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

Abstract

There is a significant delay between parents having concerns and receiving a formal assessment and Autism Spectrum Disorder (ASD) diagnosis. Telemedicine could be an effective alternative that shortens the waiting time for parents and primary health providers in ASD screening and diagnosis. We conducted a systematic review examining the uses of telemedicine technology for ASD screening, assessment, or diagnostic purposes and to what extent sample characteristics and psychometric properties were reported. This study searched four databases from 2000 to 2022 and obtained 26 studies that met the inclusion criteria. The 17 applications used in these 26 studies were divided into three categories based on their purpose: screening, diagnostic, and assessment. The results described the data extracted, including study characteristics, applied methods, indicators seen, and psychometric properties. Among the 15 applications with psychometric properties reported, the sensitivity ranged from 0.70 to 1, and the specificity ranged from 0.38 to 1. The present study highlights the strengths and weaknesses of current telemedicine approaches and provides a basis for future research. More rigorous empirical studies with larger sample sizes are needed to understand the feasibility, strengths, and limitations of telehealth technologies for screening, assessing, and diagnosing ASD.

Equivalence of the autism spectrum disorders diagnostics in children in telemedicine and face-to-face consultations: a literature review

“…The high relevance of and potential demand for remote primary ASD risk screening have been noted in many studies in connection with the significant time gap between the onset of symptoms and the age of diagnosis [18] . According to Constantino et al [19] , the median age of diagnosis in the United States is above 4 years and 27% of children with ASD are not diagnosed by the age of 8 years, while the median age of diagnosis has not decreased in more than 15 years.…”

A systematic review of interventions for echolalia in autistic children

“…Only 3 out of the 15 included studies (Guzinski et al, 2012;Shawler et al, 2020;Li et al, 2022) had social validity data; this is an evident failure among most studies to consider the social significance of echolalia and the scientific and practical importance of the study results to the wider autistic community (Armstrong et al, 1997). Social validity procedures are critical to the research process as they ensure the accurate implementation of interventions and relevance of the interventions to real-world contexts (McNeill, 2019). As such, the prioritisation of social validity offers opportunities for researchers and clinicians alike to better understand the factors that may be key to maximising the impact of interventions and evidence-based practices for all autistic participants (McNeill, 2019).…”

“…Social validity procedures are critical to the research process as they ensure the accurate implementation of interventions and relevance of the interventions to real-world contexts (McNeill, 2019). As such, the prioritisation of social validity offers opportunities for researchers and clinicians alike to better understand the factors that may be key to maximising the impact of interventions and evidence-based practices for all autistic participants (McNeill, 2019).…”

“…The Scientific Merit Rating Scales (SMRS) is a quality appraisal tool designed specifically for intervention studies for autism spectrum disorder, and therefore was appropriate for this project (National Autism Center [NAC], 2009). The SMRS tool has been used in other published systematic reviews investigating intervention effects on autistic populations (e.g., Boyle et al., 2019; Meimei & Zenghui, 2022; Sutherland et al., 2018). The SMRS provides each paper with a composite score out of five, with zero representing a poor score and five representing a strong score.…”

Validation of PleaseApp: a digital tool for the assessment of receptive pragmatic abilities in children with neurodevelopmental disorders

“…In line with this, professionals used assessment strategies during the COVID-19 pandemic lockdowns as an alternative method of service delivery (70). Moreover, teleintervention has already been shown to be a valid and effective modality in the screening and diagnosis of children with socio-communicative needs (71). In general, telehealth facilitates the diagnosis of children with developmental concerns (72).…”