Assessment of Children's Literacy via an Internet-Based Telehealth System

Objective: Interactive telehealth applications have potential for the assessment of reading disability in school-aged children. However, there is currently a lack of research on the validity of such applications. The aim of this study was to investigate the validity and reliability of an Internet-based videoconferencing system for the assessment of children's literacy on a battery of standardized assessments. Materials and Methods: Twenty children aged 8-13 years were simultaneously assessed in real-time both face-to-face and over a 128-Kbps Internet link. The assessments included eight subtests of the Queensland University Inventory of Literacy (QUIL), the South Australian Spelling Test, and the Neale Analysis of Reading Ability, 3rd edition (Neale-3). Results: The limits of agreement for the majority of raw scores fell within predetermined clinical criteria, with the exception of the QUIL nonword reading and nonword spelling measures and the rate score of the Neale-3. Weighted kappa analyses on the tests' scaled scores indicated very good agreement for all parameters (kappa 0.92-1.00). Percentage levels of agreement were adequate (above 80%) for most measures except for the nonword reading raw score of the QUIL and the reading error classification component of the Neale-3. Very good intra-and interrater reliability was determined for all online parameters (intraclass correlation coefficient 0.98-1.00). Conclusions: As issues with audio latency, break-up, and echo were observed, some modifications to the technology may improve system effectiveness and usability. However, the overall positive results of this study support the validity and reliability of the assessment of children's literacy skills via telehealth.