Pivoting to Caregiver-Mediated Synchronous Virtual Autism Assessments for Young Children

Autism spectrum disorder (ASD) assessment via telehealth, with growing support in terms of both validity and acceptability, was increasingly used during the COVID-19 pandemic and has continued due to its utility and convenience. Shifting from in-person assessments to telehealth for young children required several adaptations, namely around caregiver interactions. This study examined perspectives from providers conducting caregiver-mediated synchronous virtual assessments (CMSVAs) to diagnose ASD in young children on how they adapted their interactions with caregivers and their perceptions of the impact CMSVAs had on the caregiver. Using a qualitative design, we examined adaptations organized into three thematic goals: helping to increase caregiver comfort, engagement, and/or assessment validity. We also examined differences between in-person and CMSVA and their impact on caregivers. Participants included six psychologists contracted with a California Regional Center to provide diagnostic assessments. Providers identified five adaptation themes related to their interactions with caregivers and several differences between CMSVAs and in-person assessments. Differences appeared to have a perceived overall positive impact on caregivers. Results outline a basis for future research on caregiver interactions within CMSVAs and to begin to design CMSVA protocols and guidelines for providers to support caregivers of young children during this mode of assessment.