UPDATED JULY 15, 2021.
We have been closely monitoring state, federal and professional guidelines throughout the pandemic, as they inform how we are able to administer psychological and neuropsychological assessment. At the current time, state regulations continue to require that all healthcare practices in Massachusetts implement strict COVID-19 safety guidelines for in-person office visits. These include, but are not limited to, mask wearing by both client and clinician, regardless of anyone’s vaccination status, and maintaining social distance. We are not allowed to require proof of vaccination or refuse in-person services to the unvaccinated. This combination of rules creates the following issues for us:
1) Masking limits the amount of nonverbal information we are able to give and receive during testing sessions. The types of assessment we do are informed to an important degree by nonverbal social behavior such as facial expressions. While telehealth is not perfect, it allows us to continue to see a full range of clients’ facial expressions during evaluations. Further, some assessments involve the assessment of language skills and masks limit our ability to demonstrate and observe mouth movements during speech production. Seeing clients with masks would reduce the amount of valuable facial information we could obtain for the evaluations.
2) We would be unable to maintain social distancing during assessment procedures in our office. Psychological and neuropsychological assessments were originally designed to be administered in close proximity to the client for extended periods of time. This limits our ability to adhere to social distancing guidelines during in-person testing. However, most of the potential issues can be bypassed by using telehealth instead.
3) We do not want to put clients at risk of exposure in our office.
a. The inability to ask for proof of vaccination, combined with the rollback of masking requirements in other settings, makes it difficult to monitor potential exposures of individuals coming into the office and, in turn, more difficult to assure the safety of all our clients.
b. We do not want to increase infection risk for those who cannot obtain vaccines at this time. A great deal of our work is with children under the age of 12 who are not currently eligible for vaccination.
4) Our professional organizations have encouraged us to continue using telehealth whenever possible, out of a responsibility for the public’s health.
For all these reasons, we feel that the best course of action is to continue with our telehealth practices that began in 2020 until we receive different guidance from the government and our professional organizations. We are committed to reducing the spread of Covid in our community and to providing the most informative evaluations we can within a series of practice options that all involve some modification from standard pre-Covid procedures.
We have been able to adapt most of our testing to telehealth. We continue to accept MBHP (a form of MassHealth) and self-pay for clinical cases and remain CPCS vendors for legal cases. We are not seeing children under age nine until we resume working in person, as we have found our ability to assess young children well via telehealth to be limited. Thank you for your understanding.