Clinical and training practices: A survey of pediatric neuropsychologists serving inpatient rehabilitation.

ABSTRACT

Neuropsychologists in inpatient pediatric rehabilitation settings collaborate with an interdisciplinary team to educate, evaluate, and provide intervention to patients with acquired brain injury and their families, but there are no known studies that describe or define these clinical services. Thirty-one neuropsychologists in pediatric inpatient rehabilitation settings completed an online survey. Neuropsychologists (68.2% female; 86.4% with PhD versus PsyD) from the U.S. and Canada, who represented 22 pediatric inpatient rehabilitation sites comprised the final sample. Most sites (63.6%) were embedded within medical centers, with providers dedicating 2 to 32 hours (M = 14.25, SD = 9.26) weekly to onsite inpatient rehabilitation efforts. Providers most often saw patients with traumatic brain injury and other acquired brain injuries, including stroke and brain tumor. Trainees from various levels, most commonly post-doctoral fellows, provided clinical services on inpatient units, many with some degree of independence. Clinical practices that were standard across all or most sites included targeted discharge evaluations, serial cognitive monitoring, neuropsychology consultation to rehabilitation and non-rehabilitation units, and follow-up clinics. Provision of services was influenced by multiple factors including patient diagnosis, timing of return to school, inpatient census, and payor's effect on length of stay. Findings highlight many programmatic consistencies across sites and serve as an important initial step to guiding pediatric neuropsychology providers seeking to understand the current landscape of clinical care. Future efforts are needed to establish a true clinical guideline for practice. Although preliminary, data also support establishment of neuropsychology training programs, justify administrative resources, and serve to educate recipients of neuropsychology services.