Assessment in the time of COVID-19

I have been completing neuropsychological (and psychoeducational) assessments for many years, and COVID-19 has certainly turned the assessment world on its head. I have been viewing webinars, following discussions on list serves, and speaking with my colleagues, and at this time, I feel there is no way to do an effective, high-quality virtual assessment with children and adolescents. Here are my thoughts on this.

With respect to the interview, questionnaires, report card review and feedback, that is easily done virtually. With respect to testing, there are some verbal measures and academics that can be done via video, and some aspects of working memory (the ability to take into mind, hold and manipulate information in order to solve a problem),  but very little for visual spatial skills, visual motor skills, processing speed, attention and executive skills. In addition, the normative data that we have right now is all for in-person testing (such that we are comparing your child’s results to other children their age who were seen in-person), and we do not yet know how comparable this is to remote testing. The few studies that have been done are on small groups, and again mostly focus on verbal and academic tasks. So, this would lead to a very limited and possibly inaccurate result. As well, because many of our measures are copyrighted, there are issues with sharing materials online. It is certainly a huge limitation in the assessment world that we are now fully aware of, and working towards solutions. However, those solutions are still in the process of development, and may take some years to be fully ready for use.

If an assessment is needed for mental health purposes, however, this can usually be done virtually. It requires an interview that can be done via video session, as well as completion of questionnaires that are all available online. Assessments for ADHD are a grey area, as some clinicians (like me) prefer to do some hands-on testing, but in the current situation, using interview, documentation (e.g. report cards) and questionnaires may have to suffice, especially when a child is immunocompromised. 

I hope this is helpful for parents looking for assessments for children at this time. Knowing the how’s and why’s of the decision to not offer virtual assessments is important. There are many changes in the office, including mask wearing, air cleaning devices, and regular disinfection of surfaces. Time may be needed to help children feel comfortable in the environment before the assessment takes place.