Telepractice and the WIAT-4
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 [ASPPB], 2013; Grosch, et al., 2011; InterOrganizational Practice Committee, 2020; Stolwyk, et al., 2020) to assist psychologists in decision making and ethical and legal practice issues.
The Wechsler Individual Achievement Test–Fourth Edition (WIAT-4; NCS Pearson, 2020) can be administered in a telepractice context by using digital tools from Q-global®, Pearson’s secure online-testing and scoring 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 WIAT-4 via telepractice; however, it is important to consider the fact that the normative data were collected via face-to-face assessment using Q-interactive. Telepractice is a deviation from the standardized administration, and the methods and approaches to test administration 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 help to present the entire WIAT-4 as would be expected in face-to-face administration mode. If a professional facilitator is not used, it may impact the workflow of the session, subtest selection, and available composite scores.
In times when social distancing is necessary (such as 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 with the help of an onsite facilitator who is not in a professional role (e.g., parent, guardian, caretaker) or, in some cases, without the help of any onsite facilitator. If the examiner determines that no professional facilitator is required, the examinee or other non-professional onsite facilitator can assist with technological and administrative tasks during testing, and they 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 patient’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 all examinees, such as for young examinees or for examinees with low cognitive ability or low levels of technological literacy and experience.
Professional and nonprofessional facilitators typically do not remain in the room with the examinee throughout the testing session. The examiner should plan to minimize (as much as possible) the need for the facilitator to remain in the room. In rare cases when the 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 facilitator’s role should be defined clearly by the examiner. The facilitator should only perform those functions the examiner approves and deems necessary. In any case, if a facilitator is necessary it is preferred that the facilitator remain accessible.
If using the response booklet is not feasible, the composite score selection is impacted. The following table presents the composite scores that can be obtained with and without response booklet use.
Full Administration | No Response Booklet | |
---|---|---|
Composite Score | Composite Score Available? | |
Reading | X | X |
Written Expression |
X | No |
Mathematics | X | No |
Total Achievement | X | No |
Basic Reading | X | X |
Decoding | X | X |
Reading Fluency | X | X |
Math Fluency | X | No |
Writing Fluency | X | No |
Oral Language | X | X |
Phonological Processing | X | X |
Orthographic Processing | X | No |
Orthographic Processing Extended (Q-interacive only) | X | No |
Dyslexia Index | X | X |
Conducting Telepractice Assessment
Conducting a valid assessment in a telepractice service delivery model requires an understanding of the interplay of a number of complex issues. In addition to the general information on Pearson’s telepractice page, examiners should address five factors (Eichstadt et al., 2013) when planning to administer and score assessments via telepractice:
Conclusion
The WIAT-4 was not standardized in a telepractice mode, and this should be taken into consideration when utilizing this test via telepractice and interpreting results. For example, the examiner should consider relying on convergence of multiple data sources and/or being tentative about conclusions. Provided that the examiner has thoroughly considered and addressed the factors and the specific considerations as listed above, the examiner should be prepared to observe and comment about the reliable and valid delivery of the test via telepractice. Materials may be used via telepractice without additional permission from Pearson in the following published contexts:
- WIAT-4 manuals, digital stimulus book, digital Oral Reading Fluency booklet, and response booklet via Q-global
- WIAT-4 via Q-interactive (requires advanced technology skills and mirroring software)
Any other use of the WIAT-4 via telepractice is not currently recommended. This includes, but is not limited to, scanning the paper stimulus book, digitizing the paper record forms, holding the stimulus book or the Oral Reading Fluency booklet physically up in the camera’s viewing area, or uploading a manual onto a shared drive or site.
References
American Psychological Association Services (APA Services). (2020). Guidance on psychological tele-assessment during the COVID-19 crisis. (2020). https://www.apaservices.org/practice/reimbursement/health-codes/testing/tele-assessment-covid-19?fbclid=IwAR1d_YNXYS2Yc5mdIz_ZIYSkrrJ_6A9BQeKuIHxEEjjRh1XDR6fOYncM3b4
Association of State and Provincial Psychology Boards (ASPPB). (2013). ASPPB telepsychology task force principles and standards. https://cdn.ymaws.com/www.asppb.net/resource/resmgr/PSYPACT_Docs/ASPPB_TELEPSYCH_PRINCIPLES.pdf
Eichstadt, T. J., Castilleja, N., Jakubowitz, M., & Wallace, A. (2013, November). Standardized assessment via telepractice: Qualitative review and survey data [Paper presentation]. Annual meeting of the American-Speech-Language-Hearing Association, Chicago, IL, United States.
Grosch, M. C., Gottlieb, M. C., & Cullum, C. M. (2011). Initial practice recommendations for teleneuropsychology. The Clinical Neuropsychologist, 25, 1119–1133.
Interorganizational Practice Committee [IOPC]. (2020). Recommendations/guidance for teleneuropsychology (TeleNP) in response to the COVID-19 pandemic. https://static1.squarespace.com/static/50a3e393e4b07025e1a4f0d0/t/5e8260be9a64587cfd3a9832/1585602750557/Recommendations-Guidance+for+Teleneuropsychology-COVID-19-4.pdf
NCS Pearson. (2020). Wechsler Individual Achievement Test (4th ed.).
Stolwyk, R., Hammers, D. B., Harder, L., & Cullum, C. M. (2020). Teleneuropsychology (TeleNP) in response to COVID-19. https://event.webinarjam.com/replay/13/pyl2nayhvspsp09
Telepractice–Face-to-Face Mode
See Table 1
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Cullum, C. M., Hynan, L. S., Grosch, M., Parikh, M., & Weiner, M. F. (2014). Teleneuropsychology: Evidence for video teleconference-based neuropsychological assessment. Journal of the International Neuropsychological Society, 20, 1028–1033.
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A customer reflects on using Q-global digital stimulus books and manuals:
Q-Global has been a great solution for us. Managing testing materials between a variety of sites and districts could be very tricky. The online testing materials have completely resolved any access challenges we faced. Observing and recording the client's response through telepractice continues to require a good deal of coordination- particularly for pointing activities. However, the clinician being able to directly manage test stimuli and present them to the client through screen share technology makes that process much less cumbersome.
Thank you for being so proactive with making your tools accessible to telepractitioners!
Nate Cornish, MS, CCC-SLP
Clinical Director
VocoVision