"It was surprisingly equivalent to the appointment I had in person": Advantages and disadvantages of synchronous telehealth for delivering primary care for autistic adults.
Lauren Harris, Daniel Gilmore, Christopher Hanks and 4 others
PMID 34847744WHAT IT FOUND
Autistic adults and caregivers described virtual primary care visits as more comfortable and safer than in-person appointments, with communication rated as similar or better.
They cited reduced anxiety from avoiding waiting rooms and travel. However, they noted technology issues, privacy concerns, and the inability to perform physical exams.
Key findings
01Participants felt more comfortable during virtual visits because they were in their own homes, avoiding stressful waiting rooms and travel time.
02Communication during virtual visits was described as similar or better than in-person visits, with some patients feeling more honest and open about medication issues.
03Virtual visits were seen as safer regarding exposure to illness, but some participants expressed concerns about the privacy of health information during video calls.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The sample was small (19 participants) and recruited from a single specialized clinic, so results may not generalize to other healthcare settings or populations. Participants were predominantly white and reported high confidence with technology, meaning experiences of those with lower digital literacy, different racial/ethnic backgrounds, or intellectual disabilities are not represented. The study was conducted during the COVID-19 pandemic, which may have introduced a positive bias toward virtual care due to limited alternatives. Providers' perspectives were not included, and autism diagnoses were not independently verified. Caregivers outnumbered autistic adults in the sample, though the authors attempted to prioritize patient quotes.
Declared interests
The study was supported by an N.I.H. Extramural grant. One author (CH) is the founder and medical director of the clinic from which participants were recruited, but he was not involved in data collection or analysis to minimize bias.
The easy way to misread this
Do not interpret these findings as evidence that telehealth is superior to in-person care for all autistic adults. The study highlights specific advantages like comfort and safety, but also critical limitations such as the inability to perform physical exams and potential engagement issues. The positive views may be influenced by the pandemic context and the high technology confidence of the sample.