Bulletin

2021

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6 | Bulletin vol. 34 no. 1 The rapid technological advances in computer platforms (e.g., virtual reality, smartphones, tablets, Internet) and neuroinformatics (e.g., human genome, proteome, connectome projects, neuroimaging) offer clinical neuropsychologists an opportunity to add additional tools to their assessment batteries (Parsons & Duffield, 2019). These technological advances offer numerous advantages (e.g., large scale collection of normative data; complex and dynamic stimulus presentation; automatic response logging, etc.). Moreover, enhanced timing precision can rapidly implement adaptive algorithms, which enables implementation of subtle task manipulations and trial-by-trial analysis methods found in cognitive neuroscience. These offer greater sensitivity and specificity to individual differences in neural system function, as well as a much more efficient testing approach (e.g., adaptive testing has shown to offer a 95% average reduction in items administered; Gibbons et al., 2008). What about error in computerized measures? Much of the concern expressed about computers has been related to potential errors that can be found in computerized tests relative to hardware and software interactions (Cernich et al., 2007; Bauer et al., 2012). While hardware and software advances have made many of these concerns less relevant, there are cases in which these concerns continue as advanced platforms (e.g., virtual reality, touch screen interfaces) become more prevalent. However, the error accompanying computerized assessment must be evaluated in comparison to errors (e.g., recording and scoring responses, stimulus presentation at precise intervals, timing responses) that exist with traditional paper-and-pencil assessments (Overton, Pihlsgård, & Elmståhl, 2016). Take for example, the variance in stopwatch presses both within a single assessment (variance in stopwatch presses at start and stop) and between the clinical neuropsychologists and psychometricians that use them (variance due to motor abilities and age). If a stopwatch is calibrated to 0.01 second resolution when operated manually with a reaction time that varies by up to 0.1 s, this means the stopwatch may be started 0.1 s after the event started and then stopped 0.1 s after it ends. The resulting record of 10.20 is thus inaccurate by 0.2 seconds (Parsons, McMahan, & Kane, 2017). The Internet offers an architecture for enhanced patient access and data integration The evolution of the Internet from Web 1.0 to Web 2.0 (and now 3.0) has resulted in a dramatic change in the representation and usage of human knowledge. Bilder (2011) has argued that clinical Thomas D. Parsons, Ph.D. Computational Neuropsychology and Simulation, University of North Texas Tyler C. Duffield, Ph.D. School of Medicine, Oregon Health & Science University Neuropsychological Assessment 3.0 Maintaining relevance in the digital age neuropsychologists need to adopt the Internet for Web-based assessment and acquisition approaches that will empower rapid data collection from broadly distributed populations by means of adaptive testing strategies. As a special case of computerized assessment, Web-based testing offers a number of advantages for improving "teleneuropsychological" assessment. First, the exponential increase in access to computers and the Internet allows for interactive web-based neuropsychological assessments across the lifespan (Feenstra et al., 2017). Internet-based assessment also makes possible the acquisition of hundreds of thousands of participants in diverse geographic locations within months. This is compared to the arduous and expensive paper- and-pencil test norming practices, or normative samples that are unacceptably small (and under-representative) in commonly used neuropsychological tests. Additionally, teleneuropsychology increases feasibility for unobtrusive serial monitoring and the longitudinal behavioral data offers potential for the development of repositories that can be stored with electronic medical records, genome sequences, each patient's history, etc. Thus, technological developments in the use of the Internet for collective knowledge building are apparent in Web 2.0 practices that involve specialized web tools. Web 2.0 represents a trend in open platform Internet use that incorporates user-driven online networks and knowledge bases. Despite these advancements to the practice of neuropsychology, some clinical neuropsychologists may be concerned that during Internet-delivered assessment the identity of the test-takers is uncertain; or that the participants may be performing tasks

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