Address (and URL)

The American Board of Clinical Neuropsychology (ABCN) is the specialty board of the American Board of Professional Psychology (ABPP) that is responsible for the development and administration of examinations of competence for independent practice of Clinical Neuropsychology. Information about ABCN can found at the following websites:

Mail correspondence can be directed to ABCN at the following street address:

Department of Psychiatry (F6248, MCHC-6)

University of Michigan Health System

1500 East Medical Center Drive, SPC 5295

Ann Arbor, MI 48109-5295

Membership

As of June 2017, ABCN/ABPP has awarded specialty certification in clinical neuropsychology to 1201 specialists practicing across the United States and Canada. Of these, 91 have been awarded subspecialty certification in the practice of pediatric clinical neuropsychology. Neuropsychologists certified through ABCN demonstrate their scientific knowledge and clinical expertise through a staged examination process that includes (1) review of training credentials, (2) written examination, (3) review of case materials from the candidate’s clinical practice, and (4) oral examination.

Candidates who pass all stages of the ABCN examination process are awarded specialty certification in clinical neuropsychology and are eligible for membership in the American Academy of Clinical Neuropsychology (AACN). All board-certified specialists in good standing may vote in elections for the ABCN Board of Directors (BOD), which is comprised of 15 members each elected to 5-year terms. Officers of the ABCN BOD include the president, vice president, secretary, treasurer, the ABCN representative to the ABPP board of trustees, and other agents as may be directed by the board.

Neuropsychologists who possess subspecialty education, training, and clinical expertise in pediatric clinical neuropsychology may pursue subspecialty certification after passing all stages of the ABCN specialty examination process. Subspecialty candidates must resubmit credentials for review of education and training specific to the science and practice of pediatric neuropsychology. Once subspecialty credentials are approved, candidates may take a subspecialty written examination and, when passed, may submit a case sample from their pediatric neuropsychology practice for peer review.

Mission Statement

The mission of ABCN is to (1) develop and conduct examinations to determine the qualifications of individuals who apply for board certifications, (2) award certification in clinical neuropsychology and its subspecialties to candidates who pass all stages of the examination process, and (3) evaluate compliance of certified specialists with maintenance of certification requirements.

Landmark Contributions

Origins of ABCN. In June 1981, a joint task force of the International Neuropsychological Society and Division 40 of the American Psychological Association met to discuss education, credentialing, and accreditation in the specialty of clinical neuropsychology. The task force concluded that training as a neuropsychologist was poorly standardized and that many professionals claimed expertise in clinical neuropsychology without proper training or skill sets. During the meeting, several members of the task force discussed the need to develop a formal credentialing process to assist the public in identifying professionals capable of providing competent neuropsychological services (Report of the Division 40/INS Joint Task Force on Education, Accreditation, and Credentialing 1984; Reports of the INS – Division 40 Task Force on Education, Accreditation, and Credentialing 1987). A small planning group was subsequently formed to create a peer-review mechanism for this purpose, and in August 1981, the American Board of Clinical Neuropsychology was incorporated in the state of Minnesota as an independent credentialing body.

The ABCN planning group included Linas Bieliauskas, Louis Costa, Edith Kaplan, Muriel Lezak, Charles Matthews, Steven Mattis, Manfred Meier, and Paul Satz, who together developed a three-stage board certification process. At its inception, the ABCN examination process included (1) review of training credentials, (2) submission of case materials reflecting the candidate’s practice of clinical neuropsychology, and (3) an oral examination of, but not limited to, clinical and scientific knowledge, assessment practices, and ethical/legal issues. Prominent neuropsychologists of national reputation were chosen by consensus of the planning group to serve as the first board of directors of ABCN. The inaugural board examined each other and, in 1983, conducted the first formal set of board examinations in clinical neuropsychology. Following the first formal exams, ABCN affiliated with ABPP, the unifying governing body for specialty examining boards in psychology. The first official ABPP/ABCN certifications in the specialty of clinical neuropsychology were awarded in 1984. Twenty years later, in 2004, ABCN awarded its 500th certification (Yeates and Bieliauskas 2004), demonstrating continued interest among clinical neuropsychologists in the peer-review process. In 2014, ABCN awarded board certification to its 1000th specialist, doubling the previous milestone in half the time (Lucas et al. 2014).

Enhancements to the Board Certification Process. Bieliauskas and Matthews provided detailed facts and data regarding the development and enhancement of ABCN policies and procedures in updates published in 1987, 1990, and 1996 (Bieliauskas and Matthews 1990, 1997, 1987). In 1997, representatives from each professional neuropsychology organization were invited to meet in Houston to review current training models and propose universal standards for education and training in the specialty. The proceedings and consensus statement of the Houston Conference on Specialty Education and Training in Clinical Neuropsychology were published the following year (Hannay et al. 1998). Although largely aspirational at the time of publication, by 2002 the ABCN Board determined that a sufficient number of neuropsychology training programs had successfully incorporated the Houston Conference (HC) model and voted to include HC training and education guidelines as criteria for passing credential review. In recognition of earlier training models and to allow enough time for transition, the board allowed that only those applicants earning their doctoral degree on or after January 1, 2005, would be held to HC criteria. Others continued to be held to the eligibility criteria that were in place at the time they earned their doctoral degree (or completed respecialization in clinical neuropsychology). A survey conducted in 2012 by Sweet and colleagues (2012) indicated that HC guidelines have become widely adopted by training programs in clinical neuropsychology and that professionals who complete training in HC-adherent programs report being well prepared to engage independently in key professional activities.

In 1988, ABCN partnered with Psychological Examination Services to develop a 100-item written examination whereby candidates could objectively demonstrate the scientific knowledge acquired during their training and years of practice. The written examination was implemented in 1993 as the second stage of the certification process and must be passed before a candidate may submit practice samples. The content and psychometric properties of the written examination are reviewed and updated on an ongoing basis. In 2012 ABCN transitioned the written examination from a paper-and-pencil test administered at national meetings to a computer-based test administered on an electronic platform during 2-week examination windows, four times per year. Candidates who are eligible to sit for the written examination may do so locally at any of nearly 300 PSI testing sites across the United States and Canada. In 2015 a set of 25 beta-test items were added to the core 100 test items to provide psychometric data for informed item selection of subsequent versions of the exam. Only the 100 core test items contribute to candidate’s final exam score. In late 2015, the ABCN Board of Directors contracted with Alpine Testing Solutions, Inc. to develop and implement the next revision of the written exam.

ABCN partnered with Thomson-Reuters in 2012 to create an electronic portal in the ScholarOne online manuscript management system to allow candidates to upload electronic copies of their practice sample case materials rather than mailing paper copies, as had been the prior practice. Additionally, the ABCN Practice Sample Committee engaged in a multifaceted approach to enhance both the standardization and turnaround time of reviews. The committee recruited a cohort of dedicated specialists and provided standardized guidelines and training for practice sample reviews, thus allowing candidates to move more efficiently through the board certification pipeline.

Subspecialty Certification. In 2006, the ABPP Board of Trustees requested that ABCN form a work group to consider issues regarding the emerging interest of subspecialty practices within psychological specialties (Baron et al. 2011). After careful deliberation, the work group proposed a model whereby subspecialties reflect the normal evolution of psychological specialty practice, emerging naturally as the core knowledge base of a specialty grows and begins to be applied or tailored to unique populations, settings, or methods. The work group proposed that subspecialty development begins with the aggregation of board-certified specialists into a “special interest group” (SIG) representing shared expertise and interests in a component of the specialty. This model was endorsed by the ABPP BOT in December 2008 and incorporated into the formal policies and procedures of the ABPP Affiliations and Standards Committee.

In 2009, a group of pediatric clinical neuropsychologists formed the first official SIG within ABPP. The pediatric SIG (P-SIG) met over subsequent years to vet the interest, feasibility, and viability of developing a subspecialty of pediatric clinical neuropsychology within ABCN. Simultaneously, the ABCN BOD tasked its committee on subspecialization to consider and recommend a model of requirements and procedures by which specialists might attain certification in a subspecialty area of neuropsychology practice. The committee reasoned that subspecialty candidates have already demonstrated competencies required for neuropsychology practice by virtue of their board certification through ABCN. Thus, certification in a subspecialty of clinical neuropsychology should require only (1) clear demonstration of subspecialty-specific education, training, and practice requirements as determined by the ABCN Board in consultation with the subspecialty SIG, (2) a written examination of subspecialty knowledge and clinical application, and (3) demonstration of competent, evidence-based clinical practice in the subspecialty as determined by review of a single representative assessment case. In October 2013 ABCN submitted this proposal to ABPP and in December 2013 pediatric clinical neuropsychology was approved as the first official subspecialty within ABPP. In January 2014, all ABCN specialists with expertise in pediatric clinical neuropsychology were invited to submit applications for subspecialty credential review. Those who demonstrated the required education and training were subsequently invited to sit for a calibration administration of an objective written examination. The data from the calibration examination was used to create two parallel 30-item subspecialty written examinations which were fielded in June 2015. The subspecialty written examination is currently administered once per year. As of June 2017, 91 ABCN specialists had passed the practice sample peer-review stage and successfully earned ABPP/ABCN subspecialty certification in pediatric clinical neuropsychology.

Maintenance of Certification. ABCN has always recognized that competence in any field of medical practice is dynamic and that specialists must continuously maintain and update their competencies through ongoing professional education and engagement. In 2010, the ABCN Board endorsed a plan proposed by ABPP to require specialists to formally document the ways in which they maintain the competencies required of ongoing specialty practice. In 2013, ABCN created a maintenance of certification (MOC) committee to develop and implement procedures, materials, and criteria to allow neuropsychology specialists and subspecialists the formal means of demonstrating MOC. This process adapts the core requirements expected across all ABPP specialties in a way that is relevant to the functional competencies specific to ABCN. The MOC policy and procedures developed by ABCN were approved by the ABPP Standards Committee in 2014 and implemented on January 1, 2015.

The American Academy of Clinical Neuropsychology (AACN). ABCN expanded its mission from being a board certification body to being a membership organization of board-certified specialists in 1983. The reason for this transition was to collect dues to fund the development of the written examination. In 1996, ABPP legal counsel advised examining boards against having a dual role of being both a certifying body and membership organization. In response, the ABCN BOD voted to incorporate its membership organization as a separate academy, with an independent board of directors and separate mission statement. The AACN took on the important task of promoting board certification, advocating for standards of training and education in clinical neuropsychology, and disseminating information about the field of neuropsychology to the general public, forensic settings, schools, healthcare professionals, and clinical training programs. The AACN provides mentorship and study support for candidates seeking board certification through ABCN (Armstrong et al. 2008). Although AACN began as an organization restricted only to board-certified neuropsychology specialists, membership opportunities at this time also extend to students, individuals who are in the midst of the board certification process, and non-neuropsychology professionals (Table 1).

American Board of Clinical Neuropsychology (ABCN), Table 1 Timeline for major ABCN milestones
Full size table

Major Activities

As noted above, ABCN focuses its primary activities on developing, maintaining, reviewing, revising, and implementing the board certification examinations in clinical neuropsychology and its subspecialties. As of 2015, ABCN also conducts reviews of documentation from specialists who wish to demonstrate maintenance of certification.

The ABCN Specialty Certification Examination. A comprehensive overview of the ABCN examination process was published in 2008 (Armstrong et al. 2008) and can also be found within the Candidate’s Manual on the ABCN website (www.theabcn.org). Briefly, the specialty examination process consists of four distinct and sequential steps. First, the education and training experiences of the applicant are reviewed by ABPP for appropriate graduate training, internship, and licensure status in psychology. Applications that pass the ABPP general review are then forwarded to ABCN for review of advanced specialty credentials. Applicants who completed their doctoral training on or after January 1, 2005, must demonstrate training consistent with the Houston Conference on Specialty Education and Training in Clinical Neuropsychology, including required coursework and completion of a formal 2-year postdoctoral residency program in clinical neuropsychology. Policies and exceptions regarding candidates who received their training before implementation of the Houston Conference criteria respecialized in neuropsychology after obtaining a doctoral degree in another specialty or received training in Canada are detailed on the ABCN website (www.theabcn.org).

Once an applicant’s credentials are approved, they may sit for the written examination. The exam consists of 125 multiple-choice questions that cover a range of topics in neuropsychology. Only 100 items contribute to the candidate’s final score. The other 25 items are included to gather psychometric data to determine the item’s suitability as a future exam question. The written examination tests the candidate’s breadth of knowledge and assures that they have the scientific foundation necessary for competent practice in clinical neuropsychology. Since 2012, the written examination has been administered electronically. It is currently offered in 2-week windows, four times per year through PSI testing centers across the United States and Canada.

Candidates who pass the written examination may submit a practice sample consisting of two typical cases from their neuropsychology practice. The practice samples are peer-reviewed by at least three independent, board-certified neuropsychologists. Reviewers follow a standardized rubric to determine whether the candidate’s clinical practices, conclusions, and recommendations as demonstrated in the sample would be defensible upon oral examination.

If the practice sample is approved by at least two reviewers, the candidate is invited to participate in an oral examination of their specialty competencies. The oral examination consists of three 1-h exercises that cover (1) defense of the practice sample, (2) fact-finding, and (3) ethics and professional development. During the practice sample exercise, the candidate is given opportunities to discuss their clinical practice as applied to the specific cases they submitted. The cases also serve as a starting point leading to more in-depth discussion and evaluation of competencies such as assessment, intervention, consultation, and scientific knowledge. The fact-finding exercise presents a brief description of a case that is new to the candidate. The candidate must then gather appropriate information from the clinical history, test data, and medical record to generate an appropriate case conceptualization and differential diagnosis. The ethics and professional development exercise allows candidates to demonstrate knowledge of important ethical considerations as presented in a brief vignette. Candidates are evaluated not only on their ability to identify the ethical issues in the vignette but also on their ability to demonstrate understanding of why the issues are problematic. During this portion of the exercise, candidates are also invited to discuss their own contributions to research, teaching, practice administration, patient advocacy, or other activities that contribute to their professional development. Currently, oral examinations are conducted twice annually in Chicago, Illinois, hosted by the Neuropsychiatric Institute of the University of Illinois at Chicago.

The ABCN Subspecialty Examination in Pediatric Clinical Neuropsychology. ABCN specialists who wish to become certified in the subspecialty of pediatric clinical neuropsychology may submit their credentials for review. Applicants who have been engaged in an active pediatric neuropsychology practice within the 2 years prior to submission of their application and document a minimum of 4000 h of postdoctoral experience within pediatric neuropsychology meet criteria to pass subspecialty credential review. Applicants who completed doctoral training or respecialization in clinical neuropsychology on or after January 1, 2005, must meet the additional requirement that at least 1000 of their 4000 h of postdoctoral clinical practice was obtained under the direct supervision of a pediatric neuropsychologist. Two letters of reference must verify that the above criteria were met. Candidates who pass the credential review process may take the 30-item subspecialty written examination containing questions related to neurodevelopment, functional neuroanatomy, pediatric clinical syndromes, specialized neuropsychological assessment techniques, developmental psychology, and the ethical and legal issues of pediatric neuropsychological practice. Candidates who pass the written examination may submit a single pediatric neuropsychological case evaluation of a patient age 16 or under that clearly demonstrates independent practice at the subspecialist level of competence. The subspecialty review process differs in important ways from that of the ABCN specialty review process because the specialty review is intended to determine whether a candidate’s practice would be defensible at oral examination. In contrast, the subspecialty review process must determine if the case sample on its own sufficiently demonstrates competent practice in the subspecialty.

Maintenance of Certification. Maintenance of certification (MOC) is a process of self-examination of a specialist’s professional development since his or her initial board certification or last MOC review. The ABPP MOC model asserts that competence for independent specialty practice is established at the time of initial board certification and can be continuously maintained thereafter through lifelong learning, ongoing participation in professional activities, and self-evaluation related to core competencies. In accordance with ABPP policy, MOC is required of all ABCN specialists awarded with board certification on or after January 1, 2015. Specialists who completed board certification prior to that date may “opt in” to the process but are not required by ABPP to do so.

In the course of self-examination, specialists survey their professional activities during the 2 years prior to MOC submission and report/describe the means by which those activities served to maintain the ABCN-defined competencies required for independent practice in clinical neuropsychology. Five broad categories of professional activities support the maintenance of specialty competencies. These include (1) collaborative clinical consultation; (2) teaching and training; (3) ongoing education; (4) research, methodologies, and programs; and (5) professional leadership. Numerous activities fall within each of these categories and specialists must indicate how the activities in which they engaged served to support the competencies defined by ABPP and ABCN as essential to neuropsychological practice. Those with subspecialty certification must further ensure that MOC activities support competencies required for subspecialty practice.

Beyond engagement in professional activities, all ABCN specialists must also demonstrate appropriate self-evaluation by describing their practice, approaches to ethical or diversity issues, and the means by which they evaluate their clinical efficacy (e.g., ongoing peer review, performance evaluations, patient satisfaction data, etc.). Members of the ABCN MOC Committee review all submissions against established ABCN standards to determine if criteria for passing MOC review have been met.

Conclusion

With over 1200 certifications in clinical neuropsychology now awarded, ABCN specialists can be found across a multitude of practice settings, geographic locations, advocacy efforts, training programs, and research endeavors involving pediatric, adult, and older adult populations. Board certification through ABCN reflects validation of competence by one’s peers and assures the public that the neuropsychologist has successfully completed the education, training, and experience requirements of the specialty, including examinations designed to assess the competencies required to provide quality services in clinical neuropsychology.