Are Virtual Evaluations Effective?
Over the past few years, the rise of Zoom and other video conferencing platforms has transformed the way we interact and conduct business. Even post-COVID, many of my close friends work exclusively from home, where they connect with co-workers around the world. In fact, every other Friday, I join a teleconference of therapists located in Connecticut just to remain connected with them and to continue developing my network up there.
Although my practice in Texas consists mainly of in-person evaluations, I continue to receive requests for virtual evaluations, both in Texas and Connecticut. The three main reasons why clients request virtual evaluations are:
Convenience – scheduling virtual evaluations is much more flexible since it can be done anywhere and almost any time.
Geography – clients anywhere in Texas and Connecticut can receive a virtual evaluation.
Comfort – many clients, particularly adolescents, prefer the remote nature of a virtual evaluation.
Since I began offering virtual evaluations in 2020, I have grown increasingly comfortable with the testing process. When I first started, I had questions regarding the value, validity, and reliability of virtual evaluations. And parents often ask me: “Are virtual evaluations effective?”
Well, that question has been answered: YES! Virtual evaluations are not only valid and reliable, but they are also highly effective at identifying ADHD, dyslexia, dysgraphia, dyscalculia, and other social/emotional difficulties, such as anxiety and depression.
As early as Fall 2020, when it became clear that virtual evaluations would be necessary, researchers examined the effectiveness of remote neuropsychological examinations. Results of the study found that:
“Administering neuropsychology evaluations to children online in the comfort of their own homes is feasible and delivers results comparable to tests traditionally performed in a clinic, a new study indicates.”
Additionally, of the 58 children and adolescents who participated in the study, 94% of their caretakers and 90% of the clients stated:
“they were satisfied with home-based testing. If given a choice between remote or in-person, most indicated no preference.”
In another study in February 2021, researchers once again examined the “validity and clinical utility” of in-home teleneuropsychological evaluations. The study compared the effectiveness and experience of 111 virtual patients versus 120 in-person patients. With the exception of one particular assessment, the study found “[virtual] test scores did not significantly differ from in-person testing.” In general:
“These findings support the validity of in-home TNP testing compared with in-person neuropsychological testing.”
As COVID times have faded and the world has returned to “normal,” clinicians continue to rely on remote evaluations to deliver care and treatment to their patients. Not surprisingly, research into their effectiveness has also proliferated, as more and more families opt for this method.
In a more recent study conducted in 2023, researchers administered full neuropsychological evaluations to 28 subjects, including their general intellectual functioning (cognitive ability), memory and attention, executive functioning, language and information processing, and overall effort. An analysis of this study indicated:
“There was not significant difference between face-to-face administration of the neuropsychological battery compared with virtual administration for the majority of the tests used.”
Interestingly, the battery administered is almost exactly what I provide in my standard neuropsychological evaluation, both in-person and virtually. It is important to note, however, that the analysis also revealed some limitations in a few of the assessments, particularly those involving colors.
In a comprehensive review of the existing research, Tyler Brown and Konstantine Zakzanis found that:
“to date, the literature shows evidence for the reliability of remote administration . . . When and where needed, neuropsychologists, psychometric technicians and examinees may no longer need to be in the same physical space to undergo an assessment.”
Although virtual evaluations are certainly valid and can be very useful, careful consideration must be given before suggesting or providing such a format. I openly tell families they are not appropriate for everyone.
Nevertheless, as virtual and remote environments become more commonplace in our daily lives, I expect the demand for virtual evaluations only to increase. Personally, I have found that children, adolescents, adults, and parents find virtual evaluations surprisingly effective, convenient, and, in many cases, preferable to in-person. And, as we see above, research exists to confirm this.
If you or your child suspect you are experiencing difficulties with attention and focus, or if you suspect a learning disability may impact reading, writing, or math, a virtual evaluation may be the quickest, easiest, and most affordable path to identifying the underlying issues.