Investigating the accuracy of a novel telehealth diagnostic approach for autism spectrum disorder.

Abstract

Research indicates a substantial amount of time between parents’ first concerns about their child’s development and a diagnosis of Autism Spectrum Disorder (ASD). Telehealth presents an opportunity to expedite the diagnostic process. This project compared a novel telehealth diagnostic approach that utilizes clinically-guided in-home video recordings to the gold standard in-person diagnostic assessment. Participants included 40 families seeking an ASD evaluation for their child and 11 families of typically developing children. Children were between the ages of 18 months and 6 years, 11 months; mean adaptive behavior composite = 75.47 (SD = 15.94). All parent participants spoke English fluently. Families completed the Naturalistic Observation Diagnostic Assessment (NODA) for ASD, which was compared to an in-person assessment (IPA). Agreement between the two methods, as well as sensitivity, specificity, and interrater reliability were calculated for the full sample and the subsample of families seeking an ASD evaluation. Diagnostic agreement between NODA and the IPA in the full sample was 88.2% (kappa = 0.75), and 85% (kappa = 0.58) in the subsample. Sensitivity was 84.9% in both, while specificity was 94.4% in the full sample and 85.7% in the subsample. Kappa coefficients for interrater reliability indicated 85 to 90% accuracy between raters. NODA utilizes telehealth technology for families to share information with professionals, and provides a method to inform clinical judgment for a diagnosis of ASD. Due to the high level of agreement with the IPA in this sample, NODA has potential to improve the efficiency of the diagnostic process for ASD.

Reliability of parent recall of symptom onset and timing in autism spectrum disorder

“…To minimize comprehension or interpretation problems, it is recommended that further specific information about the behavior in question be provided. ASD screening instruments have begun to incorporate video to improve accuracy (e.g., Marrus et al, 2015; Smith et al, in press) and this strategy could be adapted to improve reporting of onset patterns. For example, longitudinal video of a child experiencing skill loss could be shown to parents to illustrate the kinds of changes in behavior that define regression.…”

Use of telehealth for facilitating the diagnostic assessment of Autism Spectrum Disorder (ASD): A scoping review

“…Research reports a delay of approximately 20 months to 5 years between seeking help and a confirmed diagnosis of ASD [7][8][9][10]. This may result in delayed access to early intervention services, which are critical for positive outcomes [11][12][13][14][15]. The long wait times also cause stress to individuals and families [7,16].…”

Modern Technologies in Studying the Mechanisms, Diagnostics, and Treatment of Autism Spectrum Disorders (Review)

“…This can be done by telemedicine examination of patients [54], during which not only the timely diagnosis new concepts. reviews of ASD but also the medical advice of specialists can be given [55].…”