Abstract

Objective: The primary aim of this project was to apply systematic review methods to synthesize the literature on outcomes of pediatric neuropsychological services. The secondary aim was to use the results of the systematic review to identify gaps in the extant literature and describe priorities for future research. Method: We identified the relevant studies using a rigorous search strategy, collected data on methodological variables, assessed the risk of bias in the studies, summarized findings by topic and subtopic areas, identified strengths and weaknesses of the literature, and provided recommendations for future research. The outcomes measured were satisfaction, changes in resource or strategy utilization, and changes in symptoms or functioning (i.e. changes in child emotional, behavioral, cognitive, or academic problems, parent stress, or family functioning). Results: The final sources of data were 26 records, pertaining to a total of 974 children who received neuropsychological services. Parents were generally satisfied with services and reported high clinician empathy and increased level of knowledge, based on the evaluation. However, they reported less often that the neuropsychologist provided actual help. Informal home and school-based strategies were implemented more often than other types of recommendations. The research on changes in child symptoms and functioning was limited, but suggests improvements. Conclusions: This is the first systematic review of outcomes of pediatric neuropsychological services. Larger studies involving data collection at multiple time points are needed in order to further clarify mechanisms leading to outcomes and potential targets for improving them.

摘要

目的：该项目的主要目的是应用系统评价方法来综合有关儿科神经心理学服务结果的文献。次要目的是利用系统评价的结果来确定现有文献中的差距并描述未来研究的优先事项。方法：我们使用严格的搜索策略确定了相关研究，收集了有关方法学变量的数据，评估了研究中的偏倚风险，按主题和副主题领域总结了研究结果，确定了文献的优势和劣势，并为未来的研究提供了建议。测量的结果是满意度、资源或策略利用的变化以及症状或功能的变化（即儿童情绪、行为、认知或学业问题、父母压力或家庭功能的变化）。结果：数据的最终来源是 26 条记录，涉及总共 974 名接受神经心理学服务的儿童。根据评估，家长普遍对服务感到满意，并报告说临床医生同理心高，知识水平提高。然而，他们很少报告神经心理学家提供了实际帮助。与其他类型的建议相比，非正式的家庭和学校策略得到了更多的实施。关于儿童症状和功能变化的研究有限，但表明有所改善。结论：这是对儿科神经心理学服务结果的第一次系统评价。需要在多个时间点进行涉及数据收集的更大规模研究，以进一步阐明导致结果的机制和改进它们的潜在目标。