UC Riverside

Autism spectrum disorder (ASD) is a heterogeneous disorder characterized by social communication deficits and the presence of repetitive and restrictive behaviors. Early ASD diagnosis results in earlier interventions and is linked to a better long-term prognosis. The gold standard assessment tool for ASD evaluations is the ADOS-2, an in-person evaluation that elicits specific behavioral responses to predefined activities. However, the COVID-19 pandemic led to a need for telehealth-based ASD assessments. Several ASD assessment tools were developed; however, many were designed to assess young children. This preliminary study aimed to evaluate the accuracy and effectiveness of two telehealth assessment tools, TELE-ASD-PEDS and TELE-ASD-KIDS, compared to the ADOS-2. Clinician diagnostic impressions were further analyzed to determine if child and family variables influenced diagnostic impressions and clinician diagnostic confidence levels at the telehealth appointment. Additionally, family experiences were collected after each appointment to understand the assessment experience. The participants were assessed twice, once through telehealth and once in-person (N = 27), and were randomly assigned to one of the assessment styles first. The results showed promising outcomes for telehealth ASD assessments. There was an overall agreement between in-person and telehealth initial diagnostic impressions (66.7%). Accuracy varied with participant characteristics, as the telehealth assessments were more accurate in identifying true ASD diagnoses for younger and less verbal participants and more accurate in rejecting ASD diagnoses for older and more verbal participants. Regarding clinician confidence for diagnostic impressions, only a caregiver-reported ASD questionnaire significantly differed between certain and uncertain confidence levels of telehealth diagnostic impressions. These results indicate that more obvious ASD-related behaviors were related to higher clinician confidence in their telehealth diagnostic impressions. As for social validity responses, caregivers reported overall positive experiences of their telehealth experience. Family and participant characteristics did not impact the family’s assessment experience. These preliminary findings support the continued use of telehealth ASD appointments as a valuable option for families seeking ASD evaluations. Telehealth assessments may facilitate timely diagnoses for all families, regardless of location and background. Future research is necessary to validate and expand on these preliminary findings.