Article : Maxime Jollivet et al., « Neuropsychologie et technologies numériques », Revue de neuropsychologie 2018/1 (Volume 10), p. 69-81. DOI 10.1684/nrp.2018.0447
I have always been interested in new technologies especially when it’s linked with psychology. I choose to talk about this scientific review because we can’t denied that technologies have made progress in all different domains in the last decade and I think it’s interesting to know how it can provide to us, as future professionals, new tools which can change our way of practicing.
This recent review (2018) is written by psychologists and doctorants from the University of Angers. Some of the authors of this paper (Maxime Jollivet, Phillipe Allain and Jérémy Besnard) are working on the assessment of social cognition with virtual reality in brain-damaged patients.
Introduction :
Kane and Parsons (2017) said « Clinical neuropsychology, as a field, was slow to adopt and use the potential offered by technology to make assessment process more efficient or to develop new approach which can improve cognition’s assessment. ».
However, this kind of statement raises some questions. Do we have to stop using traditional neuropsychology so quickly because we enter in a new era of technology ?
This article will draw a general overview on technological adaptation in neuropsychology (assessment and rehabilitation). The authors will present the advantages and limits of each way of practice in neuropsychology, to begin with the traditional pencil-paper assessment to computer-assisted tools and virtual reality.
Neuropsychology 1.0 :
This chapter is about classical neuropsychology’s assessment and revalidation tools who relies on pencil/paper tests, questionnary and external cognitive help such as memory book.
The authors underlined the huge work of the french group GRECO who allowed to create or adapt numerous tests among episodic memory and executive functions assessment. Indeed, these tools are still use today by a large number of professionals.
Although this neuropsychology 1.0 is widely spread in practices, some researchers have showed some reserves.
Indeed, for Parsons & Kane, they are two majors limitations : The first one refers to the quote above, that neuropsychology failed to follow the progress of numeric technology. Then, they are pointing at the lack of ecological validity inside the classical tools (both in the assessment and rehabilitation). However, the authors reminds us that this problem wasn’t new and neuropsychologists have developed new tools to overcome this lack by using paper/pencil tests such as TEA (Test of Everyday Attention) or questionnary (Questionnaire d’auto-évaluation de la mémoire).
Nonetheless, these kind of tests are used in a controlled context (office, laboratory) and can be difficult to transpose in daily life.
Neuropsychology 2.0 :
Since 1970, clinical neuropsychology assisted to an increase of numeric tools for assessment and revalidation with the emergence of computers and tablets.
In the first place, it was only computerized versions of traditional tests. Then, numeric editions of classical tests such as WCST, CVLT, WAIS were revised and available on computers or tablets.
In the early 2000, new tools of assessment appeared on internet such as CogniFit. This software offer a battery of cognitive assessment accessible for professionals but also non-professional (it is not for free).
Besides, these kind of software presents some flaws such as informatics bugs, less possibilities of recording answers or negative attitudes from the patient who are not used to be exposed with technology or computer.
Regarding cognitive rehabilitation, numeric tools and especially smartphones and applications (agenda, alarm…) have replaced memory book and paper list with good results.
Neuropsychology 3.0 :
Neuropsychology 3.0 refers to the use of virtual reality in the assessment and rehabilitation.
Thanks to virtual reality, we can create artificial immersive environment for the patients with safety. Indeed, patients can make mistakes without any real repercussions not like in real life (driving, cooking…).
Virtual reality (VR) answer to the lack of ecological validity by creating daily environments that we can controlled and use for neuropsychological assessment or rehabilitation.
Despite VR is a promising tool, the authors revealed that the costs of the equipment is still very expensive (3500 to 8000€) and could hinder its integration in clinical practice. Moreover, the long use of VR can create ‘cybersickness’ (headaches, dizziness and even nausea) for the patients, because of the level of immersion.
Critical evaluation :
This review brings a good overview on what technologies can provide to neuropsychologists profession, and what are the benefits and the limits of it. The authors made relevant illustrations or examples on different tools, both for assessment and rehabilitation that we might consider.
Furthermore, the authors adopts a neutral point of view and raises some questions to debate on : What technology can bring to patients, is it necessary for them, or even for the professional ? The use of technological support is it justified just only because we are in a numeric era ? The authors triggered a new debate in psychology community thanks to this clear and effective review.
Conclusion :
To my mind, I really appreciate reading this paper because I learn about new tools based on technology such as software or VR materials which I hope use one day in my future profession.
Yet, I think I will not abandon the traditional tools because they have (for some of them) good validity and are still relevant for assessment and rehabilitation.
In fact, I think the choice of the materials depends on multiples factors. For example, the age of your patients can have an influence : maybe it could be difficult to assess an elderly patient with VR or computerized versions of tests because they can be reluctant to new technology. Otherwise, patients from new generation and younger people might be more open to experiment VR and have facilities with technologies.
To conclude, I think it’s important to be aware of how we can use new technologies in our practice because they can remove some limits we can see in our traditional tests such as ecological validity. However, most important is how the professional feels about it, if this use seems relevant for the patient or not. We still and we do have a choice in what kind of clinical neuropsychology we want to practice.
Bibliography :
- Kane RL, Parsons TD. The role of technology in clinical neuropsychology. Oxford, UK: Oxford University Press, 2017.
- Jollivet M, Fortier J, Besnard J, Le Gall D, Allain P. Neuropsychologie et technologies numériques. Rev Neuropsychol 2018 ; 10 (1) : 69-81 doi:10.1684/nrp.2018.0447
Words I have learned :
To hinder : Gêner/entraver/empêcher
Widely spread : Largement propagé
Computerized versions : Version informatisée
Flaws : Défauts
Dizziness : Vertiges
To be reluctant : Être reticent
Barbara Daniel
M2 PPCECC