Have you seen a doctor over telehealth yet? I’m guessing that prior to 2020, you hadn’t even considered it. Many things tend to stay the same until there is a major reason to change it. And COVID19 gave us a big, big reason to change how we are doing things. In my work as a psychologist, prior to 2020, I had done a handful of phone therapy sessions, but other than that, every appointment with clients was in person. Since March 2020, that has flip-flopped and I have seen almost all of my clients over telehealth.

And I have been delighted with how well this has gone. While a big part of me will be grateful to be doing some more typical appointments again when we can, I think many aspects of telehealth are here to stay, and for many, I think it can give families access to providers that otherwise may be unavailable for logistical reasons.

Here are a few awesome benefits of telehealth

Convenience

Convenience is a huge benefit of telehealth. If you can get the same care by logging into a website as you would driving somewhere that may not be close to your home, finding somewhere to park, waiting in a waiting room, and then meeting with the doctor, it is nice to be able to save time and manage your comfort.

Whether it is just you or you are bringing one or more children to be seen, logistics can be challenging and time-consuming. Figuring out childcare, directions to new locations, and dealing with traffic are all other things that are less of an issue with telehealth.

It allows for greater participation of family members:

When seeing clients in my office, it was most common for one parent to accompany a child for an evaluation appointment. With telehealth, it is so much easier to include other family members. A working parent can join in during a break rather than taking half a day off of work. Grandparents can join in from other states, and everyone can have a better understanding of how to support one another and work together in the best interest of the individual.

It is easier to spread things out:

If you are traveling 2-3 hours for an appointment and taking the whole day off to be there, you will likely be cramming everything possible into that day of testing, regardless of how you are feeling, how the child is acting, or how exhausting the process is. A significant benefit of telehealth is the ability to break things up into shorter appointments without all the logistical difficulties. This can lead to a better quality evaluation, since the psychologist is seeing the individual across different days, and is much less likely to be seeing them on either one of their best or one of their worst days.

It helps providers see how things are:

There is something about walking into a doctor’s office that brings out either the best or worst in people. Being in a strange environment tends to cause young children to act more shy and quiet than normal or to throw tantrums because they are uncomfortable. For older kids and adults, it can also be intimidating to be in an unfamiliar, potentially uncomfortable place. I have noticed that being able to talk to individuals in their own homes allows them to feel more comfortable and be more open with me. Some mental health conditions, such as autism, PTSD, social anxiety, and agoraphobia can make telehealth from home much more appealing because the setting is in your control.

As a psychologist, I don’t have to see you or your child experiencing tantrums or panic attacks to understand them. If a child is experiencing social or sensory difficulties, I should be able to observe these occurring in the home with the parent just as well as I could in an office and maybe even more so, because in the child’s typical environment, they are more likely to be acting the way they normally do! I would much rather you and your family be feeling well and be able to share because everyone is comfortable. In addition to comfort, it is helpful to see some of the dynamics from home as they occur. If a mother is constantly having to attend to a sibling’s needs or a father is constantly texting on his phone throughout the appointment, these can also inform recommendations and treatment.

Choice

Last but not least, telehealth enables individuals much greater choice in providers. Rather than relying on the surrounding geographic area, families can now select providers based on the right fit. Families can skip a long waitlist of their local testing center or choose a provider who specializes in the area in which they have concerns. This is an amazing time for individuals to be able to select a provider they can connect with.

All that being said, telehealth does not work for everybody. There are certain types of assessments which are more difficult or potentially invalid if they are not administered in person.

(Unfortunately, many of these tests may have the same concerns being administered using PPE, so in a sense, the administration of some tests, such as the ADOS, right now, is potentially problematic.). For an effective telehealth session, you need to have a very good internet connection and the flexibility to troubleshoot if needed on the day of the appointment.

Telehealth for ADHD Evaluations

Most computers come with webcams and microphones now, but some sessions may need additional components, such as an additional camera (calling into the same session with a phone or an iPad) or wireless headphones. Your provider should let you know in advance if there is anything particular about the setup you need to know.

Telehealth evaluations work very well with adults, teens, and many children. If children or adults can attend the Zoom session and follow directions, the ability to read a word, understand a pattern, or complete a math problem is not significantly different, whether the question is asked live in person versus over the computer.

With individuals with significant attention problems or low ability which impairs their ability to participate in a Zoom session, telehealth is probably not a good option. In these cases, it can be challenging to determine why they are performing poorly on tasks, and it is harder for the provider to make accommodations or manipulate the environment to test the limits of the person’s abilities.

Telehealth for Autism and Therapy

Telehealth also works surprisingly well with early childhood autism evaluations. Much of the information in autism evaluations comes from interviews and questionnaires about the child’s developmental history, strengths, and weaknesses, which is easy to obtain from parents over telehealth.

Observation of the child’s behavior is crucial, and I will argue that being able to observe the child interacting with their parent over a Zoom call is more relevant and representative of their typical functioning than interaction with a stranger with a face mask, face shield, and plexiglass partition on their desk. Parents often send me videos of concerning behaviors they have taken on their phone and parents and children are often very familiar with face timing or doing Zoom calls with family members, where it is not overly disruptive or distracting.

Telehealth works well with therapy too. Parent-Child Interaction Therapy (PCIT) traditionally uses a one–way mirror with the therapist out of the room for most of the session, watching and interacting with the parent through a wireless headset. This has been easy to adapt for telehealth, and sometimes seeing the dynamics at home can be even more beneficial to know how to support families!

Insurance has stated they are covering telehealth for now, and there seems to be more and more legislation to make this more accessible and permanent. I hope it is here to stay because I think there are significant benefits for many, but we shall see.

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Need an Autism Evaluation?

Dr. Jessica Myszak has over 10 years of experience performing psychological evaluations with children and adults. She offers both in-person and telehealth evaluations. In addition to seeing clients on the Chicago North Shore, she can work with families who reside in Alabama, Arizona, Arkansas, Colorado, Delaware, Florida, Georgia, Illinois, Kansas, Kentucky, Maine, Maryland, Missouri, Nebraska, New Hampshire, New Jersey, Nevada, North Carolina, Ohio, Oklahoma, Pennsylvania, Tennessee, Texas, Utah, Virginia, West Virginia, and Wisconsin! If you want to learn more about potentially working with her, you can contact her to start the process.