We are guided by dedication to client's best interest when developing testing plans. Remote assessment has allowed us to interact without masks, distance, and added worry. At the present time, it is not possible to give many tests the way they were intended ("standardized conditions") in the DMV. This entails the evaluator sitting within about 2 feet from the examinee, no face covering, at ease, and readily able to share materials and never-before-considered "air-space". Pre-COVID, we moved freely, happily exchanged writing utensils and testing items, and took time to talk, laugh, and contemplate together.
No good testing interaction starts without a rigorous examination of all factors that impact process and outcome. We found that one of the best ways to preserve the integrity of both is to utilize remote (or virtual-, tele- assessment). There are many test publishers and assessment experts to thank for where we are today in the quick evolution of procedure. In fact, APA, IOPC, and other professional organizations have issued guidelines, shared related research, and given permissions that promote remote evaluations. We did our homework, consulted with trusted colleagues, and did a lot of personal examination and experimentation to determine what makes sense for our practice moving forward.
Here is just a sample of the permissions granted (lest anyone think we're winging it over here! 😉): https://www.pearsonassessments.com/content/dam/school/global/clinical/us/assets/telepractice/Letter-of-no-objection.pdf
Let us give you one example of the thought process. A well-known test such as the WISC-V comes with very clear guidelines regarding user responsibilities and expectations. The importance of the physical set up of the room, pacing of questions, methods of establishing and maintaining rapport, when you can ask a follow-up question, etc. is emphasized in the administration manual. This is all part of standardization, on which validity hinges.
So… if you are instead wearing masks and sitting multiple feet away from someone, using hand sanitizer between subtests, pointing through a glass divider, or perhaps interacting with your face obscured, making it harder for the participant to decipher what you’re saying, is that the same as the procedure outlined in the book? It’s not. Giving the WISC thorough the computer is not the same either. It is also an adaptation. We are finding that, in the majority of cases, teleassessment provides a better opportunity for the participant to engage more authentically—without the angst and awkwardness of COVID precautions. In addition, studies looking at the equivalence of remote assessment were well underway prior to COVID-19. We have the benefit of data that examines what's different and the same about typical (pre-COVID) in-person assessment and teleassessment. We do not have research showing the potential impact of multiple permutations of current in-person adjustments (i.e. face coverings, dividers, more sterile environments). The following is an excerpt from an article written by A. Jordan Wright, PhD, Joni L. Mihura, PhD., Hadas Pade, PsyD., and David M. McCord; published by APA early this spring:
The overarching context within which these principles are being developed is an understanding that the research and evidence base for equivalence of cognitive, neuropsychological, and other interactional measures in a remote, online format compared to a traditional, face-to-face format is extremely nascent. Some early evidence, under very controlled circumstances, of possible equivalence exists (e.g., Brearly, 2017; Cullum et al., 2006; Galusha-Glasscock et al., 2016; Harrell et al., 2014; Parmanto et al., 2013; Smith et al., 2017; Wadsworth et al., 2018; Wright, 2018).
Of course, they cited a need for study replication and were careful to restate that equivalence between in-person testing and tele-testing is not guaranteed. Since that time, additional studies have been published and we have had an opportunity to apply our own experience and clinical judgment to the questions raised by COVID-conditions. We know that few people are functioning in the same way cognitively, emotionally, behaviorally, and certainly socially—as we were before March 2020. As evaluators, we have to account for those changes as well through shifts in test selection, methods of delivery, interpretation, etc.
Successful remote assessment occurs when all parties work together to consider individual needs and circumstances, and take time to plan and prepare. It requires strict adherence to professional ethics and testing guidelines but a gentler more flexible execution. Some technology is required (i.e. laptop with video camera), you may have to mail back a completed record form, etc. but we have been able to do this comfortably since April. Testing companies continue to update products, hosts upgrade the functionality of virtual platforms, and we learn and grow in our own test selection, administration, and interpretation efforts.
We expect and invite questions!! Please reach out so we can talk through various options.