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Presence Spotlight for Schools: Christine Limongello, MA, EdS, NCSP

A school psychologist transitions to teletherapy

How has the Presence online platform enabled you to help your students and the schools you serve in new ways?

When comparing testing remotely versus testing in person, I find that some students feel more comfortable using the technology and having that as a buffer during evaluations. A lot of students have high anxiety. They’re so used to technology at this point that I think sometimes their anxiety level decreases when therapy is through the computer versus when there’s someone sitting right in front of them, giving them an IQ test or asking them reading questions. It depends on the student of course—some students are better in person, but I find that a lot of students in this generation that’s coming up are very comfortable with all the technology so they don’t think anything of talking to this lady on the screen.

Since many of the areas I serve have limited resources, I am able to reach a large number of students in various areas to help meet their needs.

How do you build trust and rapport with parents?

Early on in my career, I realized that parents’ main objective is to ensure that those working with their child have their best interest in mind. I find that speaking from a child-centered approach is useful in conveying the message that we are all working collaboratively for the benefit of the child.

Parents are invited and attend the evaluation planning meetings most of the time so that’s a huge part of it. The parent is part of the team that gives us their own concerns. We go through each domain. For example, we’ll begin, “Are there any educational needs?” and everyone will respond. Then we’ll summarize, “Okay, these are the concerns. These are the evaluations that will be done.” Then we’ll go to language concerns and we’ll talk about that. So the parents are very involved that way. I speak with them by phone, I send them electronic scales to complete for adaptive skills, executive functioning skills, behavior and emotional development. It’s all electronic so as soon as they fill it out, I get an email saying they filled it out and I’m able to include their observations into the report, too.

Describe how you work with the Primary Support Person to support your students during therapy sessions, particularly those with more significant needs?

Currently, I have students in kindergarten through 5th grade. I have some older kids, too. But I also do the play-based assessments for preschoolers, so for that, I work closely with the PSP. Play-based assessments are done in a large play area and the occupational therapist, speech therapist, physical therapist, social worker, and PSP are all there. I’m on the camera so the PSP will move the camera so that we’re able to see everything, and it’s also helpful because if someone on the team is on maternity leave, they’re able to get the recording too, or watch remotely with me through the platform.

We’re able to see what skills a preschooler has to determine whether or not they qualify for special education. Preschoolers are a challenging population, just based on their age. And the fact that they most likely have special needs on top of that increases the challenges.

So the PSP is very instrumental with those assessments as well, just making sure I can see everything. And then afterwards we all meet as a team and discuss our observations. “Did you see that? Did you see this?”

If someone’s home sick, we do it remote. And as I mentioned, if somebody’s on maternity leave, then they’ll join me on the platform, too. During the pandemic we were all remote and we would all observe the parent and the child in their home.

What has your experience been completing evaluations via the Presence platform? How would you address any hesitation providers or schools might have about this evaluation modality?

When I was a lead back in 2019–2020 and we were getting new schools on the platform, they did question online evaluations. They would ask, “How comprehensive are the evaluations? Are you really able to capture the student strengths and weaknesses?”

But I think a good clinician knows how to ask the right questions. I don’t think being in the room is really the issue. It’s really about how you are using the information from staff, from parents, from your own observations, from scales. You’re bringing in all different types of information. So there’s really not much of a difference, I find, between on-the-ground versus virtual.

What advice would you give districts considering online therapy?

I would advise districts that online therapy can be a useful resource. By allowing teletherapists to complete evaluations and consultations, they can provide their on-site professionals more flexibility and availability to support the ever-growing mental health needs that affect so many children. Working in tandem is to the benefit of the children.

Ideally, districts will take the load off of their on-the-ground psychologists. Let them deal with this ever-growing mental health issue, and let us do the evaluations. I don’t need to be there to do that. I help out some of my local districts—and they’re just drowning in evaluations. They don’t do comprehensive evaluations. If I say, “Do you need scales?” they’re not doing scales because they don’t have enough time or resources to do them right now. So take that off of them.

Give us the evaluations. Let us handle that and let your on-the-ground psychologists handle the other issues. I would love to see that.

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