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School psychologists are expected to be experts in consultation, counseling, special education, mental health, threat assessment, and academic interventions. In districts with many school psychologists, these different roles may become differentiated across multiple folks. For example, one school psychologist might take on the counseling cases, while another one does the functional behavioral assessments, and yet another is in charge of developing all of the parent training materials. This type of role distribution is also seen in our assessment work. For example, one school psychologist might do all of the preschool testing, while another one does the bilingual testing, and yet another does the autism assessments.

This task differentiation occurs even though most school psychologists are originally taught to be generalists instead of specialists. To become specialized, practitioners often seek postgraduate professional development or supervision in their areas of interest. This training is then reinforced through extensive practice within their schools. Given this, school psychology specialists are usually available only in high population districts with sufficient staff and high caseloads.

Unfortunately, these types of specialized service providers are often not available in districts with lower populations. This is because low-population districts often employ a single school psychologist, or they contract services to an outside provider. Providing specialized school psychological services becomes even more complicated in low-population districts spread over large geographical areas. For example, one district in Alaska (North Slope Borough) spans almost 95,000 square miles but serves only about 2,000 students. By comparison, 39 U.S. states are geographically smaller than this one district. The North Slope Borough district, which is larger in land area than Wisconsin, does appear to have its own school psychologist (per website).

A compounding issue is that there are cultural differences found in rural districts that may not be found elsewhere. For instance, research shows that rural populations tend to have negative views on mental health, believing that people struggling with mental health are “faking and pretending,” they should “get over it,” and they are weak. They tend to believe that “God is all you need” to handle mental health issues, they view mental health issues with fear and shame, and they place negative judgement on mental illness (Crumb et al., 2019). Added to this are issues related to working with a large migrant farmworker population. According to the U.S. Department of Labor (2022), migrant farmworker families are likely to not have access to health insurance, to not speak English, and to not be documented to work in the United States. About 17% of these workers migrate from farm to farm throughout the year. The average total family income was less than $30,000 per year. These additional issues require culturally competent school psychologists.

So, what are some ways that a rural district might receive generalized or specialized school psychology services? Many rural school psychologists and psychological contractors have shifted to the use of teleassessment methods. Luckily both the American Psychological Association (2020) and NASP (2017) provide guidelines on the use of teleassessments. These recommendations cover issues such as test security, privacy, psychometric stability, interpretation considerations, and training requirements.

Several ethical concerns to consider, along with possible solutions, include:

Is the data obtained through teleassessment valid when considering changes in administration against the established standardization and normative practices?

• Challenges can be addressed most effectively when teachers and parents make contact at the earliest signs of struggle.
• Discussing issues right away allows teachers and parents the ability to develop a treatment plan quickly and effectively.

What ethical and legal issues arise from the use of a site-based confederate or testing assistant?

• Recommendation: Train confederates in the use of assessments.
• Recommendation: Conduct practice administrations with confederates prior to conducting the actual assessment.

How do we know that the child is not being prompted by another person in the room prior to responding?

• Recommendation: Have at least two cameras in the room.
• Recommendation: One camera will be facing the child, and another will be facing the room.

Are there any potential HIPPA/FERPA violations?

• Recommendation: Check the technology, physical space, and storage.
• Recommendation: Train anyone else working with the child on legal and ethical issues.

What linguistic issues might invalidate the data?

• Recommendation: Choose tests with professionally translated materials.
• Recommendation: Train any translators on the Translator Code of Ethics (American Translators Association, 2022), HIPPA/FERPA, and basic psychometrics.

What cultural issues might invalidate the data?

• Recommendation: Consider impact of cross-cultural differences between the examiner and the person being assessed.
• Recommendation: Consider issues such as rapport and willingness to open up in a teleconferencing format.

How are data derived from teleassessments interpreted?

• Recommendation: Examine data obtained through interpreters and teleassessment with caution and acknowledge the limitations of such data.
• Recommendation: Assessment results obtained through teleassessment and interpreters are described as such and are reported qualitatively.

The requirement for school psychologists as specialists is already here. This need is poorly met for rural districts. Although rural populations are discussed in more detail, many of the concerns and solutions discussed are applicable to any setting where school psychologists are providing specialized services to underrepresented groups.

References

American Psychological Association. (2020, May 1). Guidance on psychological tele-assessment during the COVID-19 386 crisis. https://www.apaservices.org/practice/reimbursement/health-codes/testing/tele-assessment-covid-19 American

Translators Association. (2022). Code of ethics and professional responsibilities. https://www.atanet.org/about-us/code-of-ethics/

Crumb, L., Mingo, T. M., & Crowe, A. (2019). “Get over it and move on”: The impact of mental illness stigma in rural, low-income United States populations. Mental Health & Prevention, 13, 143–148. https://doi.or/10.1016/j.mhp.2019.01.010

National Association of School Psychologists. (2017). Guidance for delivery of school psychological telehealth services. https://www.nasponline.org/assets/documents/Guidance_Telehealth_Virtual_Service_ Delivery_Final (2).pdf

U.S. Department of Labor. (2022). Findings from the National Agricultural Workers Survey (NAWS) 2019-2020: A demographic and employment profile of United States farmworkers (Research Report No. 16). https://www.dol.gov/agencies/eta/research/publications/findings-national-agricultural-workers-survey-naws-2019-2020