Many people with cognitive concerns often encounter evaluation obstacles. Increasing access to neuropsychological care is essential. Geographical disparities—nearly half of nonmetropolitan areas lack psychologists, and rural patients are much less likely to receive neuropsychological testing—and workforce shortages—roughly 4,000 practitioners serve the entire United States (American Academy of Clinical Neuropsychology, 2007)—exacerbate this access crisis (Wang et al., 2022). The solution lies in a dual-technological approach: utilizing teleneuropsychology (teleNP) to bridge physical distance and Artificial Intelligence (AI) to streamline the administrative burden that limits clinician capacity.
When used in accordance with American Board of Professional Psychology (ABPP) practice standards, these “alternate technologies” provide a path to increase access while maintaining diagnostic rigor. This article explores how ABPP-certified experts are uniquely positioned to lead this digital transformation, ensuring that innovation enhances equity and quality.
TeleNP as the Foundation of Access Expansion
TeleNP directly addresses geographic and mobility barriers by enabling remote neuropsychological assessment. A growing evidence base supports its clinical validity. A 2025 meta-analysis of 24 studies (N = 1,197) found no meaningful difference between teleNP and in-person testing (Cohen’s d = 0.01), with 77% of measures differing by less than one point (Alva et al., 2025). Similarly, Inter Organizational Practice Committee (IOPC) guidance reports strong concordance for verbal tasks, including digit span, verbal fluency, and verbal memory, with differences within one-tenth of a standard deviation (Bilder et al., 2020).
TeleNP has also demonstrated validity in clinical populations, including individuals with mild cognitive impairment and early Alzheimer’s disease. Within-subject studies report intraclass correlation coefficients ranging from 0.54 to 0.92 across multiple cognitive domains (Yildirim et al., 2025). Patient satisfaction is high, with over 87% reporting being “very satisfied” (Gnassounou et al., 2022).
However, teleNP is not a universal substitute for in-person assessment. Several critical limitations must be acknowledged:
- Test validity constraints: Not all neuropsychological measures have been validated for remote administration.
- Visuospatial and constructional tasks: Performance may be compromised by 2D presentation and camera limitations.
- Differential diagnosis challenges: Subtle behavioral cues may be more difficult to detect remotely.
- Technical moderators: Internet speed, latency, and device quality can significantly impact performance.
To mitigate these risks, structured teleNP protocols are essential, including standardized room scans, identity verification, environmental controls, and documentation of any deviations from standard administration (Bilder et al., 2020). A rigorous tele-neuropsychology protocol is needed to standardize room scans, patient authentication, and environmental controls to mitigate common challenges like internet instability and distractions (American Psychological Association, 2024; Fox-Fuller et al., 2022). Clinicians must document any administrative modifications and address potential limitations to diagnostic conclusions whenever technical or environmental factors compromise the assessment (Bilder et al., 2020).
TeleNP has significant potential to reduce disparities in access, particularly for rural, medically underserved, and mobility-limited populations. However, its effectiveness depends on addressing the digital divide.
Telehealth utilization remains lower among older adults, non-English speakers, lower-income populations, and uninsured individuals. Over one-quarter of U.S. households lack reliable broadband access (Tilhou et al., 2024). ABPP-certified specialists are essential advocates for inclusive teleNP models that minimize technological barriers, including audio-only options, device and internet access support, and culturally concordant language services (Curfman et al., 2022).
AI as an Efficiency Multiplier for Neuropsychological Care
AI offers its greatest value in neuropsychology when applied to administrative infrastructure rather than diagnostic decision-making. Analyses suggest AI could reduce healthcare spending by 5–10% annually through improved operations, documentation, and scheduling rather than direct patient care (Wachter & Brynjolfsson, 2024). Early successes include reducing documentation burden, automating scheduling, and streamlining prior authorization (Wachter & Brynjolfsson, 2024; Sahni & Carrus, 2023).
In neuropsychology, appropriate non-diagnostic AI applications include administrative triage and scheduling optimization, structured synthesis of clinical histories, report formatting and documentation support, and patient-facing education about assessment processes and recommendations (Sahni & Carrus, 2023; Bhuyan et al., 2025; Kronenberger et al., 2025; Calderone et al., 2025). In all cases, neuropsychologists retain full responsibility for interpretation, diagnosis, and recommendations.
The American Psychological Association emphasizes that AI use must align with ethical principles of beneficence, autonomy, justice, privacy, transparency, and scientific integrity (Putica et al., 2025). Key considerations include privacy and data security, algorithmic bias, professional competence, informed consent, accountability, and test security. AI systems must not compromise proprietary test materials or enable coaching, and ultimate clinical responsibility remains with the board-certified neuropsychologist.
APA’s 2025 Ethical Guidance for AI in Professional Practice underscores that AI should augment—not replace—clinical expertise by automating discrete tasks and allowing clinicians to focus on higher-level clinical and ethical responsibilities.
Cross-Specialty Collaboration and ABPP Leadership in Technology-Enabled Care
Neuropsychology plays a critical role within multidisciplinary cognitive care teams by providing diagnostic precision that extends beyond clinical interviews, neuroimaging, and brief cognitive screenings. The Alzheimer’s Association DETeCD-ADRD guidelines emphasize neuropsychological evaluation as essential for early detection, disease staging, cognitive profiling, trajectory monitoring, and the development of individualized care recommendations. This level of specificity is particularly valuable across conditions such as dementia, traumatic brain injury, stroke, epilepsy, and multiple sclerosis.
Within this broader care framework, teleneuropsychology (teleNP) not only expands access but also strengthens cross-specialty collaboration. By removing geographic barriers, teleNP enables neuropsychologists to partner more effectively with rural primary care providers, contribute to virtual memory clinics, and support neurology practices that lack local neuropsychological services. Teleconsultation models further enhance this collaborative approach by improving triage accuracy and facilitating timely access to specialty care in underserved regions.
As teleNP expands and artificial intelligence (AI) becomes increasingly integrated into clinical workflows, the need for strong professional leadership becomes more pronounced. ABPP board certification uniquely positions neuropsychologists to guide this evolution while maintaining the highest standards of clinical practice. The certification process reflects advanced competence in psychometrics, evidence-based assessment, and ethical decision-making—core skills required to critically evaluate emerging technologies and ensure their appropriate use.
In this context, ABPP-certified neuropsychologists serve not only as clinicians but as stewards of the field. Their role extends to shaping best practices for teleNP and AI integration, training the next generation of providers, and advocating for equitable access to high-quality neuropsychological services. Rather than functioning solely as gatekeepers, they act as translational leaders, ensuring that technological advancements enhance collaboration, expand access, and preserve diagnostic integrity within an increasingly complex healthcare landscape.
Integrating TeleNP and AI: A Unified Model for Access and Capacity
The full potential of innovation in neuropsychology lies not in teleNP or AI alone, but in their intentional integration. TeleNP addresses geographic barriers by expanding where care can be delivered, while AI enhances efficiency by optimizing how care is delivered. Together, they form a cohesive, technology-enabled model that targets both access and capacity constraints.
Within this unified framework, AI-supported workflows—such as automated intake, documentation, scoring, and triage—can streamline teleNP services, allowing neuropsychologists to evaluate more patients without compromising quality. At the same time, teleNP provides the infrastructure through which these efficiency gains translate into real-world access, particularly for underserved populations.
Realizing this model requires careful attention to ethical oversight, digital equity, and interdisciplinary collaboration. When implemented within established professional standards, teleNP and AI integration can expand access, improve sustainability, and enhance the overall quality of care.
ABPP board-certified neuropsychologists are central to this transformation. By leading the responsible adoption of these technologies, they ensure that innovation serves its intended purpose: delivering comprehensive, equitable, and high-quality neuropsychological care to all individuals with cognitive concerns.
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Alexandra Davis, PsyD
Correspondence: info@dralexdavis.com
Bryan Freilich, PsyD, ABPP-CN
Board Certified in Clinical Neuropsychology
Correspondence: BFREILIC@montefiore.org