Commentary: Embracing innovation is necessary to improve assessment and care for individuals with ASD: a reflection on Kanne and Bishop (2020)

Abstract

This commentary is offered in response to Kanne and Bishop (2020) who urge caution in adopting new devices and processes for ASD assessment and advocate that that comprehensive, expert‐driven, diagnostic models for ASD remain essential to maintain quality standards. While we agree that there is a critical shortage in current care, we propose that developing suites of tools and innovative approaches for screening, risk‐classification, formal diagnosis, and rich assessment of abilities and challenges may be of great value to families and necessary to improve current systems of care. As well, the evaluation of ‘assessment quality’ should take into consideration both content and process, with a focus on achieving meaningful outcomes and optimizing family experience.

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

“…Finally, given that the tool has been adapted for applications across provider type and setting, ongoing work is necessary to examine potential differences in scoring cut-offs and tool functionality across these groups. Addressing these limitations in ongoing work by our group and others will be essential for creating models of care that accurately identify ASD-related concerns in young children while meeting families' diverse needs (Zwaigenbaum and Warren 2020). In addition, continuing to apply machine learning approaches as our datasets grow can continue to help clinicians identify and interpret these patterns on a large scale.…”

“…Further, there is evidence that some young children can be identified as having ASD based on a briefer evaluation (Juárez et al 2018;Swanson et al 2014). A tiered model that streamlines risk classification and early intervention access for those children with clear phenotypic profiles of ASD may, by reducing need for comprehensive testing, simultaneously reduce wait times for those children whose complex presentations warrant additional evaluation (Zwaigenbaum and Warren 2020). At present, however, most phenotypic presentations are funneled into the same model of care, regardless of provider capacity or family preference.…”

Utilization of telemedicine to support caregivers of young children with ASD and their Part C service providers: a comparison of intervention outcomes across three models of service delivery

“…Specifically, the therapies recommended for most children at the time of ASD diagnosis (i.e., applied behavior analysis (ABA) provided under the direction of a board certified and licensed behavior analyst) are frequently difficult to obtain, particularly for families who live in under-resourced communities [9,10]. Addressing these barriers requires creative approaches that leverage both existing service systems and novel tools for reaching families [11].…”

Use of the TELE-ASD-PEDS for Autism Evaluations in Response to COVID-19: Preliminary Outcomes and Clinician Acceptability

“…Even before the disruptions due to COVID-19, there has been a growing need for novel models of care to address delays in accessing autism-specific diagnostic and intervention services (Zwaigenbaum and Warren 2020 ). Although a stable diagnosis of ASD is possible in the second year of life for many children (Corsello et al 2013 ; Pierce et al 2019 ), diagnostic delays persist, with the average age of diagnosis hovering around four years of age (Maenner et al 2020 ).…”