT and an architecture licensing exams. No one has asked about other exams. Neuropsych testing seem like an overkill for those issues.. they mostly look if the individuals have historically had accommodations throughout their education
 
I've at least had success writing letters of support for accommodations for LSAT and an architecture licensing exams. No one has asked about other exams. Neuropsych testing seem like an overkill for those issues.. they mostly look if the individuals have historically had accommodations throughout their education

Yeah weirdly enough I just also had success writing a letter for ACTs for ADHD. I warned the family my letter might not be enough and they might have to go do neuropsych eval but guess it was. My impression was that they’ve historically been very strict with standardized tests but maybe that’s not as much of the case anymore.
 
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Yeah weirdly enough I just also had success writing a letter for ACTs for ADHD. I warned the family my letter might not be enough and they might have to go do neuropsych eval but guess it was. My impression was that they’ve historically been very strict with standardized tests but maybe that’s not as much of the case anymore.

Depends. If they have had documented history of accommodations and/or an IEP, there is a streamlined process. Some situations still require proof via some type of evaluation. Some testing also has expiration terms (e.g, more than 3 or 5 years old).
 
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Yeah weirdly enough I just also had success writing a letter for ACTs for ADHD. I warned the family my letter might not be enough and they might have to go do neuropsych eval but guess it was. My impression was that they’ve historically been very strict with standardized tests but maybe that’s not as much of the case anymore.

There's been a bit of a sea-change on the validity of tests of attention to diagnose ADHD that's filtering down to policy. I can think of at least one major insurer of the top of my head that no longer pays for neuropsychological testing for uncomplicated ADHD, but @splik is also right that some other agencies are slow to catch on.
 
There's been a bit of a sea-change on the validity of tests of attention to diagnose ADHD that's filtering down to policy. I can think of at least one major insurer of the top of my head that no longer pays for neuropsychological testing for uncomplicated ADHD, but @splik is also right that some other agencies are slow to catch on.

There are many major insurers here who won't, unless there are well documented neurological ruleouts also in play.
 
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I've seen a lot of psychological reports with bogus psychotic diagnoses. Most psychologists have very little experience with psychosis unless they got training in inpatient settings or an early psychosis program etc I'm not sure if that has anything to do with. But I've read what look like very sensible reports and testing right until you get to the assessment part and these obviously personality disordered individuals are dx with schizophrenia and schizoaffective disorder based on their Rorschach etc without any reference to diagnostic criteria etc. Truly bizarre.

Pretty much this, yes. Some psychologists want to try to pull a House and diagnose the zebra (to themselves, anyway) that everyone else seems to have "missed." Plus, it's easier to be led astray by symptom checklists if you've never or hardly ever seen the condition in-person.

To the OP, someone already posted the link to ABPP, which has the largest number of board-certified neuropsychologists and also offers certification in numerous other areas (e.g., clinical, forensic, health). Due (IMO) largely to politics and professional in-fighting, there's also ABN (American Board of Professional Neuropsychology), which is smaller. At least in my experience, most of the newly-trained folks over the last 5-10 years skew heavily toward ABPP.

If a person isn't boarded, you can check to see if they've completed a two-year fellowship, especially if they're early- or mid-career (it was a bit less standardized with some of the older-career folks). Sticking with fellowships at AMCs, the VA, or other hospital systems rather than private practice may be a heavy-handed but decent quality screen in that regard. And sometimes, unfortunately, trial-and-error is the only way. If you call them and ask if they offer ADHD testing and one of the first things out of their mouth isn't, "well yes, if it's necessary" or "it depends," you may want to move on.
 
Most psychologists have very little experience with psychosis unless they got training in inpatient settings or an early psychosis program etc I'm not sure if that has anything to do with.
Pretty much this, yes. Some psychologists want to try to pull a House and diagnose the zebra (to themselves, anyway) that everyone else seems to have "missed." Plus, it's easier to be led astray by symptom checklists if you've never or hardly ever seen the condition in-person.
This actually surprises me a bit. The two programs I've been associated with had psychologists who were very familiar with psychosis and generally did pretty well with these patients. I guess not all psychology PhD programs require inpatient rotations? Seems strange to me.

Side question, what are people's thoughts on neuropsych testing done via telehealth? I was pretty spoiled in residency by having some very solid psychologists readily available for neuropsych evals, but my current outpatient clinic is telehealth to some very rural areas. We do have 2 psychologists associated with the clinic who also do telehealth who I trust from a therapeutic standpoint and are both well-trained to do neuropsych testing. One of them will actually do neuropsych evals via telehealth as some of our patients are 4+ hours away from the nearest in-person testing and would have to likely wait a year to be tested. I can see parts of the evals done via telehealth, but not sure how other exams like a Trails A/B could be done. Any thoughts?
 
This actually surprises me a bit. The two programs I've been associated with had psychologists who were very familiar with psychosis and generally did pretty well with these patients. I guess not all psychology PhD programs require inpatient rotations? Seems strange to me.

Side question, what are people's thoughts on neuropsych testing done via telehealth? I was pretty spoiled in residency by having some very solid psychologists readily available for neuropsych evals, but my current outpatient clinic is telehealth to some very rural areas. We do have 2 psychologists associated with the clinic who also do telehealth who I trust from a therapeutic standpoint and are both well-trained to do neuropsych testing. One of them will actually do neuropsych evals via telehealth as some of our patients are 4+ hours away from the nearest in-person testing and would have to likely wait a year to be tested. I can see parts of the evals done via telehealth, but not sure how other exams like a Trails A/B could be done. Any thoughts?

It can be done, but is limited. I only did these for essentially confirmatory testing from a clinical perspective. We've put the cart ahead of the horse for some o fthe things that have been ported to electronic format. For example, some processing speed tasks have different norms when studied paper vs. electronic, yet we're still using paper norms for those. It's also a different environment, with a lot of factors that are beyond the clinicians control. During teh pandemic, the amount fo times there were major distractions during testing was very common. Something that is very rare in my office testing settings. I'm not a fan of it, but recognize that in-person is not feasible in some settings. So, it does allow for care for underserved populations, but like everything else, it is subpar care compared to what is available in more urban settings.
 
This actually surprises me a bit. The two programs I've been associated with had psychologists who were very familiar with psychosis and generally did pretty well with these patients. I guess not all psychology PhD programs require inpatient rotations? Seems strange to me.

On this point, there's quite a bit of variance: some people will do externships in inpatient psychiatric facilities or community mental health centers where they will get exposure, but it's pretty easy to skirt the experience if you don't want it, IME.
 
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On this point, there's quite a bit of variance: some people will do externships in inpatient psychiatric facilities or community mental health centers where they will get exposure, but it's pretty easy to skirt the experience if you don't want it, IME.

Yes, I would say that most of us had inpatient/SPMI experience, especially by the end of internship, but it was possible for someone to forgo that if they so chose. Personally, I do not have a lot of experience with psychosis. Most of my inpatient experience was on intensive PTSD tx, SUD tx, TBI rehab, at least for a treatment perspective. More variable when it comes to inpatient evaluation.
 
This actually surprises me a bit. The two programs I've been associated with had psychologists who were very familiar with psychosis and generally did pretty well with these patients. I guess not all psychology PhD programs require inpatient rotations? Seems strange to me.

Side question, what are people's thoughts on neuropsych testing done via telehealth? I was pretty spoiled in residency by having some very solid psychologists readily available for neuropsych evals, but my current outpatient clinic is telehealth to some very rural areas. We do have 2 psychologists associated with the clinic who also do telehealth who I trust from a therapeutic standpoint and are both well-trained to do neuropsych testing. One of them will actually do neuropsych evals via telehealth as some of our patients are 4+ hours away from the nearest in-person testing and would have to likely wait a year to be tested. I can see parts of the evals done via telehealth, but not sure how other exams like a Trails A/B could be done. Any thoughts?
Yeah, to the best of my knowledge, AP(sychology)A doesn't require accredited programs to provide inpatient rotations, although I'd have to double-check that to be sure. I had it available in my program and took advantage (and there was a professor who worked exclusively in SMI), but not everyone else did.

As WisNeuro said RE: remote neuropsych, it can be done and there's research to support that it's viable and valid, but it's limited in some ways. I would say it certainly beats the service not being available to the patient, unless it's being provided by a poorly-trained clinician. In the example you've provided, it can also serve as a good midway point between a brief cognitive screen (e.g., the MMSE, MoCA) and a full in-person neuropsych, such as to let you know if more in-depth testing is even needed, to kick-off some treatment recommendations, etc.
 
Yeah, to the best of my knowledge, AP(sychology)A doesn't require accredited programs to provide inpatient rotations, although I'd have to double-check that to be sure. I had it available in my program and took advantage (and there was a professor who worked exclusively in SMI), but not everyone else did.
I'm pretty sure it's not a requirement. People were avoiding the CMHC and inpatient hospital practica like in plague in my fully accredited home program and the standards haven't changed since then. Most of my experience with this population comes from working on a PACT team back when I was a master's level clinician. There was some mechanisms for supervision in psychosis CBT in those centers, but I wouldn't call it stellar by psychologist training standards. In all fairness though, it's a little tough to do in-vivo supervision with people who already believe they're being watched.
 
Yes, I would say that most of us had inpatient/SPMI experience, especially by the end of internship, but it was possible for someone to forgo that if they so chose. Personally, I do not have a lot of experience with psychosis. Most of my inpatient experience was on intensive PTSD tx, SUD tx, TBI rehab, at least for a treatment perspective. More variable when it comes to inpatient evaluation.
Yeah, to the best of my knowledge, AP(sychology)A doesn't require accredited programs to provide inpatient rotations, although I'd have to double-check that to be sure.
That just seems so foreign to me given ACGME requirements and the frequency of psychotic symptoms and talking with my dad (retired psychologist who was an inpatient psych tech for years before grad school). But guess not that surprising given the treatments and patient targets for a lot of therapies.

It can be done, but is limited. I only did these for essentially confirmatory testing from a clinical perspective. We've put the cart ahead of the horse for some o fthe things that have been ported to electronic format. For example, some processing speed tasks have different norms when studied paper vs. electronic, yet we're still using paper norms for those. It's also a different environment, with a lot of factors that are beyond the clinicians control. During teh pandemic, the amount fo times there were major distractions during testing was very common. Something that is very rare in my office testing settings. I'm not a fan of it, but recognize that in-person is not feasible in some settings. So, it does allow for care for underserved populations, but like everything else, it is subpar care compared to what is available in more urban settings.
As WisNeuro said RE: remote neuropsych, it can be done and there's research to support that it's viable and valid, but it's limited in some ways. I would say it certainly beats the service not being available to the patient, unless it's being provided by a poorly-trained clinician. In the example you've provided, it can also serve as a good midway point between a brief cognitive screen (e.g., the MMSE, MoCA) and a full in-person neuropsych, such as to let you know if more in-depth testing is even needed, to kick-off some treatment recommendations, etc.
Any links to research would be appreciated. It's just a weird case which I may make a thread for later, but the TL;DR was acute onset of severe paranoia and psychotic symptoms in an 80+ yo woman 6 mos ago which has been persistent and worsening. No chronic psychosis or primary psychotic disorders, before that was extremely high functioning, did some basic neuro testing which was actually pretty suggestive of mild or no neurocognitive deficits associated with dementia and seemed much more consistent with persistent delirium without obvious reason. Turned down the consult twice and instructed to obtain neuro consult before basically being forced to accept it d/t nearest neurologist being 2.5 hours away with no openings for 4 months.
 
Any links to research would be appreciated. It's just a weird case which I may make a thread for later, but the TL;DR was acute onset of severe paranoia and psychotic symptoms in an 80+ yo woman 6 mos ago which has been persistent and worsening. No chronic psychosis or primary psychotic disorders, before that was extremely high functioning, did some basic neuro testing which was actually pretty suggestive of mild or no neurocognitive deficits associated with dementia and seemed much more consistent with persistent delirium without obvious reason. Turned down the consult twice and instructed to obtain neuro consult before basically being forced to accept it d/t nearest neurologist being 2.5 hours away with no openings for 4 months.
Cullum has been doing some research on this for a number of years even pre-dating COVID, such as:

Munro Cullum, C., Hynan, L., Grosch, M., Parikh, M., & Weiner, M. (2014). Teleneuropsychology: Evidence for Video Teleconference-Based Neuropsychological Assessment. Journal of the International Neuropsychological Society, 20(10), 1028-1033. doi:10.1017/S1355617714000873

Using a similar battery:

Hannah E. Wadsworth, Jeanine M. Galusha-Glasscock, Kyle B. Womack, Mary Quiceno, Myron F. Weiner, Linda S. Hynan, Jay Shore, C. Munro Cullum, Remote Neuropsychological Assessment in Rural American Indians with and without Cognitive Impairment, Archives of Clinical Neuropsychology, Volume 31, Issue 5, August 2016, Pages 420–425, Remote Neuropsychological Assessment in Rural American Indians with and without Cognitive Impairment

A more recent but still pre-COVID review/meta:

Brearly, T.W., Shura, R.D., Martindale, S.L. et al. Neuropsychological Test Administration by Videoconference: A Systematic Review and Meta-Analysis. Neuropsychol Rev 27, 174–186 (2017). https://doi.org/10.1007/s11065-017-9349-1

Before even that, there's:

Svenn E., J., Terje, S., Stein, A., & Jan-Magne, K. (2003). Neuropsychological assessment and telemedicine: A preliminary study examining the reliability of neuropsychology services performed via telecommunication. Journal of the International Neuropsychological Society, 9(3), 472-478. doi:10.1017/S1355617703930128

More recently and mostly internationally:

Bloch, A., Maril, S. & Kavé, G. How, when, and for whom: decisions regarding remote neuropsychological assessment during the 2020 COVID-19 pandemic. Isr J Health Policy Res 10, 31 (2021). How, when, and for whom: decisions regarding remote neuropsychological assessment during the 2020 COVID-19 pandemic - Israel Journal of Health Policy Research

Ruth Sumpter, Emma Camsey, Steven Meldrum, Max Alford, Iain Campbell, Catherine Bois, Susan O’Connell & John Flood (2023) Remote neuropsychological assessment: Acceptability and feasibility of direct-to-home teleneuropsychology methodology during the COVID-19 pandemic, The Clinical Neuropsychologist, 37:2, 432-447, DOI: 10.1080/13854046.2022.2056922
 
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