Telepractice and the CVLT–C, CVLT–II and CVLT3

Computers and connectivity

Two computers with audio and video capability and stable Internet connectivity—one for the examiner and one for the examinee—are required. A stationary web camera, microphone, and speakers or headphones are required for both the examiner and the examinee. It is recommended that the examiner have a second computer screen or paper format manual so he or she has the ability to view the Administration and Scoring Manual while maintaining view of the client.

Audio considerations

High-quality audio capabilities are required during the administration. An over the head, two-ear, stereo headset with attached boom microphone is recommended for both the examiner and examinee. Ensure adequate volume and voice clarity before beginning administration. Because a single word can’t be repeated during administration of a trial, adequate audio is required. Record any lapses in transmission or evidence of poor audio during testing to include in the report and consider in interpretation.

Audio check

Test the audio for both the examiner and examinee prior to the administration to ensure a high-quality audio environment is present. Testing the audio may include an informal conversation prior to the administration where the examiner is listening for any clicks, pops, or breaks in the audio signal that distorts or interrupts the voice of the examinee. The examiner should also ask the examinee and facilitator if there are any interruptions or distortions in the audio signal on their end.

Video

High-quality video (HD preferred) is recommended during the administration to allow full observation of the examinee. Make sure the full faces of the examiner and the examinee are visible using each respective web camera.

Peripheral camera or device

A stand-alone peripheral camera that can be positioned to provide a view of the session from another angle or a live view of the examinee’s progress is helpful. Alternately, the onsite facilitator may join the teleconference from a separate device (e.g., a smartphone with a camera or another peripheral device) and set it in a stable position to show the examinee’s pointing or written responses.

If using an onsite facilitator who is not in a professional role (e.g., parent/guardian/spouse), the examiner should use their professional judgment about the capacity of the facilitator to perform the required functions correctly and without interfering in the testing session. A parent/guardian/spouse does not typically remain in the room during testing except on rare occasions as described in the test manual, so it is necessary to train him or her how to place the peripheral camera/device in a stable position before beginning the session.

The facilitator should silence the audio and mute the microphone on any peripheral devices to prevent feedback. Instruct the facilitator not to capture video or take photos as this is a copyright violation.

Manage audiovisual distractions

As with any testing session, make sure the examinee’s environment is free from audio and visual distractions. If you are unfamiliar with the examinee’s planned physical location, meet virtually with the facilitator in advance of the testing session. Ask the facilitator to show the intended testing room and provide a list of issues to address to transform the environment into an environment suitable for testing. For example, remove distracting items, silence all electronics, and close doors. Ask the examinee and facilitator to close all other applications on the computer, laptop, or other device, and to silence alerts and notifications on the peripheral device. Ensure radios, televisions, other cellular phones, fax machines, smart speakers, and equipment that emit noise are silenced and removed from the room.

Lighting

Establish good overhead and facial lighting for the examiner and examinee. Close blinds or shades to reduce sun glare on faces and the computer screens.

Practice

During the telepractice setup, and before administering to an examinee, practice the mechanics and workflow of the entire test using the selected teleconference platform so that you are familiar with the administration procedures. For example, use a colleague as a practice “examinee.”

Standardized procedures

Follow the administration procedures of face-to-face administration as much as possible. For example, a word in the word list cannot be repeated within a trial in face-to-face administration; therefore, do not say it more than once in a telepractice administration. Plan ahead on how to address auditory glitches or delays as bandwidth and connectivity may interfere with standard administration and may require some adjustments to standard procedures. For example, if the connection is lost momentarily it may be appropriate to repeat a word that was not heard; however, all modifications like this need to be noted in your report and considered when applying norms obtained from in-person assessments. For clients with poor connectivity, consider whether online administration is appropriate.

Facilitator role and training

If a facilitator is utilized during the CVLT administration, their role for most telepractice assessments is largely to manage audiovisual needs and materials. Train the facilitator to troubleshoot audiovisual needs that arise during the testing session, including camera angle, lighting, and audio checks. Inform the facilitator to sit unobtrusively and silently out of the examinee’s view when not actively engaging in his or her role. In these cases, the facilitator’s role is not to manage rapport, engagement, or attention during the testing session and he or she is not to interfere with the examinee’s performance or responses.

If using an onsite facilitator who is not in a professional role (e.g, parent/guardian/spouse), you should use your professional judgment about the capacity of the facilitator to perform the required functions correctly and without interfering in the test session. You should communicate expectations about the facilitator’s role immediately prior to the testing session, when the examinee is not present, to ensure that nothing is disclosed to the examinee about the tasks. Do not allow the facilitator to show or warn the examinee about any portion of the test. Expect to provide verbal guidance to the facilitator during the testing session.

Any other roles and responsibilities for which an examiner needs support, such as behavior management, should be outlined and trained prior to the beginning of the testing session. The examiner is responsible for documenting all behaviors of the facilitator during test administration and taking these into consideration when reporting scores and performance.

Appropriateness

Ensure that a telepractice administration is appropriate for the examinee and for the purpose of the assessment. Use clinical judgement, best practice guidance for telepractice (e.g., Interorganizational Practice Committee, 2020), information from professional organizations, existing research, and any available federal or state regulations in the decision-making process.

Preparedness

Before initiating test administration, ensure that the examinee is well-rested, able, prepared, and ready to appropriately and fully participate in the test session.

Facilitator role

Explain the role of the facilitator to the examinee so participation and actions are understood.

Headset

It may not be appropriate or feasible for some examinees to use a headset due to behavior, positioning, physical needs, or tactile sensitivities. Use clinical judgement on the appropriate use of a headset in these situations. If a headset is not utilized, ensure your microphone and the examinee’s speakers are turned up to a comfortable volume 

Copyright

Pearson has provided a Letter of No Objection to permit use of copyrighted materials for telepractice via nonpublic facing teleconferencing software and tools to assist in remote administration of assessment content during the COVID-19 pandemic.

Record Forms

You can use paper record forms or the Q-interactive® platform to capture responses from examinees. Scores can be obtained through the Q-global platform; however, administration directions and recording of responses are available through the paper record forms or Q-interactive administration platform.

Equivalence Evidence

Telepractice Versus Face-to-Face Administration

The CVLT and similar verbal list learning and recall tasks have been studied in several studies comparing face-to-face administration with remote administration in examinees who are typically developing and those with clinical diagnoses (Barcellos et al., 2017; Cullum et al., 2006; Cullum et al., 2014; Galusha-Glasscock et al., 2016; Hildebrand, Chow, Williams, Nelson, & Wass, 2004; Kirkwood, Peck, & Bennie, 2000; Ragbeer et al., 2016; Stain et al., 2011; Wadsworth, Dhima, et al., 2016; Wadsworth, Galusha-Glasscock, et al., 2018). Other studies support equivalence of tasks that are highly similar to the verbal requirements of the CVLT (e.g., simple list learning tasks) with nonclinical and clinical examinees using telepractice compared with face-to-face administration and scoring (Galusha-Glasscock et al., 2016; Vahia et al., 2015). In addition, a meta-analysis of telepractice studies provides rigorous support for telepractice and face-to-face mode equivalence (Brearly et al., 2017).

Digital Versus Traditional Format

The CVLT has demonstrated equivalence across digital and paper administration in numerous studies; thus the most recent publication of the CVLT3 was collected completely via face-to-face digital collection. A number of investigations of the various forms of the CVLT have produced evidence of equivalence when administered and scored via digital or traditional formats to examinees without clinical conditions (Daniel, 2012).