Toward Novel Tools for Autism Identification: Fusing Computational and Clinical Expertise

Corona, Laura L.; Wagner, Liliana; Wade, Joshua; Weitlauf, Amy; Hine, Jeffrey F.; Nicholson, Amy; Stone, Caitlin; Vehorn, Alison; Warren, Zachary

doi:10.1007/s10803-020-04857-x

Cited by 23 publications

(28 citation statements)

References 36 publications

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“…While children with TAP scores in the ASD Risk range were all diagnosed with ASD, clinicians overrode TAP risk outcomes in 28% of children for which ASD was ruled out. Our findings are similar to those reported in Corona et al (2021) , in which an overall sensitivity of .90 and specificity of .78 was found.…”

Section: Discussionsupporting

confidence: 92%

Tele-assessment of young children referred for autism spectrum disorder evaluation during COVID-19: Associations among clinical characteristics and diagnostic outcome

Keehn

Enneking

Ryan

et al. 2022

Autism

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Since the onset of the COVID-19 pandemic, there has been a rapid acceleration of innovative research on health services delivery, including real-world clinical implementation and evaluation of tele-assessment for the diagnosis of autism spectrum disorder. Extending this promising work, the present study examined clinical characteristics and diagnostic outcome for young children receiving autism spectrum disorder tele-assessment during the COVID-19 pandemic. The standard tele-assessment procedure included caregiver clinical interview, administration of the TELE-ASD-PEDS (TAP; a novel caregiver-mediated remote autism spectrum disorder observational assessment tool), Vineland-3, and diagnostic feedback and family counseling. Overall, our findings suggest that a definitive autism spectrum disorder diagnosis can be determined for most young children evaluated using standard tele-assessment procedures. While TAP scores and measures of adaptive functioning and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition autism spectrum disorder symptoms are highly associated with autism spectrum disorder diagnostic outcome, a specific pattern of Restricted and Repetitive Behaviors independently predicted differential autism spectrum disorder outcome. Furthermore, our findings suggest that the TAP is useful for evaluation of at-risk children above 36 months of age with delayed language. These results add to an increasing body of research supporting use of tele-assessment, and specifically the TAP, for diagnosis of young children referred for autism spectrum disorder evaluation. Lay abstract The diagnosis of autism spectrum disorder (ASD) has traditionally been made through in-person evaluation. While the COVID-19 pandemic disrupted access to ASD services, there has been remarkable growth in research focused on novel ASD diagnostic practices, including the use of telemedicine. We implemented a standard ASD tele-assessment evaluation procedure, including use of a novel remote clinician-coached, caregiver-delivered ASD assessment tool (TELE-ASD-PEDS; TAP), with the goal of continuing to provide diagnostic services to young children and their families during the pandemic. We examined the relationship between child characteristics and diagnostic outcome for 335 children, ages 14–78 months, who received ASD tele-assessment conducted by psychologists and pediatricians in an outpatient clinic of a Midwestern academic medical center. We found that clinicians could make a determination about ASD diagnosis for most children (85%) evaluated using tele-assessment. Child clinical characteristics, including TAP scores and clinician ratings of ASD symptoms, were related to diagnostic outcome (i.e. diagnosis of ASD, no ASD, and Unsure about ASD). When all clinical characteristics were examined together, the presence of specific repetitive behaviors predicted ASD diagnosis. We also found that the TAP is effective for making an ASD diagnosis when used as part of comprehensive tele-assessment evaluation in children ⩾ 36 months of age with delayed language. Our study adds to an increasing body of research supporting use of tele-assessment for diagnosis of ASD. Although further research is needed, telemedicine may help families from different backgrounds and geographic locations to access high-quality diagnostic services.

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Section: Discussionsupporting

confidence: 92%

Tele-assessment of young children referred for autism spectrum disorder evaluation during COVID-19: Associations among clinical characteristics and diagnostic outcome

Keehn

Enneking

Ryan

et al. 2022

Autism

Self Cite

View full text Add to dashboard Cite

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“…In a second direct-to-home study, following suspension of in-person appointments in response to COVID-19, our team converted face-to-face diagnostic evaluations for toddlers into telemedicine-based assessments using a novel instrument specifically designed for identifying symptoms of ASD in young children via telemedicine (TELE-ASD-PEDS [TAP]; (Corona et al, 2020a(Corona et al, , 2021Wagner et al, 2021). The TAP was designed to elicit symptoms of ASD in children under 36 months of age using widely available materials within approximately 20 min of time.…”

Section: Introductionmentioning

confidence: 99%

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

Wagner

Weitlauf

Hine

et al. 2021

J Autism Dev Disord

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The COVID-19 pandemic has increased the use of telemedicine as an avenue to address the need for diagnostic clarification in young children at risk for autism spectrum disorder (ASD). Although preliminary research has supported the use of telemedicine for identifying ASD in toddlers, little is known about the experiences of practitioners attempting direct-tohome tele-assessment. We surveyed diagnostic providers regarding changes in practice behavior in the initial months of the COVID-19 pandemic and their perceptions of ASD tele-assessment. We also examined the use of the TELE-ASD-PEDS, a novel tool for ASD tele-assessment, in response to COVID-19 at seven sites across the country. Results support the clinical acceptability and diagnostic utility of ASD tele-assessment while also highlighting critical avenues of future investigation.

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“…In-person visits included the Mullen Scales of Early Learning (Mullen, 1995) and the toddler module of the Autism Diagnostic Observation Schedule -2nd Edition (ADOS-2; Lord et al, 2012;n = 131). A subset of children was unable to attend in-person visits due to COVID-19 restrictions and were administered the TELE-ASD-PEDS (Corona et al, 2021;n = 55). Parents who participated in either in-person and virtual assessment completed the Parent Concern Form (Sacrey et al, 2015) and the Vineland Adaptive Behavior Scales III (Sparrow et al, 2016).…”

Section: -Month Clinical Assessmentmentioning

confidence: 99%

Behavioral and physiological differences during an emotion-evoking task in children at increased likelihood for autism spectrum disorder

et al. 2022

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Literature examining emotional regulation in infants with autism spectrum disorder (ASD) has focused on parent report. We examined behavioral and physiological responses during an emotion-evoking task designed to elicit emotional states in infants. Infants at an increased likelihood for ASD (IL; have an older sibling with ASD; 96 not classified; 29 classified with ASD at age two) and low likelihood (LL; no family history of ASD; n = 61) completed the task at 6, 12, and 18 months. The main findings were (1) the IL-ASD group displayed higher levels of negative affect during toy removal and negative tasks compared to the IL non-ASD and LL groups, respectively, (2) the IL-ASD group spent more time looking at the baseline task compared to the other two groups, and (3) the IL-ASD group showed a greater increase in heart rate from baseline during the toy removal and negative tasks compared to the LL group. These results suggest that IL children who are classified as ASD at 24 months show differences in affect, gaze, and heart rate during an emotion-evoking task, with potential implications for understanding mechanisms related to emerging ASD.

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Toward Novel Tools for Autism Identification: Fusing Computational and Clinical Expertise

Cited by 23 publications

References 36 publications

Tele-assessment of young children referred for autism spectrum disorder evaluation during COVID-19: Associations among clinical characteristics and diagnostic outcome

Tele-assessment of young children referred for autism spectrum disorder evaluation during COVID-19: Associations among clinical characteristics and diagnostic outcome

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

Behavioral and physiological differences during an emotion-evoking task in children at increased likelihood for autism spectrum disorder

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