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Evolution of parental knowledge and efficacy across the pediatric neuropsychological evaluation process

Cynthia A Austin, Melissa Gerstle, Katherine T Baum, Anne Bradley, Brenna LeJeune, James Peugh, Dean W Beebe
Clinical Neuropsychologist 2019 March 1, : 1-17

OBJECTIVE: The handful of studies examining parent satisfaction after pediatric neuropsychological evaluations have focused on post-evaluation appraisals. By examining parent experiences across the course of their child's evaluation, this study aimed to provide important insights into how and when parents experience changes in knowledge, understanding of care options, and efficacy during evaluation process.

METHOD: Parents of youth receiving neuropsychological evaluation completed questionnaires at four time points (prior to evaluation [n = 363], day of testing [n = 300], prior to feedback [n = 250], and post-report [n = 99]). Parents rated aspects of their knowledge and efficacy regarding their child's functioning. Parents also rated their perception of the neuropsychologist, medical provider, and school along the same domains. The resulting longitudinal data were analyzed using structural equation modeling and ANCOVA. Although primary analyses focused on the entire sample, differences between first-time evaluations and re-evaluations were also examined.

RESULTS: Families receiving an initial evaluation showed lower ratings in knowledge, awareness of options, and efficacy at the beginning of the evaluation and a significant increase in ratings by the end of the evaluation. Families returning for re-evaluation showed higher initial ratings that changed comparatively little during the evaluation. Parents receiving initial evaluations also perceived increased knowledge of their child by medical providers and school.

CONCLUSION: The study supports the clinical assumption that parents gain knowledge about their child and treatment options during a neuropsychological evaluation. The difference between initial and re-evaluation warrants further study. Studying the process and experience of neuropsychological evaluation may provide more nuanced findings than post hoc satisfaction measures.

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