This week’s blog was contributed by Carrie Champ Morera, PsyD, NCSP, LP. Carrie is a licensed school psychologist and the lead project and content director at PAR. 

During in-person assessment sessions, you're in control of setting up the physical environment to make it conducive to success. When you work with children and adolescents via telehealth, specifically for teleassessment, you provide not only clinical services but also  guidance to prepare younger clients for their remote sessions. Failure to do so can interrupt telehealth treatment or teleassessment, decrease remote participation and engagement, and jeopardize the ideal conditions needed to establish rapport and build a therapeutic alliance.  

Here are 10 tips to consider as you design and maintain a working teleassessment environment with children and adolescents. 

1. Before your first remote session with your student, let them know what to expect. Replicate what you would do during an in-person session. 

2. Before beginning teleassessment, ensure your client has all the materials they need. We developed a checklist to help you get started, available here. 

3. Provide the client with a moment to adjust after entering the assessment space. Take your time. Children may need some time to orient themselves to the virtual space. 

4. Assess the environment. Ensure your client is in a quiet and comfortable environment, has a clear working space, and has minimal distractions. Be proactive and develop a safety plan. 

5. Establish boundaries and expectations. Expect the child or adolescent to come prepared for the session as if they were meeting you in person. 

6. Consider factors unique to teleassessment—for example, age. For younger children, testing sessions may need to be shorter depending on the type of task the test requires. 

7. Openly discuss technology and platform challenges. Discuss and plan for any challenges with internet connections and anything relevant to the platform you are using. 

8. Discuss any concerns about teleassessment. Though many individuals are comfortable with technology and using devices in general, they may be fearful or lack confidence about engaging in telehealth. 

9. Consider your physical environment and telehealth setup. Mimic your in-person setting as much as you can. Maintain neat dress, minimize distractions, display a clean background, use sufficient lighting, and have your technology devices and materials ready. 

10. Relationship is key! Go back to the basics. What helps you establish rapport when you're in person? Apply some of the same strategies when using telehealth. 

This week’s blog was contributed by Melissa Milanak, PhD. Melissa is a licensed clinical psychologist and internationally recognized academic. She has extensive clinical experience providing therapy and conducting assessments with a diverse array of patient populations. 

Learning more about assessment products can improve our ability to provide the best care for our clients, patients, and students. However, continuing education can also directly relate to other professional duties, such as keeping our license current and educating trainees. 

For example, when your job is to train future providers, having accurate, easily accessible resources not only saves time but also engages trainees in new and exciting ways. PAR’s Training Portal features product-specific videos, resources, and practical applications that can provide hours of didactic support for trainees. These tools are also ideal for established providers who want to learn more about a new product or get a refresher on an instrument they might not have used recently. PAR’s Training Portal is completely free of charge and available on demand, 24/7. New content is added regularly, so it’s good practice to check back frequently for information relevant to your practice. 

You can easily put products into practice using the 40% discount we offer on training materials that provide hands-on, practical experience. With PAR’s University Partnership Program (UPP), you can determine the tests that best fit your syllabus and get access to concierge support to design your own training (including PowerPoint slides, free test kits, and products), along with student discounts and faculty research discounts. 

In addition, as a licensed provider, you must receive continuing education (CE). Though requirements can seem arduous and tedious, it’s important for you to continually learn about the tools and practices that can best help your patients and clients—and it can often be an exciting way to learn about what’s innovative and new in the industry. Even gold-standard assessments are updated and renormed as the literature grows and new insights are uncovered. The key as a provider is to balance relying on the assessments we know and love and have served us well (and helped many of our patients and clients over the years) while also keeping current with updates and edits, new product offerings, and useful new applications of our reliable tools! 

PARtalks, our webinar platform, offers a vast array of CE sessions on products and applications. Featuring experts from a variety of backgrounds and topic areas, as well as insight from product authors and knowledgeable PAR staff, our webinars cover many topics relevant to psychological practice. Check out PARtalks frequently to see what webinars are coming up and which offer CE credits. And if you miss a live session, head back to the PAR Training Portal to view a recording. 

Whether you are working with trainees or looking to further your own education on a topic, PAR offers a number of options to help you! 

This week’s blog was contributed by Carrie Champ Morera, PsyD, NCSP, LP. Carrie is a licensed school psychologist and the lead project and content director at PAR. 

The increased use of telehealth—including teleassessment—has changed psychological assessment practices. Although many of us have adjusted our assessment practices to keep up with the times, we have to keep in mind that, when engaging in teleassessment, our practices must be ethical—just as if we were providing in-person assessment services. 

Here are 10 ethical considerations for practitioners to consider when providing services via teleassessment. 

1. Obtain informed consent. Just as you would do with in-person assessment practices, obtain informed consent prior to providing telehealth services. Informed consent is more than a form—it’s a process. 

2. Train and practice. Carefully review standardization procedures for the assessment. Practice the assessments several times using the technology and platforms with which you plan to administer them. 

3. Consult with colleagues. Talk about ethical dilemmas with colleagues, consult the literature, and continue to update your ethical guidelines. It’s important to lean on one another for practice, support, and guidance. 

4. Follow the publisher’s guidelines. PAR developed a statement on telehealth that addresses test security and measurement concerns. The integrity and security of the tests must always be maintained. 

5. Keep forms and data secure. Make sure paper protocols and electronic forms are stored securely. Consider password protections, encryption, and malware protection and keep backups. 

6. Establish and maintain professional boundaries. It can be tempting to relax your professional boundaries in a telehealth setting. Dress professionally, reduce distractions, and set clear expectations with your clients. 

7. Consider cultural factors. Consider the implications for clients from traditionally marginalized backgrounds or various socioeconomic and ethnic backgrounds or those with less computer experience. 

8. Document the use of digital and remote assessments. Include a statement in your report that assessment was conducted via telehealth. Record any technical issues, and disclose any modifications or alterations of standardized procedures. 

9. Consider the psychological effects of the pandemic in digital and remote assessment. We’ve seen a general increase in anxiety, depression, grief and loss, and isolation. Go beyond scores and evaluate individual item responses. Stressors all contribute to these psychological effects, perhaps now more than ever. 

10. Take advantage of PAR resources. We have many teleassessment resources and a wide selection of products available for administration, scoring, and/or interpretation on PARiConnect—and we are always adding more! Need to brush up on your teleassessment skills? Check out this video from PAR’s Director of Customer Support, Daniel McFadden, or visit the PAR Training Portal for more insight. You can use PAR products via telehealth technology while retaining the integrity and security of the measures. PAR has several tools available to help you navigate this challenge. 

Digital options to help us complete the work we do are increasingly important as digital interactions become more common in psychological assessment. We at PAR are committed to helping you serve your clients and recognize your increasing need for digital materials. Digital assessment options (like online and remote products, e-Stimulus Books, and e-Manuals) offer several benefits, including improved flexibility and support for your practice—whether you work in school, hospital, private practice, or other settings. Digital solutions can also provide increased accessibility and security in addition to environmental benefits like reduced use of paper. 

We want to provide you with more options for test administration (e.g., on-screen vs. paper-and-pencil) while reducing the number of materials you need for administration and addressing concerns about hygiene with printed materials. We are expanding our library of e-Manuals, e-Stimulus Books, and remote assessment tools and adding more products offering administration, scoring, and interpretation via PARiConnect. We now offer more than 100 e-Manuals, which are easily accessed from our new Digital Library in PARiConnect. These digital versions of PAR professional manuals are also downloadable (limited to a single user and device). See our full list of e-Manuals. 

Our In-Person e-Stimulus Books allow for easy, safer administration of stimuli via tablet and are designed for in-person testing sessions. Convenient and user friendly, these digital tools provide flexibility and confidence in testing and are hygienic and easy to clean. Visit parinc.com/e-stim to see what’s new. We also offer remote tests designed to be administered via videoconferencing. Learn more about our remote assessment solutions. 

Finally, our online assessment platform, PARiConnect, allows you to administer and score tests from most internet-connected devices. Designed in strict adherence with HIPAA, this flexible tool is adaptable for any organization, from small, solo practitioners to large, multilocation groups. More than 75 assessment tools are currently available, and we are continually adding new products. New to PARiConnect? Get three free uses just for signing up. 

No matter your setting, we have a digital solution that can help take your practice beyond paper and pencil! 

This week’s blog was contributed by Maegan Sady, PhD, ABPP-CN. In addition to being a licensed psychologist and board-certified neuropsychologist, Maegan is a project director in PAR’s research and development department. She worked as a pediatric neuropsychologist for nearly a decade before joining PAR. 

Psychological assessment allows for three types of clinical decisions: diagnosis, treatment planning, and measuring change over time. Assessment involves integrating information from multiple sources—tests, rating scales, observations, and interviews—to answer a given referral question and provide recommendations. 

To best serve clients and patients, providers should engage in evidence-based assessment (EBA; related terms include evidence-based medicine, evidence-based practice, empirically based assessment, and evidence-based instruments). EBA relies on scientific knowledge to help providers make clinical decisions. Although EBA has been a longstanding goal in psychology, clear documentation of EBA standards has been in place for only the past 15–20 years. 

Choosing reliable, valid assessment tools is the foundation of EBA. Basic psychometric strengths include representative normative samples, strong internal consistency, sound construct validity, and test–retest statistics (built-in change metrics are a bonus!). Because validity applies to the use of a test for a specific presenting problem in a particular individual, studies using discriminant function analyses and base rates identify the clinical utility of tests for given populations. 

To use an EBA approach, ask: What tools can I use to rule the proposed diagnosis in or out? For which related conditions do I need to screen? What else do I need to know about this client to recommend an appropriate treatment? Which tests are sensitive to change in the constructs being targeted? 

Increasingly more tools are available to providers to address real and perceived barriers to practicing EBA. Special issues of journals are devoted to using EBA for various conditions, books contain systematic reviews of instruments, and professional organizations have position papers on topics including serial neuropsychological assessment and effort/malingering. 

To keep up with advances in research relevant to your practice, create Google Scholar or PubMed alerts to generate periodic emails (use search terms like “evidence-based assessment,” “meta-analysis,” or “systematic review,” along with key disorders) and organize the literature in a free citation manager. For an informal approach, follow known researchers and EBA gurus and join social media groups for your clinical interests. Subscribe to professionally focused podcasts and queue up relevant episodes for your next commute, walk, or hammock session. 

At PAR, we aim to propel the growth of EBA by working with our customers to make it easier to search for information about tests and to collaborate on clinical data repositories. Visit the PAR data collection page for more information. 

Browse parinc.com/resources for training and supplemental materials, put our products to the test in your clinical research, and reach out to us if you have data on clinical samples. Though the initial adoption of EBA practices takes time and effort, you’ll see the results via more precise decision making and buy-in from clients. It’s never too late to jump on the bandwagon! 

June is Alzheimer’s and Brain Awareness Month, and it’s a great time to shed light on the impact of Alzheimer’s in our communities. About 6.5 million Americans age 65 years and older—or 1 in 9 people in this age group—live with Alzheimer’s dementia (i.e., dementia due to Alzheimer’s disease). This number is expected to grow as the baby-boom generation ages.  

Alzheimer’s is a progressive disease that causes problems with memory, thinking, and behavior in primarily older people. Average survival after diagnosis in people age 65 years and older is 4 to 8 years, but some individuals live up to 20 years with the disease. This takes a huge toll on both those living with Alzheimer’s and those who care for them. 

There are many ways to support people in your community who are dealing with the daily effects of Alzheimer’s disease: 

• Learn about the risk factors and incidence rates of Alzheimer’s. Visit alz.org to read facts and figures, find resources for help, and learn about advocacy. 

• “Go purple” in June to raise awareness. Wear purple, turn your Facebook page purple, and share your story on social media using the hashtags #ENDALZ and #GoPurple.  

• Contribute your time or money to organizations that support people living with Alzheimer’s, like the Alzheimer’s Association, the Alzheimer’s Foundation of America, or a local group.  

For more information about what you can do in June to highlight Alzheimer’s disease, visit https://www.alz.org/abam/overview.asp.   

Looking for products to assess dementia or Alzheimer’s disease? Learn more. 

This week’s blog was contributed by Sierra Iwanicki, PhD. Sierra is a clinical psychologist and project director in the research and development department at PAR. 

In the mid-20th century, humanistic psychology emerged in direct response to perceived limitations of psychoanalysis and behaviorism. Contrary to those earlier theories, humanism focused on the individual as a whole person, with the cardinal belief that perceived experiences fundamentally shaped us as human beings. In the 1940s and 1950s, clinicians began to encourage the collaborative use of projective instruments (e.g., drawings, Rorschach, TAT) to develop insight with clients. 

A few decades later, clinicians began to write about the use of psychological assessment within a humanistic frame. Ray A. Craddick criticized the approach of treating a “person primarily as a series of building blocks of traits, factors, habits, etc. [calling] the separation of man into parts…antithetical to both the humanistic tradition and to personality assessment.” Drawing from a phenomenological perspective, researchers like Constance Fischer first wrote about the “testee as a co-evaluator,” and later articulated a model of collaborative, individualized psychological assessment. In subsequent years, clinicians continued to write about the therapeutic benefits and collaborative approaches of assessment. 

In 1993, Stephen Finn coined the term therapeutic assessment to describe a semi-structured, systemized method for using assessment in a collaborative, therapeutic fashion. Since then, he and psychologists like Constance Fischer and others have promoted collaborative methods to conduct assessments. 

According to Finn and colleagues, defining elements of collaborative and therapeutic assessment include: 

• Having respect for clients (e.g., providing them with comprehensible feedback) 

• Taking a relational view of psychological assessment (e.g., acknowledging the vulnerability of clients in the assessment situation) 

• Maintaining a stance of compassion and curiosity rather than judgment and classification (e.g., fully understanding clients in all their complexity, not just summarizing them in terms) 

• Having a desire to help clients directly (e.g., not just providing helpful information to other stakeholders) 

• Taking a special view of tests (e.g., viewing tests as tools and results as ways to understand and help clients) 

• Staying flexible (e.g., conducting a home visit as part of an assessment) 

Fast forward to 2021: A multidisciplinary database search yielded more than 4,000 peer-reviewed journal articles related to psychological assessment as a therapeutic intervention, therapeutic assessment, or collaborative assessment. However, Kamphuis et al. note that the treatment utility of assessment has long been controversial, stipulating a broader view of relevant outcome metrics, more powerful research designs, and use of stepped assessment, taking into account the complexity of the patient’s psychopathology. Nevertheless, there is consensus that therapeutic assessment tends to yield more useful psychological assessment data as well as increase the effectiveness of assessment feedback. 

In fact, a meta-analysis found the therapeutic benefits of individualized feedback following psychological assessment yielded a notable effect size of .42. More recently, a meta-analysis compared well-defined therapeutic assessment compared to other forms of intervention and showed three areas where it was superior: 1) decreasing symptoms (effect size .34), 2) increasing self-esteem (effect size .37), and 3) fostering therapeutic alliance and engagement and satisfaction with treatment (effect size .46). Overall, 

research has shown that collaborative and therapeutic assessment is effective for adults, couples, children, adolescents, and families. According to the Therapeutic Assessment Institute, more than 35 studies have demonstrated that collaborative/therapeutic assessment is generally effective at improving outcomes for a wide range of clients with diverse clinical problems across various settings. 

The Therapeutic Assessment Institute was formed in 2009 to promote and coordinate training in Therapeutic Assessment. Learn more. 

This week’s blog was contributed by Maegan Sady, PhD, ABPP-CN. Maegan is a project director in PAR’s research and development department in addition to being a licensed psychologist and board-certified neuropsychologist. She worked as a pediatric neuropsychologist for nearly a decade before joining PAR. 

As we emerge from the pandemic, the need for flexibility in assessment is here to stay. The only way to begin to combat socioeconomic and technological disparities is to offer more options, but how do we do it? Several themes on flexible assessment have emerged from what we learned during the pandemic, and PAR is ready to help. 

Shifting formats 

Many psychologists have adopted a hybrid, in-person/telehealth assessment model, necessitating careful deliberation over personal and professional implications. Which tests can be given remotely, and what evidence is needed to make that decision? Which clients are a good fit for teleassessment? Which tests can be given while wearing personal protective equipment (PPE)? If we sit six feet away from our client, how do we indicate where to start on the response page? How do we assess patients who cannot travel and do not have high-speed internet? In essence, how can we answer every referral question without compromising our ethical obligations to our tests, our patients, and each other? 

Thankfully, timely guidelines emerged from the American Psychological Association; the Inter Organizational Practice Committee, which focuses on neuropsychology; and a new book, Essentials of Psychological Tele-Assessment. More recently, journal articles are beginning to present viable models for teleassessment and hybrid practice, both generally and for special populations (e.g., older adults, pediatric medical patients, historically underserved populations). Evidence is building that testing remotely or with PPE can be valid for many tests and within many populations. A few articles even address the impact of teleassessment on trainees, with recommendations for supervisors. 

Digital tools are more flexible 

Whether you’re testing someone face-to-face, from the next room, or fully remotely, electronic materials make life easier. Digital versions of more than 150 test manuals allow you to access administration and normative information from your home office and clinic any day of the week. Digital stimulus books, available for some of PAR’s most popular tests, allow you to cut back on the number of items you’re transporting and cleaning. They also make it easier to switch to a new test in the moment. To provide full remote administration options, we modified or specially designed eight performance-based tests for remote administration, and indirect evidence supports the remote utility of multiple others. 

To use these tools most effectively, you can find white papers and video demonstrations for digital and remote administration on our website. Our digital materials do not confine you to a single device type, and our E-stimulus books do not require Wi-Fi or Bluetooth. 

Screening as a model of care 

With longer waitlists, pressure to assess more patients in less time, and more complex presenting problems, screening approaches are becoming more valuable. Screening can assist with triage, and doing so within a telehealth format has been shown to reduce wait times, increase satisfaction, and lead to more timely intervention and referral. Questionnaire-only assessment can be an efficient way to make treatment recommendations for patients with primarily emotional or behavioral concerns. More than 60 rating scales are available on PARiConnect as well as in print, meaning this evaluation approach can save time whether it’s executed remotely or in-person.  

Screening in the context of a full evaluation allows you to cover more domains in less time. With 15 screeners/short forms of rating scales available on PARiConnect and several more in print, you can quickly add a measure of suicide risk, substance abuse, trauma, or depression to your battery. You can also use one of our performance-based screening tests to efficiently determine whether mental status, intellectual ability, or academic performance requires a closer look.  

New presenting problems 

In addition to new formats, testing is also changing in terms of content. Psychologists know all too well that the past two years have magnified or introduced multiple forms of stress and trauma, including anxiety, grief, effects of systemic racism, and food and housing insecurity. As a result, experiences of PTSD, depression, substance abuse, and parenting stress have increased. Adding a few extra measures to your test library is a good way to ensure you’re able to assess for a wide range of presenting issues. 

Validity 

With new procedures come new potential threats to validity. Practitioners must consider the integrity of testing remotely, in PPE, and under the general stress of a pandemic, in addition to more traditional considerations around effort and applicability of tests. There are creative ways to mitigate these threats, and we must document our efforts in our reports, citing limitations in interpretation where necessary. 

Poised for success 

In spite of challenges, psychologists have persisted. Testing settings are fluid, clinical conclusions have more caveats, and the list of areas for future research is longer than ever—but patients continue to depend on you. We have our work cut out for us, but together we can make psychological assessment more accessible, meaningful, and innovative. 

Learn more about our digital assessment options. 

April is Autism Acceptance Month, a time to not only recognize, but to open up and accept individuals with autism.  

Up until last year, this had been referred to as Autism Awareness Month. The Autism Society of America suggested by the name change to encourage people to move beyond awareness and into acceptance of those affected by autism. This change in mindset can help drive positive changes for individuals and families affected by autism.  

According to the Centers for Disease Control and Prevention, 1 in 44 children are diagnosed with autism. More than 7 million people in the U. S. are on the autism spectrum across all racial, ethnic, and socioeconomic groups. There is a growing need for first responder training and employer advocacy programs. For more information regarding these and other types of autism support, please visit the Autism Society.  

If you’re treating a child you suspect may have ASD or another developmental disorder, remember that PAR has products to assist you, such as the PDD Behavior Inventory™ (PDDBI™), the PDDBI-Screening Version, and the Behavior Rating Inventory of Executive Function, Second Edition (BRIEF2).   

There are additional free resources on the PAR Training Portal for those who specialize in assessing and treating autism or other learning disorders. Located under the Achievement/Development header, you can find a recorded webinar on how to use the PDD Behavior Inventory (PDDBI) on PARiConnect as well as an interactive course on the PDDBI family of products.  

This week’s blog was contributed by Theo Miron, PsyS. Theo is a licensed specialist in school psychology and a nationally certified school psychologist. He spent nearly 18 years providing psychological services to public school students in Minnesota, Arizona, and Texas. 

School psychologists in the U.S. report that completing student assessments is the task they perform most frequently. These psychoeducational and psychological tests are based on the basic principles of measurement theory, standardized testing, and normal distributions. Practitioners receive extensive training in measurement theory—maybe even to the extent that their dreams are filled with visions of the normal or bell curve. 

The normal curve is a fundamental concept psychologists use to help measure and explain student performance; that is, how a student functions in comparison to other children of the same age or grade level. We psychologists love to throw around the numbers associated with standard scores, percentile ranks, T scores, and scaled scores, knowing our fellow psychologists and well-versed teachers will know exactly what we’re talking about. Unfortunately, though, measurement theory is a relatively obscure field, so this type of language may puzzle parents, students, and clients. 

During my first few years as a school psychologist, I struggled to find an effective way to explain these types of results. As a visual learner, I thought adding visual aids to my results meetings might help explain the information more clearly. So one year, I harnessed my inner artist and drew a nice normal curve with standard deviations clearly marked out. I then headed to the copy machine and generated a hundred more. During results meetings, I’d break out my box of colored markers and a ruler and start mapping out the standard scores from the different tests I had given, with the normal curve as the back drop. Once done, I’d have a few marked-up normal curves for each measure the student had taken. 

Using these visual aids during results meetings helped both parents and teachers start to understand what the different scores meant. Not only did I receive some nice compliments on my “art projects,” but I also started noticing that more parents had questions and comments about the results. One parent explained she’d sat through several of these types of meetings over the years, but mine was the first one where she completely understood what the scores meant and how her child compared to other students his age. 

These days, you can keep your art supplies in your drawer. Simply log on to PARiConnect, our online assessment platform, scroll to the Quick Links section in the bottom right corner, and click Interactive Bell Curve.  

This new interactive tool allows you to enter relevant student data, and then add scores for up to three different tests on the same normal curve. You can enter the name of the specific assessment, the type of score you’d like to report (standard, scale, T score, or percentile), and up to 10 index or subtest raw scores. The system plots each score across the normal curve using vertical lines color-coded to the specific tests entered. When finished, you have a few options to explain results to parents, teachers, and clients: present “as is” on-screen, print out a paper copy, or print to a PDF file that can be presented (and shared) digitally. 

The interactive bell curve is a free feature available to every PARiConnect user, and it can be used for any test on the market—not just those published by PAR. So put those markers away, log on to PARiConnect, and try it out yourself. 

Learn more.  

Interested in or have questions about other assessment products for schools? Visit our school resources page.