Measuring the service system impact of a novel telediagnostic service program for young children with autism spectrum disorder

Abstract

As prevalence of autism spectrum disorder continues to increase, so too does the need for timely, accessible diagnostic consultation. The present work extends from a previous study which provided preliminary evidence for the feasibility of expert clinicians to utilize telemedicine to triage autism spectrum disorder risk in young children. However, it did not examine whether a telediagnostic model had a demonstrable impact on tertiary care center referrals and usage. We therefore examined whether the introduction of telemedicine-based diagnostic consultation for families served by a rural medical facility affected referrals overall as well as to a metropolitan tertiary care diagnostic center. Results suggest that telemedicine diagnostic consultation in partnership with a referring early intervention system may positively impact referrals for diagnostic evaluation as well as the ability of families to schedule and attend appointments.

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

“…In case of differences, consensus was reached by discussion or through consulting (SB or JC). The National Heart, Lung, and Blood Institute (NHLBI) Quality Assessment for Observational Cohort and Cross-Sectional Studies tool [56] was used for five studies [9,59,60,61,63]. The items of the tool were evaluated by using "yes", "no", "not applicable", "cannot determine", or "not reported".…”

“…The overall quality was rated as good, fair, or poor. Eight studies were rated as "fair" quality [9,15,22,58,59,61,62,63]. Whereas, two studies were rated as poor-quality assessment [28,60].…”

“…The parents were equally satisfied with the video conferencing and the face to face approaches. Two studies by Juarez et al [62] and Stainbrook et al [63] examined the accuracy of diagnosis using telehealth (videoconferencing) compared to the in-person assessment in 20 cases and feedback from both the families and clinicians on the acceptability of telemedicine [62]. Furthermore, the impact that telehealth had on the tertiary care referrals has been examined [63].…”

“…The telehealth assessment saved an average of 3.92 h of the anticipated families' travel time compared to going to the hospital-based ASD clinic. The study examining the impact of telehealth (videoconferencing) on tertiary care referrals [63] found that the telehealth diagnostic consultation could positively impact referrals for the diagnostic assessment. Telehealth accelerated access to the diagnostic assessment compared to waiting at the tertiary centre.…”

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

“…One promising avenue for increasing access to early ASD assessment is telemedicine-based evaluation (Corona et al 2020b ; Juárez et al 2018 ). Most existing work regarding tele-assessment of ASD relies upon having a trained provider present with the family in one location, while a remote psychologist converses with the family and observes the child’s behavior (Juárez et al 2018 ; Stainbrook et al 2019 ). Additional preliminary work has explored tools for caregiver-mediated tele-assessment, in which caregivers complete assessment activities with their child, while being coached by a remote provider (Corona et al 2020b ).…”