Identifying Patient Characteristics to Understand Which Children May Receive Diagnostic Clarity in a Virtual Autism Spectrum Disorder Evaluation.
Randi A Phelps, Erika Sample, Rachel K Greene and 1 others
PMID 35064874WHAT IT FOUND
Children who already received school services for autism were more likely to get a clear diagnosis during a virtual visit.
Older children and those with prior psychiatric diagnoses were more likely to need an in-person evaluation.
Key findings
01Children receiving educational services for ASD were significantly more likely to receive diagnostic clarity at the virtual visit rather than being referred for in-person testing.
02Older children were more likely to be referred for in-person evaluation, and those with a history of anxiety or mood disorders were also more likely to need further testing.
03Higher severity scores on the clinician-administered CARS-2 predicted diagnostic clarity at the virtual visit, but this measure is not available at the time of scheduling.
STILL TO COME
How it was doneWhat they found
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What it does not show
Small sample size (87 total, only 22 completed in-person follow-up) limits statistical power and generalizability. High missing data for caregiver-reported measures (only 45.98% completed behavioral/emotional measures). The sample was over 70% Caucasian and did not collect socioeconomic status data. The study did not account for the specific content or quality of school records that may have influenced diagnostic clarity. Only 4 participants were under age 3, so findings may not apply to very young children where telehealth tools like TELE-ASD-PEDS are relevant.
The easy way to misread this
Do not use these findings to deny in-person evaluations to older children or those without school services. The study shows who is *more likely* to get a clear diagnosis virtually, not that virtual assessment is sufficient for all. The lack of relation between virtual data and in-person outcomes in the small follow-up group suggests caution in assuming virtual tools alone can definitively rule out ASD in complex cases.