The telepractice information in this document is intended to support professionals in making informed, well-reasoned decisions regarding remote assessment. This information is not intended to be comprehensive regarding all considerations for assessment via telepractice. It should not be interpreted as a requirement or recommendation to conduct assessment via telepractice.
Clinicians should remain mindful to:
- Follow professional best practice recommendations and respective ethical codes
- Follow telepractice regulations and legal requirements from federal, state and local authorities, licensing boards, professional liability insurance providers, and payors
- Develop competence with assessment via telepractice through activities such as practicing, studying, consulting with other professionals, and engaging in professional development.
Clinicians should use their clinical judgment to determine if assessment via telepractice is appropriate for a particular child, referral question, and situation. There are circumstances where assessment via telepractice is not feasible and/or is contraindicated. Documentation of all considerations, procedures, and conclusions remains a professional responsibility.
The Bayley-4 has two administration methods: The Social-Emotional & Adaptive-Behavior scales, questionnaires completed by parents or caregivers, and the Cognitive, Language and Motor scales, administered by a qualified professional through observation and direct interaction with the child.
For telepractice administration, The Social-Emotional & Adaptive-Behavior Questionnaires can be administered in 2 ways:
- using Q-global for Remote On-Screen Administration (ROSA) which does not require video contact;
- using Q-global for On-Screen Administration (OSA) via video-conferencing.
For ROSA, clinicians use Pearson’s Q-Global system to email a link (URL) to parents or caregivers who then use the link to access and complete the questionnaire using any internet connected device; upon completion the questionnaire is immediately ready for reporting in Q-global. For OSA, the items may be read aloud to the parent/caregiver using the guidelines on page 270 of the Bayley-4 Administration Manual. This requires the use of video-conferencing and screen sharing to allow the parent/caregiver to view the questions and responses as they are read aloud by the clinician. Details regarding the Q-global system and how it is used are provided on the Q-global product page.
Either approach allows the clinician to calculate raw scores and derive norm-referenced scores for the Bayley-4 Social-Emotional and Adaptive Behavior scales.
The Cognitive, Language and Motor subtests cannot be administered in a standardized format via telepractice. However, the clinician can interact with and observe the child via telepractice to obtain qualitative information on cognitive, communication and motor skills (e.g., attends to the clinician on camera, shifts attention when name is called, babbles, reaches and grasps objects etc.). The clinician can review the Bayley-4 items at the age-appropriate start point in order to identify developmentally relevant skills. Information can be obtained through observation or caregiver questions; however, items involving specific manipulatives cannot be administered remotely.
Refer to the Item Presentation Summary located in the Q-global resource library for full details of items for which information can be obtained through observation or caregiver questions. This document is also hosted in the Q-global resource library. Further guidance on using the document is available in the following recorded presentation:
Further guidance on developmental risk indicators is available in Appendix A of the Bayley-4 Technical Manual, and in Chapters 8, 9 and 10 of the Bayley-4 Clinical Use and Interpretation (Aylward, 2020).
This approach does not allow for calculation of scores for the cognitive, language and motor scales, but clinicians can use observations and information from the caregiver to inform their clinical opinion. The term “informed clinical opinion” appears in the regulatory requirements for the implementation of Part C of the Individual with Disabilities Education Act (IDEA) as an integral part of an eligibility determination. Using quantitative and qualitative information from the Bayley-4, along with information on the child’s developmental history, interviews with parents, and information from medical providers, social workers, and educators, clinicians can make recommendations about the child’s current developmental status and the potential need for early intervention.