Clinician Perspectives on Telehealth Assessment of Autism Spectrum Disorder During the COVID-19 Pandemic

Abstract

This study examined clinician insights into telehealth assessment services for autism spectrum disorder implemented during the COVID-19 pandemic. 35 clinicians from multiple disciplines across 17 sites in the Autism Care Network were interviewed. Themes identified through qualitative analyses included factors related to confidence in diagnosis (impressions of in-home observation; child and family factors that affected diagnostic confidence; changes in rapport); patient and family factors related to telehealth (perceived family benefits of and barriers to telehealth; factors related to healthcare disparities; factors specific to non-native English speakers); and institutional and workplace factors related to transitioning to telehealth (institutional support; changes to efficacy, attendance, and work satisfaction). Results suggest that telehealth has potential to be an effective tool in autism assessment practice. Supplementary Information The online version contains supplementary material available at 10.1007/s10803-022-05435-z.

Telehealth Autism Diagnostic Assessments With Children, Young People, and Adults: Qualitative Interview Study With England-Wide Multidisciplinary Health Professionals

“…The findings reported here are broadly consistent with those outlined in a handful of recent studies examining professionals’ experiences of providing telehealth autism diagnostic assessments in the United States and Australia [ 13 , 16 , 19 ]. Studies have reported that professionals appreciated the convenience, flexibility, efficiency, and cost and space savings of telehealth.…”

“…Although internet use has broadly increased over the past decade (from 79.7% to 90% of the United Kingdom adult population), it is a cause for concern that individuals with longer-term health issues or from lower socioeconomic status backgrounds may be excluded from telehealth opportunities, or lack access to skill-based training or support to use this. In addition, poorer than required computer literacy of patients, their families, and professionals was highlighted as an important consideration in this study, mirroring findings elsewhere [ 13 , 16 ]. The unexpected onset of the COVID-19 pandemic is likely to have meant that some services were unable to swiftly assess digital poverty and competencies of patients, families, and professionals and accommodate needs accordingly.…”

“…Recent studies [ 16 , 36 , 37 ] have similarly reported that systemic changes to service provision may enhance telehealth in autism services, as well as the acceptability and satisfaction of patients, their families, and professionals. At the onset of the COVID-19 pandemic, many services were able to maintain routine care.…”

“…Some autism diagnostic services temporarily shut down waiting lists and suspended direct clinical work for several months, exacerbating already lengthy waiting times [ 13 , 14 ]. However, overall, many services started conducting partial or complete autism diagnostic assessments using telehealth [ 13 - 16 ].…”

“…Since the start of the COVID-19 pandemic, a handful of studies, primarily conducted in the United States and Canada, have examined the feasibility and acceptability of telehealth autism diagnostic assessments or the perspectives of patients or health professionals [ 14 - 16 , 19 - 21 ]. Preliminary findings indicate that some professionals and services can find telehealth to be convenient, flexible, and satisfactory when working with individuals across the life span.…”