Dr. Jordan Answers: Are Tele-Assessments and Teletherapy Really Valid? Exploring the Real-World Value and Impact in Schools

School districts continue to grapple with staffing shortages as they strive to deliver assessments, mental health counseling, speech therapy, and other special services to the students who need them.

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The statistics are overwhelming, and districts and schools are struggling to keep up:

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• 20% of all students have a learning difference. (source)
• 25% of special educators turn over each year. (source)
• 50% of a special education teacher’s workday is spent on paperwork. (source)

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We asked Parallel Learning’s chief clinical officer, A. Jordan Wright, Ph.D., ABAP, ABPP, to answer questions about the benefits of teleservices—which include tele-assessments, teletherapies, and remote instruction—and how districts can use them to better support teachers and students.

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In what ways can schools use tele-assessments, and for what purposes?

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Dr. Jordan: Schools can benefit from using fully-online, evidence-based testing to evaluate students’ most common learning and thinking differences, including:

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• Learning disabilities like dyslexia or other disorders of reading, writing, and math
• Attention-Deficit/Hyperactivity Disorder
• Emotional disturbances
• Intellectual disability

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Parallel offers virtual, cross-disciplinary, special educational services that include psychoeducational assessments. Based on a student's results, we make targeted and individualized recommendations to support the student, which can include (among other things) speech therapy, behavioral mental health counseling, or specialized academic instruction or coaching, all which Parallel can provide as well.

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How does the clinical quality of tele-assessments compare with in-person assessments?

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Dr. Jordan: The biggest question we get asked is whether tele-assessments are valid. I published research in 2018 and 2020 showing direct, specific evidence that tele-testing can be equivalent to on-site, in-person testing.

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An effective tele-assessment partner, like Parallel Learning, follows evidence-based tele-assessment procedures, as outlined and reviewed in Essentials of Psychological Tele-Assessment, which I wrote with a wonderful colleague, Susan Raiford.

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Assessments should closely approximate evaluations as they would be conducted in a traditional, in-person format. For example, in one study, we compared every single Wechsler Intelligence Scale for Children (WISC-V) subtest task a kid took in a tele-assessment with traditional assessment results. We discovered that it didn’t change the overall IQs that emerged from this test, whether they were taken in-person or remotely.

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There is a great deal of research supporting administration of many types of tests (though not every test) virtually. Tele-assessment uses the data from these tests–together with reviews of student records, surveys with teachers and parents, interviews, and observations–to assess students’ needs.

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Are there specific tests that cannot be performed through a tele-assessment?

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Dr. Jordan: Children under 7 seem to react differently in tele-assessments than they would with in-person tests, which skews—and invalidates—the data.

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There are also some tests that are play-based and require a great deal of in-person interaction. For example, there is a particular test in which students interact with bubbles. There’s no way for kids to interact with bubbles online in the way they would in real life. We can work with your school psychologist to help you determine what tests should and should not be taken online.

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Can tele-assessments screen for Autism Spectrum Disorder?

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Dr. Jordan: Tele-assessment can screen for signs and symptoms consistent with Autism Spectrum Disorder, though there are limitations to the types of tests tele-assessment can use. If a district requires the use of an ADOS-2 (an interactive, play-based measure), then an in-person evaluation would be required (or at least that particular test would need to be given in person). However, there are lots of other tools that can be effectively used to identify ASD.

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We gather information about the characteristics of autism through structured interviews, observation, and rating scales as part of a multidisciplinary school evaluation.

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How well does teletherapy work in schools?

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Dr. Jordan: Teletherapy refers to any remote therapy that connects a therapist to a client, typically using videoconferencing technology. Not only is it convenient, but research suggests that it works just as well as in-person therapy.

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• Teletherapy, telespeech therapy (tele-SLP), remote tutoring, and virtual remediation have been used and validated by research for several years.
  
  
• Speech therapy is very effective when it's done remotely, and research shows kids improve. Since the majority of interactions during a speech therapy session involve speaking aloud and listening—and don't require a lot of writing—it's well-suited to teletherapy.
  
  
• Delivered in a teletherapy setting, research shows that Cognitive Behavioral Therapy (CBT) performs just as well as it would in an in-person setting. In one study, researchers found that a particular type of teletherapy actually yielded more robust results than in-person services.
  
  
• If I were a school leader, I would invest in virtual executive functioning coaching to support elementary and middle school kids. When they can self-regulate, plan, organize, and get themselves in a state where they can focus, they’re better able to succeed academically.

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What are some ways in which schools can benefit from teleservices?

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Dr. Jordan: At Parallel, we’re dedicated to helping school districts get the resources they need to support different learners and thinkers.

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1. Teleservices allow more providers to be available to a school district and for kids to be seen more frequently and on demand. If a school counselor or SLP is already engaging in other important work at that moment, your kids can still have access to services if needed.

2. Using teleservices, schools can extend therapy to a student’s home. We can have the parents join in a way that’s much more accessible and equitable than if we were asking them to drive to a school.
   
   
3. We’ve found that teleservices can be more effective than in-person services in certain circumstances. Adolescents tend to feel safer and less vulnerable in a tele-environment. While we lose some information because we cannot see a kid’s entire body, because teletherapists are forced to focus entirely on the face, there are a lot of subtle facial expressions we might miss in person because we’re distracted by the rest of the body.

4. Finally, we provide a staffing solution for districts. We can help lift the burden from their in-school psychologists, who already work with too many kids. Teleservices also help reduce burnout, not just by reducing the workload of the school psychologists, but by allowing in-school staff to spend more time on aspects of the work they enjoy.

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It’s important to understand that not all teleservices companies are the same. When choosing a partner, district leaders should determine that the services the company provides align with best practices and research. To maximize their chance of success, school leaders should also look for companies that have a good track record of partnering with districts and are not simply a generalist solution.

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To learn more about tele-assessment research, read Dr. Wright’s white paper Psychoeducational Tele-Assessments for Schools.

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