The telepractice information in this document is intended to support psychologists in making informed, well-reasoned decisions around 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.
Psychologists 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.
Psychologists should use their clinical judgment to determine if assessment via telepractice is appropriate for a particular examinee, 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.
Several professional organizations and experts have provided guidance on telepractice assessment (American Psychological Association Services [APA Services], 2020; Association of State and Provincial Psychology Boards, 2013; Grosch et al., 2011; Inter Organizational Practice Committee, 2020; Stolwyk et al., 2020) to assist psychologists in decision making and ethical and legal practice issues.
The Kaufman Assessment Battery for Children–Second Edition, Normative Update (KABC-II NU; Kaufman & Kaufman, 2018) can be administered in a telepractice context by using digital tools from Q-global®, Pearson’s secure online testing platform. Specifically, Q-global digital assets (e.g., stimulus books) can be shown to the examinee in another location via the screen-sharing features of teleconference platforms. Details regarding Q-global and how it is used are provided on the Q-global product page.
A spectrum of options is available for administering the KABC-II NU via telepractice; however, it is important to consider the fact that the normative data were collected via face-to-face assessment. Telepractice is a deviation from the standardized administration, and the methods and approaches to administering it via telepractice should be supported by research and practice guidelines when appropriate.
Providers engaging in telepractice assessment may train facilitators to work with them on a regular basis in order to provide greater coverage to underserved populations (e.g., only two providers within a 500-mile radius, shortage of school psychologists within a school district). If such a facilitator is well trained and in a professional role (i.e., a professional facilitator), they can present manipulatives and picture cards as well as adjust audiovisual equipment. This approach yields all of the published KABC-II NU composite scores that are available in face-to face assessment mode. It is important to note that the published test structure for examinees age 3 differs from that for examinees ages 4–18. For this reason, regardless of administration mode (i.e., face-to-face or remote), the composite scores for examinees age 3 are always fewer in number than those for examinees ages 4–18.
In times when social distancing is necessary (e.g., during the COVID-19 pandemic), using a professional facilitator may not be safe or feasible. If testing must occur under these conditions, it is possible that the examinee may participate without the help of an onsite facilitator for most subtests. If the examiner determines that no facilitator is required, the examinee can assist with technological and administrative tasks during testing and should be oriented to these responsibilities prior to, and again at the beginning of the session. An initial virtual meeting should occur in advance of the testing session to address numerous issues specific to testing via telepractice. This initial virtual meeting is described in the administrative and technological tasks portion of the Examiner Considerations section and referred to in various sections of this document. The examiner should consider best practice guidelines, the referral question, and the examinee’s condition, as well as telepractice equivalence study conditions to determine if this is possible and appropriate. Independent examinee participation may not be possible or appropriate, for example, for examinees in certain age ranges (e.g., younger children), with low cognitive ability, or with low levels of technological literacy and experience.
If the examiner determines that the examinee cannot participate independently, and testing must occur under social distancing constraints, the only facilitator available may be someone in the examinee’s home (e.g., a parent, guardian, or caretaker). If the onsite facilitator is not in a professional role (i.e., nonprofessional facilitator), they can assist with technological and administrative tasks during testing and should be oriented to these responsibilities in the initial virtual meeting and again at the beginning of the session. The examiner should plan to minimize (as much as possible) the need for the nonprofessional facilitator to remain in the room. In rare cases when the nonprofessional facilitator must remain in the room, they should do so passively and unobtrusively, and merely to monitor and address the examinee’s practical needs, as well as any technological or administrative issues as necessary. The nonprofessional facilitator’s role should be defined clearly by the examiner. The nonprofessional facilitator should only perform those functions the examiner approves and deems necessary. In any case, if a nonprofessional facilitator is necessary it is preferred that the nonprofessional facilitator remain accessible.
A professional facilitator must be used to administer the following subtests for telepractice: Triangles, Rover, Story Completion, and Hand Movements. Omitting these subtests impacts the approach to deriving composite scores.
Under standardized in-person testing, for a 3-year old, only the global scale index—either Fluid-Crystallized Index (FCI) or Mental Processing Index (MPI), and the Nonverbal Index (NVI) are derived. For 4- to 18-year-olds, in-person testing and depending upon the model chosen, either the FCI or the MPI, the NVI and 4–5 scale indexes are derived (Simultaneous, Sequential, Learning, Knowledge, and Planning after age 7).
If a professional facilitator is not available and assuming all necessary subtests apart from Triangles, Rover, Story Completion, and Hand Movements are administered, substitution or proration may be used to obtain composite scores. Specific substitution rules are outlined in the KABC-II Q-global Manual on page 37 and proration guidelines appear on the subsequent page. The manual provides additional guidance on interpretive considerations. One substitution of a supplementary subtest for a core subtest is allowed. Proration is allowed for the global scale indexes, NVI, and for ages 4–6 only, the Simultaneous Index. Table 1 summarizes the available approaches to obtaining composite scores without Triangles, Rover, Story Completion, and Hand Movements.