Children’s Clinical Services offers assessments through telehealth to maintain necessary services for children in Denver
Long before COVID-19, the Children’s Clinical team at Rocky Mountain Human Services (RMHS) knew that telehealth was a necessary piece of the puzzle for children in need of services and supports.
The team anticipated the need for virtual services for families and worked to ensure telehealth was an option in their toolbox. When stay-at-home orders were put in place as a result of the pandemic, the foresight and planning done by the team allowed them to continue offering assessments and services using telehealth with a minimal amount of disruption to families.
The RMHS Children’s Clinical team provides comprehensive assessments, consultation and intervention services. They are expert clinicians who use a multi-disciplinary approach to identify needs and offer individualized recommendations for intervention. For children entering the Early Intervention (EI) program, clinicians provide an assessment in five key skill areas: communication, physical/motor, social emotional, thinking and self-help. The assessment determines whether a child is eligible for EI and forms the basis of the child’s service plan.
Typically, the assessment is done in-person, by a team of clinicians with expertise in each of the five skill areas. As it became unsafe to continue in-person services, the Children’s Clinical team quickly moved to telehealth and started doing virtual assessments with families.
“Virtual assessments are the exact equivalent of an in-person evaluation,” said Julia Spratt EI Therapy Manager at RMHS. “There’s no difference in the quality of the clinical impression being used.”
The first step in the process begins with the RMHS Intake team, which works with the family to schedule the assessment and become comfortable with the technology and the process. This is reinforced by the service coordinator who starts the assessment, ensuring that family is not struggling with the tools and technology and can focus on their child and the assessment process.
Clinicians use a parent-coaching model to guide parents through the assessment via Microsoft Teams. The clinicians provide easy-to-follow instructions for parents during the assessment. They utilize props, such as baby dolls and giant mouth puppets to give parents visual examples of what they are asking during the assessment. Because parents conduct the assessment, children respond more naturally than they do when working with a clinician, who is unfamiliar to the child.
The change has not been without challenges. Reaching families without internet access or proper equipment is difficult and creates gaps for children in need, but work is being done to fill those gaps. Currently, Early Intervention Colorado is working closely with EI providers and is offering resources and options for families who have connectivity barriers. This includes some funding for the purchase of technology and the ability for some services to be offered over the telephone. The Early Intervention and Mill Levy teams at RMHS also have been working to determine ways that they can meet the needs of families during this challenging time.
“This is going to allow us to access more kids in an extremely equitable way,” Spratt said. In-person evaluations are not always the best option for families living in rural areas, living with compromised immune systems or who struggle to make the trip to the RMHS office during the week. Telehealth and virtual assessments will not replace in-person services, but they will give families another great option to conveniently access necessary supports.
“Telehealth is not meant to be a substitute for everyone but an option for certain people,” said Lindsay Washington, Children’s Clinical Psychologist Team Lead at RMHS. “Virtual assessments are another way that RMHS can increase accessibility and continue to meet families where they are.”
In addition to the virtual EI assessments, RMHS psychologists are exploring other options for telehealth use in the future.
The RMHS department of Developmental & Behavioral Health created a pilot program for clinicians to provide diagnostic evaluations of autism spectrum disorder through telehealth. This pilot program incorporated a new assessment measure developed by Vanderbilt University as well as information provided through Vanderbilt’s free webinars and materials for clinicians to facilitate assessment of autism spectrum disorder through telehealth.
RMHS plans to create more accessible options for Coloradans moving forward as they continue to develop innovative ways to reach people based on their individual needs.