Table 1.

Summary of included publications

Reference Type of document	Purpose/aim	Design (D) Population (P) Setting (S)	Methods (M) Intervention type (I) Relevant outcomes (O)	Relevant results/recommendations
Allen et al., 1986 Position paper	Advocate a collaborative process approach to NPA and provide guidelines for discussing the results with psychiatric patients and family members	P: Psychiatric patients and family members	N/A	Advice to begin with in-person feedback to evaluate misunderstandings and emotional reactions.
Arffa & Knapp, 2008 Research paper	Examine utility and value ratings of NPA by measuring parent perceptions, as well as determining whether testing led to diagnostic changes or recommendations	D: quantitative, descriptive P: 64 parents of children with complex neuro-developmental and acquired neurological disorders S: neurodevelopmental outpatient clinic	M: survey (70% response rate), medical records O: satisfaction with NPA, number of recommendations	Feedback was given in-person, 2 weeks to 2 months later. All received a written report. Greatest utility rating of NPA was understanding strengths and weaknesses. An average of 6.5 primary and 11.1 secondary recommendations were given.
Belciug, 2006 Research paper	Evaluate caregiver concerns after neuropsychological feedback	D: quantitative, descriptive P: 45 caregivers of patients with stroke	M: survey O: concern regarding patient’s level of functioning after NPA with feedback	Concerns related to safety, the future, dealing with emotional aspects, and what to do when the patient cannot perform a task independently were the most prominent after the feedback session.
Bennett-Levy et al., 1994 Research paper	To explore the consumer experience with an NPA and how neuropsychologists can improve their quality of service	D: quantitative, descriptive P: 129 patients with various diagnoses (most common head injury and stroke) S: 5 outpatient clinics (2 hospitals, 3 rehabilitation centers)	M: survey (51% response rate) O: experience with NPA	One influence on NPA consumer experience was whether they received feedback and if this was seen as useful. A total of 32% patients did not receive feedback, and when it was given, this was not always remembered (30%) or understood (24%). The majority found the feedback session useful (67%). Only 26% received feedback on paper.
Bodin et al., 2007 Research paper	Enhance understanding of parent satisfaction with pediatric neuropsychological evaluation	D: quantitative, descriptive P: 117 parents of children with various diagnoses (most common ADHD and epilepsy) S: outpatient clinic (children’s hospital)	M: survey (35% response rate) O: satisfaction with NPA	All received a written report. Overall, parents were satisfied and 54% found the session helpful. A total of 68% felt that it helped them address their child’s problems. The majority agreed that feedback helped in understanding the child’s strengths and suggested ways of addressing problems.
Carone et al., 2010 Opinion paper	Present conceptual framework for providing feedback regarding invalid responding or effort with recommendations for how to handle complaints	P: any diagnostic group	N/A	In-person feedback model with three phases (Table 3)
Carone et al., 2013 Opinion paper	Review and update symptom validity feedback model and describe feedback approach with patients reporting with persisting symptoms after MTBI	P: MTBI patients	N/A	In-person feedback model with three phases with additional tips for patients with MTBI (Table 3)
Carone, 2017 Opinion paper	Present a feedback model for patients who are not reassured by feedback because they blame external factors	P: patients with high level of cognitive complaints, but normal test performance	N/A	In-person feedback model with three phases (Table 3)
Cheung et al., 2014 Research paper	Explored parent and teacher understanding of neuropsychology reports, implementation rates for recommendations and their perceived effectiveness. Barriers were also evaluated	D: qualitative P: 17 parents of childhood who had a brain tumor and 8 teachers S: children’s hospital	M: semi-structured interviews O: perceived effectiveness of report, difficulty of implementing recommendations	Feedback was given in-person, all received written report. Majority of parents found the reports clear and comprehensive. Recommendations were evaluated as effective and easy to implement. A need for a more practical translation to daily life, a glossary for terminology, and a follow-up consultation was expressed.
Clement et al., 2001 Opinion paper	Describe use of a neuropsychology telemedicine clinic in an army medical center.	P: patients with neurological disorders or brain injury S: army medical center	N/A	Experiences with feedback via telemedicine were positive in areas where these services otherwise would not be available.
Connery et al., 2016 Research paper	Examine impact of neuropsychological consultation when invalid performance has been identified in a pediatric population. Additionally, provide a conceptual feedback model	D: quantitative, non-randomized P: 70 parents of children with history of MTBI S: outpatient pediatric concussion program	M: survey I: comparing group with noncredible effort and feedback model (n = 9) to those with no validity concerns present and feedback care as usual (n = 61) O: post-concussive symptom reduction, parent satisfaction with NPA	In both the group with the feedback model (noncredible effort) and the care as usual group (credible effort) similarly high levels of satisfaction were found. In the noncredible group, a greater reduction of self-reported symptoms was found after feedback compared to children with a credible performance.
Crosson, 2000 Book chapter	Describe applications of NPA results and summarizes problems arising when giving neuropsychological feedback and principles to use against these problems	Not specified	N/A	Describes potential pitfalls and solutions for delivering in-person feedback (Table 3).
Evans et al., 2019 Position paper	Highlight current challenges and barriers in composing neuropsychological reports and communicating key findings to Spanish speaking caregivers of school-aged Latino children	P: Spanish speaking caregivers of school-aged Latino children	N/A	Recommendations for report writing, such as language translation and considering both cultural and linguistic differences.
Fallows & Hilsabeck , 2013 Research paper	To see whether supplementing oral feedback with written information leads to greater retention of information and improved adherence to recommendations	D: quantitative, randomized P: 66 veterans with cognitive or no cognitive disorders S: veterans administration in a neuropsychology clinic	M: structured interview after feedback and 1 month later by phone I: group with oral feedback (n = 36) and group with oral feedback + written information (n =30) O: retention of diagnostic information, adherence to treatment recommendations	Group with both in-person feedback and supplemental written letter freely recalled more recommendations one month after feedback compared to the no letter group. Overall recall of recommendations and diagnostic information (with exception of knowing they had cognitive problems) was low.
Farmer & Brazeal, 1998 Research paper	Evaluate reaction of parents to their child’s NPA, specifically related to their parent perceptions of their child and their ability to cope with their child’s disease.	D: quantitative, descriptive P: 55 parents of children with neurodevelopmental problems S: outpatient clinic (hospital)	M: survey (47% response rate) O: effect of NPA on parent perceptions of their child, coping with child’s disability, adequacy of NPA	25% of parents found the in-person feedback session most helpful of NPA. Majority evaluated the report as most useful. Feedback increased understanding of child’s strengths and weaknesses and helped make a difference for their child. Strongest predictor of NPA satisfaction were perceptions of professional’s concern, technical competence, and rating of recommendations.
Foran et al., 2016 Research paper	Develop and pilot a measure of patient satisfaction that encompasses themes, activities, settings and interactions specific to NPA process	D: mixed-methods P: 81 patients with various diagnosis (most common chronic illness, psychiatric diagnosis or traumatic injury) S: neuropsychology outpatient clinic (hospital)	M: systematic search, focus groups, pilot study O: satisfaction with NPA	Overall, high satisfaction with NPA (79%). Satisfaction with testing (85%) higher than pre-assessment (77%) and feedback (68%). A total of 44% patients received feedback from a neuropsychologist, 38% from a third party and 18% no feedback. Critique on feedback was related to difficulty of understanding the information and emotional impact of diagnosis.
Gass & Brown, 1992 Opinion paper	General framework for presenting feedback is described with an emphasis on techniques designed to maximize patient benefit. Special issues are discussed	P: patients with brain injury	N/A	In-person feedback model with six phases (Table 3)
Gorske,2007 Position paper	Present a humanistic model for providing neuropsychological feedback	Not specified	N/A	In-person feedback model with five phases (Table 3)
Gorske & Smith, 2009 Book	Describe a client-centered approach in using NPA feedback therapeutically.	Not specified	N/A	In-person feedback model with five phases (Table 3)
Green, 2000 Book chapter	Discusses the final stage of NPA, provision of feedback to the patient and others, and planning of treatment interventions and follow-up services.	Not specified	N/A	Recommendations given for in-person feedback, such as that it is sometimes more appropriate to receive feedback from another professional or to ensure that the information is understood and accepted.
Griffin & Christie, 2008 Opinion paper	Discusses current approaches in NPA of children	P: children S: hospital- or community-based	N/A	An audit showed that most families found the report difficult to understand or unhelpful. Recommendations given for in-person feedback, such as communicating in an understandable manner and sending a written report with creative/child-friendly language.
Gruters et al., 2020 Research paper	Gain insight into experiences of patients and family members with an NPA and diagnostic disclosure at the memory clinic	D: qualitative P: 14 memory clinic patients and 13 family members S: three hospital-based clinics	M: focus groups O: experiences with NPA and diagnostic disclosure	The following themes were identified: uncertainty, early diagnostic paradox (both positive and negative experiences with NPA and diagnostic disclosure) and knowledge utilization (low information retention).
Holst et al., 2009 Research paper	Investigate patient's recollections of satisfaction with feedback after an NPA.	D: quantitative, descriptive P: 32 patients with ADHD or autism spectrum disorder S: 2 psychiatric outpatient clinics	M: survey O: satisfaction with feedback, self-perceived health, basic and earning self-esteem	Low levels of in-person feedback was related to low self-esteem. The more satisfied group had better physical and mental health, felt confirmed by the examiner, and had higher basic self-esteem.
Kirkwood et al., 2016 Research paper	Examine efficacy of a neuropsychological consultation as intervention for youth with persistent post-concussive symptoms following mild TBI	D: quantitative, non- randomized P: 80 children with MTBI and their parents S: outpatient pediatric concussion program	M: survey 1 week before and 1 and 3 months after NPA I: neuropsychological consultation with direct feedback O: post-concussive symptom rating	Significant decrease in post concussive symptoms 1 week and 3 months after in-person feedback in both parents and children. All received a summary of the report.
Kirkwood et al., 2017 Research paper	Examine parent satisfaction with neuropsychological consultation following MTBI in school-age children	D: quantitative, descriptive P: 71 parents of children with MTBI S: outpatient pediatric concussion program	M: survey O: satisfaction with NPA	Majority satisfied with NPA. A total of 93% found in-person feedback helpful and the majority thought feedback helped them understand problems (88%), strengths (86%), and ways to address problems (72%).
Lanca et al., 2019 Research paper	Examine self-reported cognitive and psychiatric symptoms, self-efficacy, motivation, and satisfaction following NPA with interventional feedback session	D: quantitative, descriptive P: 31 patients with ADHD or mood disorders S: neuropsychology outpatient clinic (community hospital)	M: survey O: satisfaction with NPA, psychiatric and cognitive symptoms, perceived memory ability, self-efficacy	One month after in-person feedback, reduction in psychiatric and cognitive symptoms was reported, as well as improved cognition and self-efficacy. Furthermore, high levels of satisfaction with NPA were reported.
Longley et al., 2012 Protocol	(1) investigate psychological benefit of NPA with feedback for patients with MS and their main caregivers following the feedback session and 2 months later (2) identify characteristics of patients and caregivers who will most benefit from assessment with feedback	P: patients with MS S: MS center	M: survey I: NPA + feedback, control group sham waiting list O: knowledge of cognitive profile, coping	Protocol for randomized controlled trial (study results to date yet unpublished; recruitment status: stopped early).
Lopez et al., 2008 Research paper	Outline a short intervention (three-session assessment and feedback module that translate NPA findings to daily life and eating symptoms) designed to identify and address information processing bias (poor set-shifting or strong detail focus) in patients with anorexia nervosa	D: qualitative (case study) P: 2 patients with anorexia nervosa S: outpatient clinic	N/A	In-person feedback led to adapted behavior in one patient and stopped rapid weight loss in the other patient.
Malla et al., 1997 Research paper	Determine whether detailed assessment of cognitive functions in people suffering from psychotic disorder can assist in their psychosocial rehabilitation while they are living in the community	D: qualitative (case study) P: 3 patients with schizophrenia S: community treatment program	N/A	In-person feedback in three patients led to improved outcomes by emphasizing strengths. In one patient it also led to improved feelings of self-esteem.
Martin & Schroeder, 2020 Research paper	Present survey results on how neuropsychologists approach feedback about invalid testing across various clinical settings.	D: quantitative, descriptive P: 209 clinical neuropsychologists S: various settings	M: survey O: base rate of invalidity, present three clinical case vignettes and inquire how they would give feedback	The majority (98%) of psychologists would include description of invalid findings and provide explanations (67%). There was little agreement on the approach in delivering feedback and what the goal was of the feedback session.
Meth et al., 2016 Research paper	Test a simple intervention (providing supplemental letter) in communicating neuropsychological feedback. Additionally, investigates the impact of including caregivers in the feedback session to explore whether differences exist in recall for recommendation between patients and family members	D: quantitative, randomized P: 79 patients with various diagnosis (most common psychiatric diagnosis, mild cognitive impairment, dementia) and 36 caregivers S: outpatients from neuropsychology lab (hospital)	M: telephone interview 7 weeks after NPA I: group with letter (n = 35) and group with no-letter (n = 44) O: retention and adherence to recommendations	Recall of recommendations was better in caregivers (not in patients) in the group with in-person and a supplemental letter compared to no letter. Overall level of recommendations remained low. No differences in adherences were found between the two groups.
Meth et al., 2019 Research paper	Identify types of recommendations that neuropsychologists provide to patients, and determine which specific recommendations are most and least consistently given to patients across and within different diagnostic populations	D: quantitative, descriptive P: 309 licensed clinical psychologists	M: survey O: type/frequency of recommendations	Most given recommendations across diagnoses were compensatory strategies, address cognitive deficits and to improve health. Psychologists were more likely to give recommendations that could be carried out without help from external sources.
Postal & Armstrong, 2013 Book	Reflect on how to communicate neuropsychological assessment results.	D: qualitative P: 82 psychologists	M: semi-structured interviews	Framework given on how to make in-person feedback stick (Table 3). Furthermore, concrete examples are given on how to give feedback on specific aspects based on the interviews with the psychologists.
Pritchard et al., 2014 Research paper	Preliminary evaluation of added value associated with NPA in the identification and treatment of ADHD in youth	D: quantitative, non-randomized P: 188 parents of children with ADHD S: neuropsychology outpatient clinic (hospital)	M: survey after NPA and after 5 months I: children who recently received NPA (NP+) and those who have not (NP-) O: parent rating of child symptoms, parent rating of child quality of life, satisfaction with NPA	Both patients with and without NPA reported significant improvements in the child’s behavioral and emotional symptoms. Feedback was seen as helpful and satisfaction with NPA was high.
Quillen et al., 2011 Research paper	To determine whether neuropsychological recommendations were implemented by families and whether the suggestions improved the survivor's quality of life (as perceived by parents) and school experience	D: quantitative, descriptive P: 20 parents of childhood history of cancer S: oncology center (hospital)	M: survey O: implementation of recommendations, improvement of parent perceived child quality of life	Most recommendations were academic or educational in nature and 48% were followed-up. All parents at least followed one recommendation, but adherence ranged between 16-100%. A total of 97% of the recommendations were seen as helpful in improving parent-perceived child quality of life.
Rosado et al., 2018 Research paper	Examine the impact of patient feedback regarding neuropsychological testing on patient outcomes	D: quantitative, non-randomized P: 84 patients with various diagnosis	M: survey at baseline and 6-8 weeks later semi-structured interview I: patients who attended feedback sessions (n =49) versus those who did not receive feedback (n=35) O: perceived stress, understanding of condition, coping	Patient with in-person feedback had increased quality of life, understanding of condition, ability to cope with condition compared to the group without feedback.
Ruppert & Attix, 2014 Book chapter	Brief summary of purposes and recommended practices for providing feedback on cognitive test results to patients and caregivers	P: patients with a cognitive impairment	N/A	Recommendations given for in-person feedback, such as clear communication, querying understanding throughout session, allowing patients/family to take notes, and provide written materials.
Stimmel et al., 2019 Research paper	Explore rates of adherence to neuropsychological recommendations, reasons for nonadherence, and the effect of oral (phone call) and written feedback over written feedback alone	D: quantitative, descriptive P: 55 patients with MS S: MS center (medical center)	M: semi-structured interview, retrospective record review O: adherence to treatment recommendations	Self-reported adherence to recommendations was 38%, but this varied per recommendation type (high adherence for pharmacological management and lower for psychotherapy or psychiatry referral/cognitive rehabilitation). Reasons for nonadherence were needing more information and wanting to speak with physician.
Tharinger & Pilgrim, 2012 Research paper	Evaluate whether receiving developmentally appropriate feedback in the form of individualized stories would affect how children and parents reported experiencing an NPA	D: quantitative, randomized P: 32 parents of children with primarily ADHD, CAPD or dysgraphia S: private practice	M: survey I: group with feedback following standard procedure (n = 17) and in experimental group with addition of child feedback through a fable (n =15) O: parent and child experience with NPA, satisfaction with NPA	Children who received in-person feedback with illustrative stories in a booklet experienced a greater sense of learning about themselves, more positive relationship with the assessor, and a sense that their parents learned more about them. Parents of these children reported a more positive relationship with their child and assessor, a greater sense of collaboration, and a higher level of satisfaction.
Turner et al., 2012 Research paper	Evaluate the feasibility of providing comprehensive neuropsychological evaluations and feedback via telemedicine to veterans receiving services from an urban veteran medical center	D: quantitative, non-randomized P: 15 veterans with cognitive or psychiatric disorders S: urban veteran medical center	M: informal questions during NPA I: group with in-person evaluation (n = 7), and group via telemedicine (n =8) O: satisfaction with NPA	Both groups were satisfied with receiving in-person feedback of feedback via telemedicine. NPA via telemedicine was deemed to be feasible and comparable to an in-person evaluation.
Westervelt et al., 2007 Research paper	Assess patient perceptions of neuropsychological evaluations. Furthermore, evaluated responses to neuropsychological recommendations.	D: quantitative, descriptive P: 129 patients with various diagnosis and 80 family members S: academic medical center neuropsychology program	M: survey (37% response rate) O: satisfaction with NPA	Patients were satisfied with NPA and receiving in-person feedback. Most were satisfied with the length of the feedback session and reported that it helped them understand problems, deal with problems, and reduce stress.

NPA neuropsychological assessment, N/A not applicable, ADHD attention deficit hyperactivity disorder, MTBI mild traumatic brain injury, MS multiple sclerosis