Telepractice and PEDI-CAT

Pediatric Evaluation of Disability Inventory Computer Adaptive Test (PEDI-CAT) - Telepractice and PEDI-CAT

Special recommendations for administering the PEDI-CAT via telepractice

 

The PEDI-CAT is a computer adaptive caregiver report which measures Daily Activities, Mobility, Social/Cognitive, and Responsibility. It’s designed for use with children and youth with a variety of physical and/or behavioural conditions. The PEDI-CAT can be administered in a telepractice context by utilizing Pearson’s Q-Global® software system. Details regarding the Q-global system and how it is used are provided on the  Q-global product page.

Briefly, the PEDI-CAT can be administered via on-screen administration (OSA) or remote on-screen administration (ROSA). With OSA, the examiner opens the test session on his or her computer and presents items to the informant. With ROSA, the examiner sends an email link to the informant, who opens the test session on his or her computer in a remote setting and completes the items him or herself. The examiner may or may not be present to watch the informant complete the items. ROSA is the simplest method for delivering PEDI-CAT via telepractice, but OSA may be appropriate in situations where the examiner must read the questions aloud and respond on behalf of the informant (e.g., if the informant is visually impaired or unable to read).

Conducting a valid assessment in a telepractice modality requires an understanding of the interaction between a number of complex issues.

In addition to the general information on our telepractice overview page noted above, professionals should address five themes(Eichstadt et al. 2013) when planning for administering the PEDI-CAT via telepractice:

1.Audio/visual environment

If you require video to view the informant during the administration, make sure the full face of the informant is in view. If you require audio interaction during the administration, make sure the audio is working as expected. Test the audio prior to the administration either through the informant’s speakers or headset and ensure a high-quality audio environment is present. Make sure the informant's environment is free from distractions.

2. Examiner factors

Practice the mechanics and workflow of assigning, starting, and completing the assessment using OSA or ROSA before you go through this process with an informant so that you are familiar with the administration procedures. If you are asking the informant to complete the assessment during a telepractice session while you are observing virtually, please note the audio/visual environment information above, and ensure that the session is set up appropriately to elicit a valid response from the informant. Ensure that the test taking session mimics an in-person session as closely as possible.

3. Examinee factors

As noted on the general telepractice page, ensure that a remote assessment administration is appropriate for the client and for the purpose of the assessment. Use clinical judgement, best practice guidance, existing research, and any available regulations in the decision-making process. Ensure that the person completing the rating forms has a working email address in order to access the forms. Emphasize to the informant(s) to follow the instructions as stated on the administration screen. Provide valid examiner contact information in case the informant has a question or problem with the online administration. Follow-up with the informant(s) may be needed if it does not seem that the assigned form is being completed in a timely manner.

4. Test/ test materials

The PEDI-CAT may be completed on a computer, tablet, or smartphone. As noted on the general telepractice page, if using remote administration, ensure that this format is appropriate for the client and for the purpose of the assessment. Provide valid examiner contact information so the assessment can function smoothly.

5. Other/ miscellaneous

If you are using videoconferencing software to view the informant completing the form, it may be advisable to ensure a facilitator familiar with using video-conferencing technology is onsite with the informant to assist with connecting to the video conference. If your clinical judgment deems it necessary to have a facilitator, he or she should also be trained in and able to provide emergency assistance should it be required during the test session for any reason, including if the informant should show any indication of personal distress during the assessment. Always state in your report that the test was administered via telepractice, and briefly describe the method of telepractice used. For example, "The PEDI-CAT was administered by remote on-screen administration through the Q-global system, and the examiner's facilitator monitored the administration using a live video connection."

Make a clinical judgment, similar to an in-person session, whether or not you are able to gather the best responses from the informant. Report your clinical decision(s) in your report and comment on the factors that led to this decision and your reporting or lack of reporting of the scores. For example:

"The remote testing environment appeared free of distractions, adequate rapport was established with the informant via video, and s/he appeared appropriately engaged in the task throughout the session. No significant technological problems were noted during administration, and the results are considered to be a valid estimate of the client's skills/abilities."

Or

“The informant appeared to understand the task and had no significant difficulties with the technology used to administer the PEDI-CAT. Results are considered to be a valid report and estimate of the client’s skills/abilities.” 

 

Selected Research to Date

Please refer to the following studies for considerations regarding telepractice:

Butcher, J., Perry, J., & Hahn, J. (2004). Computers in clinical assessment: Historical developments, present status, and future challenges. Journal of Clinical Psychology, 60, 331-345.

Haley S., Coster W., Dumas H., et al. PEDI-CAT: development, standardization and administration manual. Boston (MA): CRECare, LLC; 2012.

Henry, B.W., Block, D.E., Ciesla, J.R., et al. (2017). Clinician behaviors in telehealth care delivery: a systematic review. Advances in health science education, 22, 869–888 (2017). https://doi.org/10.1007/s10459-016-9717-2

Juárez, A. P., Weitlauf, A. S., et al. (2018). Early Identification of ASD Through Telemedicine: Potential Value for Underserved Populations. Journal of autism and developmental disorders, 48(8), 2601–2610. https://doi.org/10.1007/s10803-018-3524-y

Luxton, D. D., Pruitt, L. D., & Osenbach, J. E. (2014). Best practices for remote psychological assessment via telehealth technologies. Professional psychology: research and practice, 45(1), 27–35. https://doi.org/10.1037/a0034547

Russell M. et al (2003). Computer-Based Testing and Validity: A Look Back and into the Future. Technology and Assessment Study Collaborative, Boston College.

 

Conclusion

Provided that you have thoroughly considered and addressed all five themes and the special considerations as listed above, and based on the available research, there is little reason that you should have concerns about the reliable and valid delivery of the PEDI-CAT via telepractice as well as the use of the normative data. Document in your report that the administration was completed by telepractice. You may use the PEDI-CAT via telepractice without additional permission from Pearson in the following published context:

• PEDI-CAT Q-global On-screen Administration/Remote On-screen Administration and Report

Any other use of the PEDI-CAT via telepractice requires prior permission from Pearson.

 
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