Providing psychological services online was infrequent before COVID. Still, it became the only option for most people at the height of the pandemic. Therapy services were offered early in the pandemic, and psychological testing was adapted for telehealth. Now, there is often a choice, and consumers rightly ask, what are the pros and cons of obtaining mental health services in person versus remotely? And for psychological testing, how does the experience of remote testing compare to in-person testing? Are there compromises intrinsic to testing remotely?
One critical research finding that appears highly relevant to telehealth assessment is that testing performance is improved when it occurs in a familiar rather than a novel setting.
One critical research finding that appears highly relevant to telehealth assessment is that testing performance is improved when it occurs in a familiar rather than a novel setting. Too much anxiety negatively impacts performance, so factors that decrease stress are generally expected to improve performance. Research shows children test better in their own classroom than in a new, similar classroom, even in the same building (Cohen, M, 2019). We can extrapolate that they are more likely to perform to the best of their ability in their own home rather than in an unfamiliar environment. Informal feedback from children and parents who participate in telehealth assessment supports this, as they consistently report it is a relaxed, low-stress experience. If anything, the default assumption is that children will perform their best during remote testing in their home.
But what if your child hates remote learning? It is hard to know whether they dislike testing over Zoom because the activities are different. Most remote classroom instruction involves passive listening for long stretches. In contrast, psychological testing is highly interactive and requires back-and-forth exchanges throughout the testing. This is easier for most children and teens than attending to someone talking “at” them, as teachers often must do.
The other common concern for which we have good information is the adequacy of the testing instruments used in each setting. Overall, there are plenty of well-established, well-normed tests for all cognitive and academic functioning areas. This allows clinicians working remotely to confidently make critical diagnostic decisions about learning differences, specifically dyslexia, dyscalculia, dysgraphia, ADHD, and SLDs (Specific Learning Disabilities). Most schools trust results from telehealth assessments and use them to determine accommodations.
Most schools trust results from telehealth assessments and use them to determine accommodations.
At present, however, not every psychological test used for in-person testing has been adapted for remote testing. Two areas of functioning are more challenging to assess online than in person. Although it is not used in diagnosing any conditions directly, visual memory is one cognitive area that is difficult to evaluate remotely (it is sometimes included in neuropsychological testing). More importantly, autism testing is in the early stages of adapting to online administration. Consumers should be diligent if opting for a remote evaluationing provider. However, as remote assessment of autism becomes more established, it seems likely that these children may be one of the groups to benefit most from being tested in their homes.
For the vast majority of people, the experience of remote evaluations and the reliability and validity of the results compares favorably with those obtained during in-person testing.
In conclusion, for the vast majority of people, the experience of remote evaluations and the reliability and validity of the results compares favorably with those obtained during in-person testing (Rosen, V., Blank, E., et al., 2022; Ashworth, M, Pailikara, O, 2021). The choice of provider can usually be made based on practical issues such as time, money, convenience, waitlist times, etc. In most cases, it should not be driven by fears that remote evaluations for ADHD, dyslexia, and other learning differences sacrifice quality.
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