Remote Testing for ADHD and Dyslexia

We are now nine weeks into the COVID-19 pandemic, and it has completely changed the way we do business, socialize, learn, teach, and pretty much everything else.  While many states have begun to re-open businesses, they are still operating in limited conditions, particularly those involving in-person meetings.

Neuropsychological testing is the basis for most diagnoses of learning disorders and ADHD.  Typically I conduct evaluations in-person in one session that lasts about 2-3 hours.  But in early March that option went out the window.  At the same time, private school admissions season was ramping up.  Many admissions offices require updated neuropsychological testing for prospective students, so I typically see an influx of testing inquiries during the spring.  So, I had to improvise.

Thankfully the Texas State Board of Examiners of Psychologists (TSBEP) already allows telehealth practices.  However, this was something I was not overly familiar with, so immediately I had to dive in to determine what was allowed under these guidelines.  It is apparent that evaluations for ADHD and learning disorders is indeed allowed, as long as the clinician uses best practices that are valid and reliable.

To date I have only administered two evaluations remotely.  But I’m happy to say that they have both gone very well.  Both clients were very pleased with the process and the outcome.  In some ways, it is easier to administer assessments remotely, and it certainly saves everyone time.

Now that I’ve completed two full evaluations, I want to share what I’ve learned.

Zoom works

I was already pretty familiar with Zoom since our school has used it daily during the last nine weeks to conduct conference calls and interviews, so I had a good idea what to expect.  However, I was not so sure my clients would be as comfortable sitting in front of a computer screen for that long.  But in both instances, the students I worked with navigated Zoom perfectly.  It really is an easy program to use, and setting up Zoom calls is quick as well.  I give Zoom an A+ for how they’ve responded to this entire siutaiton.

There are some limitations

Even though Zoom is an excellent program, there are limitations in regards to testing.  For instance, one of the tasks utilizes blocks that the patient must manipulate.  Of course doing so remotely does not allow for the manipulation of blocks.  But there are ways around this limitation.  Many of the assessments allow the examiner to substitute other tests for the ones that do not work remotely.

Additionally, no matter how clear your computer screen is, there will come a time when it is difficult to see exactly what’s on the screen.  I remember on one particular task, a student had to identify particular colors.  It was very difficult to distinguish between green and blue on that particular task, so I had to stop every few items to make sure the student was doing it correctly.

Must keep sessions short

I know firsthand how tiring Zoom meetings are.  There is something about the multi-person interaction via computer that is draining.  After about an hour I feel myself tuning out no matter how engaging the topic being discussed.

Knowing this, I intentionally limit Zoom testing sessions to 1-1 ½ hours.  This requires that the student and I work together over two days.  However, neither of the students I worked with seemed opposed to it, and in the end it was definitely better to let them have a break after 1-1 ½ hours.  When figuring in the absence of driving to a from the appointment, we actually save time doing the testing via Zoom, even when it is over 2 days.

Gain valuable perspective of a student

It cannot be understated how important my observations during the evaluation are to the overall diagnosis.  Working with a student in person allows me to watch body language, facial expressions, foot tapping, and many other signs indicative of learning challenges.  When working online, however, it is much more difficult to pick up on these types of things.

Nevertheless, I saw many other characteristics during our Zoom sessions that I normally would not during in-person assessment. Watching a student’s attention span in front of a computer gives valuable insight into potential ADHD.  It is also great to see a student work in their own environment rather than a testing site.

Results are valid

Most importantly, the results of both evaluations have been reliable and valid.  I would never want to conduct an evaluation that did not provide useful information and a valid diagnosis.  But in both situations, I felt as confident in the process and outcome as I would have in person.  And both families agreed that the report and the diagnosis was spot on.

The reports I write always have 504 accommodations for public school in mind.  I also write reports with College Board and ACT in mind so that kids have an opportunity to qualify for accommodations on the ACT and SAT and AP exams.  Remote testing still allows for such reports.

Overall the testing experience via Zoom has been great.  Even when this pandemic is over and we are allowed to return to in-person testing, I will likely keep this as an option for clients.  It is an efficient process that reduces anxiety for some students and allows parents flexibility in when they schedule appointments.

If you suspect your child is struggling with attention, focus, concentration or any forms of reading, writing or math disorder, please contact me about a possible remote evaluation.