KWLG SAFETY PROCEDURES RE: COVID-19

June 2020

Overarching Principles

  1. We will follow federal (CDC, EPA)  and local (DC Government) recommendations for sanitizing and social distancing.
  2. We will minimize in-person exposure for clients and their families.
  3. We will minimize risk for our staff.
  4. We will respect trademark/copyright of psychological test publishers when considering remote and in-person testing modifications.

General Procedures

  1. Any service that can be provided virtually will, for the time being, remain virtual. This includes, but is not limited to, psychotherapy, tutoring, diagnostic interviews, and feedback sessions.
  2. We will limit occupancy of our office site to 10 people at any one time.
  3. We will minimize interpersonal contact among staff and clients by increasing physical distance, expanding waiting areas to unused offices, and coordinating transitions to reduce hallway traffic.
  4. Office surfaces and doors will be sanitized using an EPA-approved disinfectant spray which will be left on the surfaces for five minutes to dry.
  5. All materials will be sanitized before and after use.
  6. We request that families arriving for services do not bring more than one caretaker per child. Siblings who are not receiving a service are asked to stay home. Parents may wait in the waiting room during lengthy services, but are encouraged to wait outside of the office if they are comfortable doing so.
  7. Unfortunately we cannot allow snacks in our office space at this time. Clients with lengthy appointments may eat outside of the office, and appointments can be shortened to minimize the need for breaks.
  8. Staff will wear masks at all times and use hand sanitizer prior to touching materials. Clients will also be asked to wear masks in the office; we can provide disposable masks and gloves if needed.
  9. Staff will review their own health and will reschedule if they have a fever or symptoms of covid-19 (cough, shortness of breath, lack of taste or smell).
  10. Clients will be contacted on the day of their appointment to review possible covid-19 exposure and symptoms.
  11. Clients are asked not to attend in-person meetings with us if they have travelled
  12. All individuals entering our office space will be expected to have their temperature taken using a touchless thermometer. Those with a temperature higher than 100.4 degrees** Fahrenheit will be asked to reschedule.
  13. If staff or clients encounter known or suspected exposure to covid-19, they will be asked to refrain from entering the office until either 72 hours after fever and symptoms have resolved without medication, or 7 days after symptoms first appeared, whichever is later.

Neuropsychological Testing Philosophy

Given the inherent nuance and complexity of neuropsychological testing, we are using our clinical judgment to select modified procedures that we believe retain the integrity of the test measures used. We will balance the lack of research documentation regarding the impact of altering administration procedures on specific tests with the knowledge that delays may be harmful to the wellbeing of our clients. Families seeking testing will first undergo a detailed consultation to determine if the individual is appropriate for testing under the current conditions. Factors such as age, presenting concerns, and exposure risk will be evaluated. When possible, certain tests will be administered virtually via video conferencing. The bulk of neuropsychological testing, however, requires face-to-face administration and minimal modification. We will provide informed consent to clients that we are modifying standardized testing procedures and we cannot guarantee that the results are the same as would be found during a standardized administration. However, we believe that evaluations conducted during this time will yield generally valid and informative results.

General Procedures for Testing

  1. Families will have an initial consultation with a staff clinician to discuss current procedures, modifications, and whether testing is appropriate for their situation at the present time.
  2. Clients will complete an informed consent for testing via telehealth, as some portions of the neuropsychological evaluation can be conducted virtually. Potential concerns regarding access to adequate technology and privacy will be addressed.
  3. Intake interviews may be conducted virtually, in addition to family play observations when indicated. Parents should be present at the beginning of any virtual sessions with children to facilitate, but need not be present the entire time. A parent should, however, be in the home for the duration of any virtual appointment.
  4. Virtual testing sessions should be shorter than traditional in office sessions (around one hour at most).
  5. Hands-on subtests and paper-and-pencil tests will be administered in person. Also, tests requiring an audio recording may need to be completed in person. Autism evaluations will need an in-person session using the ADOS-2.
  6. In-person testing (conducted at our office site) will consist of the following safety modifications: A clear plexiglass sneeze guard will be placed between the tester and the client on a portable table. Visual material may be shown to the client through a portable monitor from a document camera attached to the clinician’s computer rather than using flip books. During some tests, such as ADOS-2, a face shield without a mask will be needed for both client and tester to determine eye contact. Clients will be provided with a folder with single use materials and a pencil that has been sanitized. Some materials will be placed in a plastic sheet protector which can be sanitized after use. Gloves are available and will be encouraged for use with certain manipulatives.