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TELEMEDICINE ASSESSMENTS AT POSSIBILITIES: Multi-Expert Teams Reaching Out Across Ontario

At Possibilities, it’s always been important to expand our reach, allowing us to provide highly expert and specialized assessments to individuals who need support finding answers. You want an accurate diagnosis—whether it’s for yourself or your child—and you know that finding experts who are highly specialized is hard. Accessing specialists when you do find them is hard too! At Possibilities, family physicians, pediatricians, psychiatrists, psychologists, psychological associates, and psychometrists play a role on our multi-expert Assessment Teams, combining their knowledge to make accurate diagnoses and effective Treatment Plans. It’s rare to find experts who all work together to consider information and make diagnoses. Telemedicine assessments allow our experts to work with you and your family anywhere in Ontario, no matter how remote.

No. Even before COVID-19, we were offering ADD/ADHD Assessments and physician appointments through secure Telemedicine sessions for individuals and families who were unable to travel to our Toronto office. When the COVID-19 pandemic began affecting Ontario, Possibilities transitioned all in-person appointments to secure video sessions to protect the safety of our clients and our community. We were able to continue most of our assessments and treatments over secure video appointments, providing uninterrupted help throughout the pandemic, and we continue to do so. Video sessions have allowed most of our services, such as ADD/ADHD assessments, coaching, clinical therapies, and tutoring services to continue to be provided, right from the safety of your home.

In the first few months of the pandemic, we began to transition our comprehensive Signature Assessment to a Telemedicine format. This assessment examines learning with psychoeducational testing, attention with direct testing, and mental health with clinical interviews and questionnaires. It’s completed by an Assessment Team with physicians, psychometrists, and psychologists or psychological associates. We consulted peer-reviewed research, a variety of testing manuals, and clinicians involved in the development of standardized tests, to determine how Learning Disability tests and associated cognitive measures could be adapted for secure video sessions while maintaining accuracy and safety. Our Telemedicine Signature Assessment, introduced in July 2020, has been successful and we will continue to provide it—even after the risk of the pandemic subsides. It has helped us make accurate diagnoses, secure in-school support for the students we see, and develop scientifically supported Treatment Plans to help prevent gaps from growing. Clients who cannot travel easily to Toronto benefit from the Telemedicine format as well. Without it, they wouldn’t have access to a comprehensive Psychoeducational Assessment that includes physicians who are experts in attention and mental health—in addition to the expertise the psychology team provides. With our new Telemedicine Signature Assessment Protocol, we can provide services to anyone with a computer and a high-speed Internet connection anywhere in Ontario—from Windsor to Kingston, Toronto to Barrie, Oakville to Ottawa, Oshawa to Thunder Bay, London to Sudbury, and Hamilton to Kitchener-Waterloo!

We recognize that some clinics have started providing in-person psychoeducational testing. However, because of the extended time needed for the psychoeducational component of our Signature Assessment, plus the back-and-forth sharing of booklets and other testing materials, we have concluded that in-person testing for Learning Disabilities at this time does not meet our highest standards for protecting your safety. Our team includes medical doctors—psychiatrists, pediatricians and family physicians—and our opinion currently is that the medical risks of in-person testing simply do not outweigh any hypothetical benefits. Whatever can be done safely and remotely, should be.

Yes, when we deem it is safe to do so, we will offer in-person testing to those who wish to travel to Toronto. It’s important to note that our testing sessions are only 2 to 3 hours at most—to help clients focus their attention during our assessments without getting tired and to increase our diagnostic accuracy.  So the 8 to 10 hours of psychoeducational testing needed for our Signature Assessment would require 4 or more trips to our office. For some clients, a hybrid model might work well with a mixture of video and in-person sessions. This hybrid option will only be offered when we deem in-person testing to be safe.

Our Signature Assessment combines an ADD/ADHD Assessment, a Mental Health Assessment, and a Learning Disability/Psychoeducational Assessment in an integrated package. If you’re familiar with the concept of a Psych-Ed, or a Psychoeducational Assessment, you can think of our Signature Assessment as a Psych-Ed/MD Assessment, or a Psych-Ed Plus Assessment. Why? Because a physician is always part of the Assessment Team—and that means attention and mental health will also be examined, in-depth with medical expertise, in addition to the learning needs assessed by a psychologist. Attention, mental health, and learning needs often go together. It’s essential to examine all of them so nothing gets missed.

We remain confident that our Telemedicine Signature Assessment Protocol continues to support our high clinical standards and diagnostic accuracy. Our diagnostic accuracy comes from our comprehensive approach and extensive testing. We never do Learning Disability Assessments in isolation—and that hasn’t changed with video testing. Our Signature Assessment will always look at more than just attention, or learning, or mental health alone. In fact, our Signature Assessment is a combination of an ADD/ADHD Assessment, a Mental Health Assessment, and a Learning Disability/Psychoeducational Assessment all rolled into one. All our assessments are also done by a Multidisciplinary Team that includes physicians, psychometrists, and psychologists with expertise in a range of diagnoses and treatments. Offering assessment services remotely doesn’t change our skill or expertise in diagnosis and treatment. Our experts on the Multidisciplinary Assessment Team will continue to consider all the information you provide, and the data we receive from testing, to make accurate diagnoses and scientifically sound recommendations.

Yes! First and foremost, remote testing minimizes your risk of exposure to COVID-19 and its variants as the pandemic continues. Being assessed in your own home might also be more comforting and reassuring to you or your child than being tested in an environment that is completely unfamiliar. Being tested in person these days—when the examiner and the examinee are separated with plexiglass and wearing protective equipment as assessment materials being exchanged are diligently disinfected—would likely be distracting and disconcerting, to say the least. Our remote testing offers a solution where these distractions and worries are not a concern.

Making adjustments for video testing has not meant compromising the depth or breadth of the assessments that we offer. With that being said, video assessments may not work for everyone. We have been able to conduct ADD/ADHD assessments successfully over video with very young children. The portion of the Telemedicine Signature Assessment that examines whether a Learning Disability is present is more extensive and requires multiple testing sessions. Nonetheless, we have had great success administering our Signature Assessment through Telemedicine with elementary, high school, and university students. For clients of all ages, our examiners do their best to accommodate any challenges and help testing proceed. If we feel that accuracy is compromised during the course of a video assessment, and that in-person testing may be beneficial and necessary, we’ll discontinue the video assessment. Often we can discern from the first part of the Signature Assessment—when attention is being tested in a shorter video session—whether the longer Learning Disability portion of testing over video will be possible.

If testing for Learning Disabilities using our Telemedicine Signature Assessment Protocol is not right for you or your family member, you still have options. You may proceed with the ADD/ADHD testing at our clinic, that includes a medical consultation around ADHD treatments. These are shorter assessment and consultation sessions offered over secure video appointments. Therapies with psychology, social work, speech-language pathology, and coaching can also be accessed at Possibilities, again through a secure video connection.

If you would prefer that the Psychoeducational component of testing be done in-person, we cannot provide you currently with a definitive timeline for in-person testing at Possibilities. If you need the psychoeducational component completed more immediately than we can provide, we recommend that you seek out clinics that have decided that in-person testing is currently safe enough. We recommend you contact the Learning Disabilities Association of Ontario to find alternative providers.

For any questions, email us at info@possibilitiesclinic.com or call 1-833-482-5558. We look forward to exploring possibilities with you!

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