Screen to Screen Versus Face to Face: Evaluating Telehealth Autism Diagnostic Assessments for Young Children in a Diverse Clinical Setting

Access to autism diagnostic assessments continues to be problematic for many families and children. While telehealth assessments have been shown to be feasible and reliable in research settings, less is known about the agreement between telehealth autism assessments compared with in-person evaluations in clinical settings with linguistic, cultural, and social diversity. Twenty-one minimally verbal children (between 23.9 and 51.7 months, mean = 36.5 months, SD = 8 months) participated in a telehealth autism assessment (the TELE-ASD-PEDS; TAP) with a parent, and then in an in-person, multidisciplinary team assessment. Telehealth clinicians were blinded to history and questionnaire information; in-person clinicians were blinded to the telehealth results. Assessment results in each setting, along with diagnostic impression (telehealth) and diagnostic outcome (in-person), were compared. Assessment scores across the settings showed very good agreement and were strongly correlated (r = 0.75, p < 0.001). There was diagnostic agreement (either autism/autism or no-autism/no-autism) for 19/21 children, or 90% of the participants. This study adds to the growing literature on autism diagnostic assessments administered via telehealth. Our research builds on previous work by comparing telehealth findings directly with in-person assessment and diagnostic results. The results of the present study yielded high rates of diagnostic agreement as well as strong agreement between telehealth and in-person assessment scores for young children with limited language and high levels of autism symptoms, which to our knowledge, have not to date been directly compared.