Remote services and tele-assessment have been increasing over the last several years, even more so post-pandemic. Parallel has built a tele-assessment platform to conduct virtual psychological assessments to diagnose Dyslexia, ADHD, and other learning and thinking differences. As clinicians, you may have curiosities around the process and validity of tele-assessment. We spoke with our Chief Clinical Officer, Dr. Jordan Wright, to answer your frequently asked questions.
Q: Are tele-assessments valid?
A: Yes! Data show that the level of test error in tele-assessments is not significantly different from those given in person. There is error in tests given remotely, just like there always has been in all psychological testing. Our tests can’t directly and precisely measure a child's verbal abilities, for example; they measure a proxy for underlying skills, and there is always error built into it. That's why we use multiple methods, to try and triangulate and validate findings from different, imperfect tests," Dr. Wright says. Just like with traditional assessments, our providers ask teachers for feedback as well as having parents and guardians and children themselves fill out surveys. Testing is never the sole factor in an assessment.
Q: How can you control the child's/teen's environment?
A: There is a lot of collaboration with families that goes into creating a solid testing environment that is private and quiet. In rare cases, a test might need to be aborted due to certain circumstances, such as loud siblings, etc. Parallel has also had good success with partnering with schools and libraries to provide a quiet environment.
Prior to testing sessions, parents and guardians are coached on what they can and cannot do. Additionally, when an adult is in the room (such as for younger kids), they are instructed to sit where they can be seen by the providers on camera. In most cases, the parents and guardians are not in the room during direct testing, but if they are in the room, providers are able to watch the interaction.
"In the 6 or 7 years that I have been doing tele-assessment, it has never really been a problem that parents interfere with the testing. If a parent does interfere, it’s pretty easy to redirect them in the moment," states Dr. Wright.
Q: What advantages does tele-assessment provide?
A: While there are a lot of advantages, one of the main benefits of tele-assessment is the increased access it provides to those who might not have been able to benefit from traditional, in -person assessment. "More kids have more access to more providers this way," Dr. Wright explains. Examples of this include individuals who might not have had geographical access to a provider and/or those families who have mobility differences.
Also, there is something special about seeing a kid in their own environment that allows the provider to gain more insight into their everyday lived experience, including guardian-child relationships. In addition, seeing the child in their own environment offers ecological validity.
Q: What are the limitations of tele-assessment?
A: Research has shown that assessing before the age of 7 is discouraged because younger kids interact with technology in different (often less controlled!) ways. Additionally, the Autism Diagnostic Observation Schedule, or ADOS-2, is not something that can be done through a tele-assessment, as there are necessary in-person interactive components. Further, while tele-assessment can increase access to assessments for many, it does require adequate technology, consistent and reliable internet access, and quiet and private space, which not every kid has. As such, it increases access for many, but it also limits access for many of the most marginalized communities.