B-162: Quality Improvement: Involvement of Neuropsychology in a Multidisciplinary Pediatric Spinal Differences Clinic

Abstract

Objective: Children and adolescents with spina bifida (SB) are at risk for cognitive challenges. This study analyzed the utility of implementing neuropsychology (NP) consultation services within a multidisciplinary spinal differences clinic (SDC) to increase access to outpatient NP evaluations. Method/Data Selection: Rehabilitation providers from a children’s hospital submitted NP referrals for patients aged four to 17 years old. Participants have a medical diagnosis of SB and are followed by the SDC. The data presented reflects a 10-month period that was sorted into two categories: 1) March 2025-2026; zero NP consultations 2) September 2025-February 2026; 102 NP consultations. The following information was gathered for each category: total number of NP referrals, completed intake Neuropsychology History Questionnaires (NHQ), and scheduled NP evaluations. Results/Data Synthesis: Results showed a greater number of NP referrals placed following NP consultation in the SDC. By contrast, the number of completed NHQs (which is required to schedule an appointment) by the patients’ families and the number of scheduled NP evaluations did not significantly change with NP consultation. Conclusions: This study showed variable outcomes related to the inclusion of NP consultation within a multidisciplinary SDC. Increased NP referrals may reflect appropriate identification of patients who would benefit from outpatient NP services. There was no change to the number of NHQs completed or number of appointments scheduled. The number of scheduled NP evaluations may reflect various confounding variables (e.g., not receiving or filling out the NHQ). Further investigation of the barriers to accessing outpatient NP evaluations can assist with increased adherence to the SB Collaborative Care Network guidelines.