Characterizing Available Tools for Synchronous Virtual Assessment of Toddlers with Suspected Autism Spectrum Disorder: A Brief Report

Abstract

The COVID-19 pandemic, and associated social distancing mandates, has placed significant limitations on in-person health services, requiring creative solutions for supporting clinicians engaged in the diagnosis of autism spectrum disorder (ASD). This report describes the five virtual instruments available at the time of manuscript development for use by experienced clinicians making diagnostic determinations of ASD for toddlers across the 12- to 36-months age range. We focus on synchronous virtual assessments in which clinicians guide the child’s caregiver through a range of assessment activities and observe spontaneous and elicited behaviors. Assessments are compared on dimensions of targeted behavioral domains, specific activities and presses employed, scoring approaches, and other key logistical considerations to guide instrument selection for use in varied clinical and research contexts.

Transitioning to Telemedicine During COVID-19: Impact on Perceptions and Use of Telemedicine Procedures for the Diagnosis of Autism in Toddlers

“…Prior to COVID-19, barriers such as geographic distance, lack of qualified providers, and cost in terms of time and financial resources (Bishop-Fitzpatrick & Kind, 2017;Mazurek et al, 2014) prompted some groups to investigate tele-assessment options. The onset of the COVID-19 pandemic, including suspension of in-person appointments and ongoing social distancing requirements in clinic settings, hastened tele-assessment uptake (Berger et al, 2021;Jang et al, 2021;Wagner et al, 2020). Alfuraydan (2020) reviewed 10 studies investigating ASD tele-assessment from 2000 to 2019.…”

Feasibility and acceptability of a telehealth model for autism diagnostic evaluations in children, adolescents, and adults

“…Echoing these concerns, a recent report undertaken during the pandemic characterized the available tools for synchronous virtual assessment of toddlers. The authors identified the need for additional research to better understand the populations for whom telehealth evaluations are feasible and appropriate and to track the experiences of clinicians and families using telehealth (Berger et al, 2021). Data collected from telehealth diagnostic models during the pandemic can inform efforts to improve the deployment of telehealth methods and may have implications for expanding the use of telehealth to increase accessibility to underserved populations and improve patient care.…”

Rethinking autism spectrum disorder assessment for children during COVID‐19 and beyond

“…The shift to fully remote evaluations may result in a cohort of trainees across disciplines with limited “hands‐on” experience serving children with ASD and their families. Although there are several excellent tools and assessments available (Berger et al, 2021 ), clinical judgment based on observations from face‐to‐face assessments (integrated with parent/caregiver report) is paramount in ASD diagnosis. Ultimately, the impact of the shift to remote assessment over the last year on trainee development of clinical expertise remains to be evaluated.…”

“…Traditional face‐to‐face ASD assessments, which were associated with extremely long wait times before COVID‐19, have become more difficult to access, or entirely untenable in some settings. Many clinical programs have adapted to these constraints, leveraging telehealth‐based approaches that were developed pre‐pandemic (Corona et al, 2021 ; Schrader et al, 2020 ) or adopting novel online “virtual” screening and assessment models (Berger et al, 2021 ; Jang et al, 2021 ). Positive aspects of telehealth models include easier access for some families living in remote locations or with complex schedules, as well as multiple opportunities to observe children in their familiar home environment with other family members such as siblings (Ameis et al, 2020 ; Wagner et al, 2020 ).…”