There is a hot debate going on right now amongst psychologists about whether psychological evaluations can be provided virtually during the COVID19 crisis. This is a big deal because face-to-face testing is clearly better than virtual testing; however, it is possible that we may need to make some exceptions during this crisis. It is also possible that some psychologists, and publishing companies, may use this crisis to make virtual test administration the ‘new normal.’ In our opinion at Psychological Solutions, this would be a disservice to the field and our clients. For us, the question is not; “Can we provide psychological evaluations virtually?”, but, “Should we provide psychological evaluations virtually?” We dug deep into this issue, considered the question from multiple angles, and would like to present our position on this matter.

First, can we provide psychological testing virtually? Yes, there is technology available to provide the measures that are most commonly seen in our field virtually (e.g., WISC-5, WAIS-4, Woodcock-Johnson Achievement, WIAT-3, MMPI, MACI.) In fact, the top publishers in the field (e.g., Pearson, Riverside) have recently provided digital administration materials for use during this crisis. Also, licensing laws, privacy laws, and ethical guidelines have been loosened during this crisis to allow for telepractice; this can vary state-by-state. 

However, this does not mean that we should provide psychological evaluations virtually, nor does it mean that the test results obtained in virtual administration are equivalent to results obtained in face-to-face testing. It is important to note that the tests have been standardized and normed based on face-to-face administration and not on virtual administration. Moreover, psychological evaluations are about much more than the test scores; they go beyond test scores to really ‘tell the story’ of how a student has ended up where they are at this point in time and what they need in order to move forward. The face-to-face interaction that occurs during testing and interview sessions is an important and informative part of the overall evaluation process.

That being said, face-to-face testing is not always possible during this crisis. In these cases, virtual administration should only be considered when students cannot wait for face-to-face testing and test results are needed for a pending and critical clinical decision. In these cases, the following should be considered:

• There is preliminary research on some measures (e.g. Woodcock-Johnson IV) suggesting that scores on virtual administration are equivalent to face-to-face scores; however, equivalency studies have not been completed on all measures. This should be considered in choosing the measures.
• The digital materials and procedures used during virtual testing should be provided by the publishing company to ensure that the tests are as close to standardization standards as possible. For example, psychologists using Pearson products should use the Q-Global or Q-Interactive platform rather than their own methods of digitizing the assessments.
• Not all tests can be completed online; for example, neuropsychological and autism spectrum disorder evaluations need a face-to face component (such as for the ADOS-2). In these cases, virtual administration could be used as a screening tool rather than for full conceptualization and diagnosis, with the face-to-face testing to be completed when possible. 
• Can the program provide the equipment, internet connection, and a facilitator to help and monitor the student during testing? Not all programs have a setting conducive to virtual administrations; for example, virtual administration is not a viable option at many wilderness programs. 
• Privacy and security should be carefully considered and HIPAA regulations maintained.
• Parents/clients need to provide informed consent and changes to standardization documented in the report. 
• Virtual administrations should not be provided only because they are more convenient.

Bottom line: While it is possible to provide a basic psychological evaluation virtually, this option should be used as a last resort when testing cannot be face-to-face because of COVID19, and when a time-sensitive clinical decision needs to be made based on the test results.

Tracine Smoot, PhD, Licensed Psychologist – April 8, 2020