Best practice recommendations for spoken and signed language interpreter-mediated clinical neuropsychological services.

Objective: The increasing linguistic and cultural diversity of the United States population has intensified demand for equitable, patient-centered neuropsychological services. Yet, a persistent shortage of bilingual and multilingual neuropsychologists, across both spoken and signed languages, has resulted in growing reliance on interpreters. Despite this reality, empirically informed and clinically actionable guidance for interpreter‑mediated neuropsychological practice remains limited. This manuscript addresses the urgent need for well‑articulated best practice recommendations tailored to interpreter‑mediated clinical neuropsychological services in the United States. Method: This paper presents an expert‑informed narrative synthesis of (a) peer‑reviewed empirical literature, (b) existing national and international professional guidance, and (c) interdisciplinary expert consensus grounded in the authors' training and work experience. Relevant ethical, legal, clinical, training, and systems‑level considerations were integrated to develop practice‑focused recommendations responsive to U.S. healthcare contexts. Results: The manuscript outlines a comprehensive framework for interpreter‑mediated neuropsychological care, including clinician-interpreter collaboration, interpreter qualifications and credentialing systems, curricular and training recommendations, ethical and legal obligations, and financial considerations specific to the U.S. healthcare system. A step‑by‑step protocol is provided to guide pre‑assessment, assessment, and post‑assessment phases of interpreter‑mediated neuropsychological services, with explicit inclusion of both spoken and signed language interpretation. Conclusion: These best practice recommendations offer a clinically actionable foundation for enhancing the quality, equity, and sustainability of interpreter‑mediated neuropsychological services in the United States. By directly addressing persistent gaps in training and clinical implementation, this framework supports current practice while remaining adaptable to ongoing empirical advances and future refinement in this evolving area of clinical neuropsychology.