A scoping review of telehealth diagnosis of autism spectrum disorder

Abstract

Background Considering the COVID-19 pandemic, understanding the reliability, validity, social validity, and feasibility of using telehealth to diagnose ASD is a critical public health issue. This paper examines evidence supporting the use of telehealth methods to diagnose ASD and outlines the necessary modifications and adaptations to support telehealth diagnosis. Methods and procedures Studies were identified by searching PubMed and PsychInfo electronic databases and references lists of relevant articles. Only peer reviewed articles published in English with a focus on using telehealth for the purposes of diagnosing ASD were included. Searches were conducted through June 3rd, 2021. Outcomes and results A total of 10 studies were identified as meeting inclusion criteria. Of the eight papers that reported on reliability (e.g., accuracy), telehealth methods to diagnose ASD were between 80–91% accurate when compared with traditional in-person diagnosis. Six studies reported on validity (i.e., sensitivity and/or specificity). All six studies calculated sensitivity, with values ranging from 75% and 100%. Five of the six studies calculated specificity, with values ranging from 68.75% and 100%. The seven papers that reported social validity indicated that caregivers, as well as adult participants and clinicians, were mostly satisfied with telehealth. Feasibility was reported by seven studies and suggests that telehealth methods appear largely viable, though some challenges were reported. Conclusions and implications Although findings reviewed here are promising, more research is needed to verify the accuracy, validity, and feasibility of utilizing telehealth to diagnose ASD. Studies with larger sample sizes and samples across sites will be critical, as these will allow clinicians to identify subjects most likely to benefit from telehealth as well as those more likely to require an in-person assessment. This research is important not only due to the current pandemic, but also due to increased prevalence rates of ASD and an insufficient number of diagnostic providers—particularly in rural and/or otherwise under-served communities.

Expectations and Concerns about the Use of Telemedicine for Autism Spectrum Disorder: A Cross-Sectional Survey of Parents and Healthcare Professionals

“…Observing children exclusively in a predictable and home-like environment could mask these dysfunctional behaviours. According to the literature, most healthcare professionals believe that telemedicine cannot replace face-to-face interaction and that changes to traditional practises are needed to adapt them for telemedicine [ 75 ]. Although the American Telemedicine Association has issued general guidelines for the use of telemedicine in mental health assessment [ 76 ], similar specific guidelines have not yet been developed for the ASD population, nor have standardised tools been specifically developed and validated specifically for the diagnosis of ASD using only technological modalities.…”

“…Although the American Telemedicine Association has issued general guidelines for the use of telemedicine in mental health assessment [ 76 ], similar specific guidelines have not yet been developed for the ASD population, nor have standardised tools been specifically developed and validated specifically for the diagnosis of ASD using only technological modalities. For example, although ADOS is considered one of the “gold standards” for diagnosing ASD in face-to-face settings, not all of its items are appropriate for remote use (e.g., the imitation task, in which the ASD child is asked to repeat actions and behaviours performed just before by the healthcare professional) [ 75 ]. However, a new telematic assessment tool for ASD, called the Brief Observation of Symptoms of Autism (BOSA), has been developed and adapted by ADOS [ 77 ].…”

“…In addition, they also need to to prepare and send instructions and educational materials to parents prior to the virtual appointment. Parents, through parent training programs delivered by telematics systems, mediate intervention on their children [ 20 , 73 , 74 , 75 , 78 , 79 , 80 ], thus ensuring a more family-centred approach to care [ 81 , 82 ]. In contrast, few studies focus on distance interventions that directly target children and adolescents with ASD.…”

A systematic review of telehealth screening, assessment, and diagnosis of autism spectrum disorder

“…For example, Alfuraydan et al [ 3 ] reviewed the application of telehealth for ASD diagnosis but not for screening. Other reviews have mainly focused on the psychometric properties of telemedicine for ASD diagnostics [ 23 , 42 , 43 ]. For instance, Desideri et al [ 11 ] reviewed the application of telemedicine for the early screening of children with ASD under 6 years of age along with psychometric properties.…”

Incorporation of Telepsychiatry for Patients with Developmental Disorders into Routine Clinical Practice—A Survey of Specialty Clinics Adapting to Telepsychiatry During the COVID-19 Pandemic

“…Telepsychiatry assessment procedures used by Juarez et al, 2018, supported feasibility, accuracy, clinical utility, and high parent satisfaction in this population. Stavropoulos et al, 2022 , completed a review of ten studies. Results seem promising with reliability (accuracy) of 80–91% with high parent and clinician satisfaction in diagnosing ASD through telepsychiatry.…”