Course Title: Symposium 3 - Advancements in Tele-Neuropsychology Practice and Training During COVID-19 (Stelmokas)


Credit Hours: 0


Instructor(s) Julija Stelmokas; David Marra; Dawn Bowers; Amber Rochette; Franchesca Arias; Cristina A. F. Román; Diomaris E Safi; Ana Linda Díaz Santos; Munro Cullum; Lana Harder


Chair: Julija Stelmokas, PsyD
Clinical Assistant Professor
University of Michigan Department of Psychiatry
Clinical Neuropsychologist
VA Ann Arbor Healthcare System

Invited Symposium 3:


Advancements in Tele-Neuropsychology Practice and Training During COVID-19

Abstract:

This symposium will describe advances, barriers, and opportunities for tele-neuropsychology (teleNP) practice and training in the United States. Since the start of the COVID-19 pandemic, neuropsychologists have rapidly adopted and expanded teleNP service delivery. Despite significant teleNP research advancements prior to COVID-19, including in-home teleNP services, there remained significant barriers to adoption of teleNP practice clinically. The five person dyads will present on changes and progress in teleNP clinical practice and training throughout the course of the COVID-19 pandemic, based on findings from their own and others’ research. Dr. Munro Cullum and Dr. Lana Harder will initially present background and evidence-based history of teleNP and findings from in-home pediatric teleNP prior to COVID-19. Dr. Dawn Bowers will then describe with Dr. David Mara changes in teleNP practice in the initial stage of the COVID-19 pandemic, including results from a recent national survey of neuropsychology providers. Although several professional resources have been disseminated to support practitioners, the specific factors that influenced decision-making and satisfaction with tele-NP service delivery remained unknown. Drs. Stelmokas and Rochette will discuss results from a recent national survey describing practice adjustments several months into the pandemic and examining factors that influenced service delivery changes; they will additionally present specific recommendations and development needs to improve the continued development of teleNP within the United States. Finally, two additional dyads will focus on parallel changes to practice and training with a specific focus on linguistically diverse populations. Drs. Arias and Roman will present background and preliminary data on practice trends among cross-cultural clinicians and Drs. Safi and Diaz Santos will describe preliminary data on trainees’ attitudes regarding teleNP and COVID-19 repercussions and implications for training.


Chair's Biography:

Dr. Julija Stelmokas is a board-certified Clinical Neuropsychologist at the VA Ann Arbor Healthcare System providing inpatient and outpatient services. She is a Clinical Assistant Professor with the University of Michigan Department of Psychiatry, VISN 10 Geriatric Mental Health Champion, and a Research Scientist at the VA Ann Arbor Geriatric Research, Education and Clinical Center (GRECC). She earned her Psy.D. from Pacific University (neuropsychology track), and then completed internship and post-doctoral training in clinical neuropsychology at the VA Ann Arbor/University of Michigan Consortium, and an Advanced Geriatrics Fellowship through the VA Ann Arbor GRECC.
Her professional interests focus on program development, and specifically, the integration of neuropsychology within team-based settings and tele-neuropsychology. Clinical interests include geriatric neuropsychology and rehabilitation as well as the use of motivational interviewing in neuropsychological feedback. Areas of research include tele-neuropsychology, cognitive screening, rehabilitation engagement and outcomes, and various geriatric syndromes, e.g., falls, delirium, polypharmacy, dementia.


David Marra, PhD
Dr. David Marra is a Neuropsychology Post-Doctoral Fellow at the University of Florida. He obtained his undergraduate degree from UF (psychology, minor in statistics), completed his doctoral work at Marquette University, and a clinical neuropsychology internship at the University of Florida. Broadly, Dr. Marra’s research aims to improve health outcomes using “big data” and advanced analytical techniques, such as machine learning, meta-regression, and non-linear modelling. In light of the COVID-19 pandemic, he has also conducted research to document and facilitate changes in neuropsychological practice, focusing on the utilization of telehealth services to ensure continued clinical care, while maintaining the health and safety of vulnerable older adult populations. Recently, Dr. Marra received pilot CTSI funding to work with a multi-disciplinary team of neurologists, neuropsychologists, and bioinformatic specialists to investigate the acute neurologic effects of COVID-19 in a large, electronic medical record dataset. He is also working to develop normative data for teleneuropsychological assessments in an ethno-racially representative cohort. Once validated, he intends to use this research infrastructure to recruit and assess cognitive functioning in patients with a history of COVID-19 infection to document the latent neurocognitive effects of the virus.
Dawn Bowers, PhD
Dr. Dawn Bowers is a professor and board certified clinical neuropsychologist in the Department of Clinical & Health Psychology at the University of Florida. She directs the Cognitive Neuroscience Lab at the Fixel Institute of Neurological Diseases and serves as the fellowship director for the UF Neuropsychology post-doctoral program. She directs two interdisciplinary clinics, including a post-doc run clinic, where neuropsychology is embedded with other providers (neurology, psychiatry, neurosurgery) in order to provide ‘one stop shopping’ for patients. She supervises graduate students, interns, and post-doctoral fellows. As lead neuropsychologist for the Fixel Institute, she oversees the neurocognitive module of the INFORM database, containing neuropsychological data on over 2500 individuals with movement disorders, mild cognitive impairment, and individuals with various dementias. Dr. Bowers has been a funded researcher for over 35 years, with multiple R01’s and currently directs three randomized clinical trials focused on novel interventions for older adults at risk for Alzheimer’s disease and those with Parkinson disease. She is strongly devoted to mentoring, and serves as MPI of an NINDS funded T32 predoctoral training grant focused on interdisciplinary training in movement disorders across the disciplines of biomedical engineering, neuroscience, and cognitive neuroscience/neuropsychology.
Amber Rochette, PhD
Dr. Amber Rochette is a second-year Neuropsychology Postdoctoral Fellow in the VA Ann Arbor Healthcare System (VAAAHS) and University of Michigan Health System Postdoctoral Training Consortium. She received her doctoral degree from Kent State University and completed her pre-doctoral clinical internship at the VAAAHS. Dr. Rochette’s clinical and research interests focus on geriatric neuropsychology, therapeutic neuropsychological assessment and feedback, tele-neuropsychology, and using neuropsychological data to inform clinical outcomes.
Franchesca Arias, PhD
Dr. Franchesca Arias is a bilingual/bicultural Clinical Neuropsychologist and her research focuses on identifying factors that propel, or interfere with, healthy cognitive aging across all ethnoracial and socioeconomic groups. Dr. Arias is particularly interested in the intersection between preoperative individual and contextual –level factors and their influence on perioperative outcomes in older adults. Clinically, Dr. Arias provides neuropsychological services in English and Spanish at the Cognitive Neurology Unit at Beth Israel Deaconess Medical Center. Dr. Arias completed a NIA-funded T32 Postdoctoral Fellowship in Pain and Aging through the Department of Dentistry at the University of Florida (T32-AG049673, Fillingham, PI). During her postdoctoral fellowship, she completed specialty training in perioperative cognition. Her work has linked preoperative patient-specific characteristics to postoperative outcomes in minimally invasive procedures. She completed her predoctoral internship at the University of Florida and her doctorate in Clinical Psychology at Fordham University (neuropsychology track). Her dissertation investigated how executive functioning and characterological facets of inhibitory control associated with participation in risky behaviors in adults stabilized on opioid agonist therapy. She is currently funded by the Alzheimer's Association and her research examines social determinants of health in the context of delirium. Dr. Arias is active in national organizations, particularly those seeking to reduce health disparity.
Cristina A. F. Román, PhD
Dr. Cristina A. F. Román is a Postdoctoral Fellow of Neuropsychology at the Warren Alpert Medical School of Brown University. She completed her bachelor’s degree at the University of California, Los Angeles and her Ph.D. in Clinical Psychology (Focus: Neuropsychology) at The Pennsylvania State University under Dr. Peter A. Arnett. She completed her pre-doctoral internship at the Charleston Consortium (Medical University of South Carolina/Ralph Johnson VA). Dr. Román works with adults and older adults with a wide range of conditions, including medical/neurological diagnoses (e.g., epilepsy, concussion, brain tumor, stroke), traumatic brain injuries, neurodegenerative diseases (e.g. Alzheimer’s disease), and comorbid psychiatric conditions (e.g., anxiety, depression). Her research focuses on the structural neural correlates (i.e., lesions, atrophy, white matter changes) of cognition and mood in multiple sclerosis and aging populations, as well as the impact of racial disparities and psychosocial influences on cognition and mood, brain changes, and access to neuropsychology/neurological care (e.g., tele-neuropsychology). Dr. Román is an active member of the Spanish TeleNP Assessment & Research (STAR) Consortium, Hispanic Neuropsychological Society (including the Social Justice and Advocacy Committee), National Academy of Neuropsychology, Division 40 of the American Psychological Association, Brown Psychology’s Diversity Committee, Chokehold Scientific Review Group, and the Organization for Human Brain Mapping. She is also the co-founder of Bilingual Neuropsych Words of the Week on Twitter (@BilingualNP).
Diomaris E. Safi, PhD
Dr. Diomaris E. Safi is a licensed psychologist specializing in neuropsychology and forensic evaluations. She is fully bilingual in English and Spanish. Dr. Safi has extensive experience in administering neuropsychological tests, diagnosing and treating various psychological conditions, and providing case consultation. Previously, Dr. Safi was the training director of a consortium of postdoctoral programs for the largest HMO in the country. She has served on multiple doctoral dissertation committees and provided postdoctoral supervision in psychological, neuropsychological, and forensic assessment nationally and internationally. Currently, Dr. Safi serves as a clinical supervisor at the Hispanic Neuropsychiatric Center of Excellence in UCLA, where she teaches and supervises neuropsychology externs and postdoctoral fellows. Additionally, Dr. Safi is an APA-approved CEU provider teaching professionals how to conduct Competency to Stand Trial evaluations for non-English-speaking individuals. Dr. Safi has authored or coauthored multiple peer-reviewed journal articles, book chapters, and peer-reviewed professional presentations. She has worked with civil and criminal attorneys on state and federal cases in the US and Mexico (in English and Spanish), offering full batteries of neuropsychological assessments, and case conceptualizations, witness interviews, and expert forensic testimony. Her areas of expertise include death penalty litigation, competency to stand trial, intellectual disabilities, and trauma-related disorders.
Ana Linda Díaz Santos, PsyD
Dr. Ana Linda Díaz Santos is a second-year Spanish/Cross-Cultural Adult Neuropsychology fellow in the Department of Neurology at Baylor College of Medicine. She completed her B.S. in social sciences with a minor in psychology from Universidad del Turabo, Gurabo, Puerto Rico. She completed her M.S. in psychology with a concentration in applied health sciences from Nova Southeastern University, Fort Lauderdale, Florida and her Psy.D. in Clinical Psychology (Neuropsychology track) with honors from Albizu University in Miami, Florida. She completed her pre-doctoral internship at New York University, Langone Medical Center- Rusk Rehabilitation. Her dissertation was titled: “Two Novel Memory Measures and their Association with Cortical Thickness in Older Adults at Risk for Alzheimer’s Disease.” Her clinical interests include: neuropsychological assessment of Spanish-speaking individuals, neurodegenerative disorders in Hispanics/Latinos, specifically Alzheimer’s disease, epilepsy, and assessment of language/brain mapping in bilingual or primarily Spanish speaking patients undergoing brain surgery. Research interest include health disparities and health literacy in minorities and acculturation factors influencing neuropsychological performance in the Hispanic/Latino community.
Munro Cullum, PhD
Dr. Munro Cullum is a Clinical Neuropsychologist who specializes in the assessment of cognitive disorders. He is board-certified in Clinical Neuropsychology (ABPP/ABCN) and serves as the Vice Chair and Chief of the Division of Psychology in the Department of Psychiatry, where he holds the Pamela Blumenthal Distinguished Professorship in Clinical Psychology. He is the PI of the Concussion-Texas (ConTex) studies, serves as the Scientific Director of the Texas Alzheimer's Research and Care Consortium (TARCC) and is co-leader of Clinical Core Leader in the UTSW Alzheimer's Disease Center. He is a past-president of the Society for Clinical Neuropsychology and the National Academy of Neuropsychology and the incoming President of the Sports Neuropsychology Society. He is actively involved in research, teaching, and clinical practice in neuropsychology. His research includes investigations into short and long term effects of concussion and early detection and differential diagnosis of neurodegenerative conditions of aging. His clinical research lab is also involved in cognitive test development and in telemedicine applications of neuropsychology.
Lana Harder, PhD, ABPP
Dr. Lana Harder leads the Neuropsychology Service and Neuropsychology training program at Children’s Health in Dallas, Texas. She holds dual faculty appointments as Associate Professor of Psychiatry and Neurology at UT Southwestern. She is board certified in Clinical Neuropsychology and is a board-certified Subspecialist in Pediatric Neuropsychology. Nationally, Dr. Harder serves on the Board of Directors of the American Board of Clinical Neuropsychology (ABCN) and the Association of Postdoctoral Programs in Clinical Neuropsychology (APPCN) and serves on the Board of Directors and Medical and Scientific Council of the Seigel Rare Neuroimmune Association. She is a Fellow of the National Academy of Neuropsychology. Dr. Harder earned her doctorate from the University of Texas at Austin and completed her pre-doctoral internship at the Kennedy Krieger Institute and Johns Hopkins School of Medicine. She completed post-doctoral fellowship at Texas Children’s Hospital and Baylor College of Medicine. Dr. Harder has served as a Pediatric Neuropsychologist at Children’s Health since 2008. She was a founding member and is the current Co-Director of the Children’s Pediatric Demyelinating Diseases Clinic. Dr. Harder published the first paper on pediatric tele-neuropsychological assessment. In addition to this work, her research interests include brain imaging correlates of neuropsychological functioning in transverse myelitis and multiple sclerosis and longitudinal cognitive and psychosocial outcomes for pediatric multiple sclerosis, transverse myelitis, acute disseminated encephalomyelitis, and neuromyelitis optica.