Teleneuropsychology in Latin America: Experiences and challenges during the COVID-19 pandemic

The COVID-19 pandemic accelerated the use of teleneuropsychology (TeleNP) to deliver remote neuropsychological services in settings with limited clinic access.

Objective:  To examine TeleNP practices in Latin America (LA), focusing on clinicians’ perceptions of utility, validity, and barriers.

Methods:  A descriptive, exploratory cross-sectional survey was conducted between November 2020 and January 2021 among health professionals practicing neuropsychology in LA. The instrument, validated through a Delphi process, assessed professional background, TeleNP use, patient profiles, applied tests, and perceived advantages and challenges.

Results:  A total of 212 clinicians from 10 countries participated (mean age and clinical experience=42.7 years and 12.3 years, respectively). Participants were primarily psychologists (75.9%), but also neurologists, geriatricians, psychiatrists and speech-language pathologists. TeleNP adoption rose from 4.2% regular and 13.7% occasional pre-pandemic use to 58% at the time of the survey, with significant cross-country variation (χ²=79.0, df=30, p<0.001). TeleNP was used mainly for patient (90%) and informant (89.5%) interviews, screening (71.8%), and, in half of the cases, more extensive assessments. The advantages reported were improved access (81.5%), reduced transportation costs (79.8%), patient comfort (66.1%), and easier scheduling (66.1%). The main barrier identified was limited patient connectivity (84.7%). Regulatory knowledge was heterogeneous: 36.7% reported TeleNP authorization in their country, 23.5% reported no authorization, and 39.8% were unsure.

Conclusion:  TeleNP adoption in LA increased during the pandemic and is perceived as a valid, accessible modality to address geographic disparities in neuropsychological care. However, heterogeneous implementation, regulatory uncertainty, and technological limitations remain major challenges, underscoring the need for standardized guidelines.

Keywords:
Neuropsychology; COVID-19; Neuropsychological Tests; Latin America; Health Services Accessibility; Dementia