SLPPilotAutism : the international journal of research and practice2022

Leveraging telehealth to evaluate infants with prodromal autism spectrum disorder characteristics using the telehealth evaluation of development for infants.

Meagan R Talbott, Sarah Dufek, Greg Young and 1 others

PMID 34549613

WHAT IT FOUND

Telehealth assessments identified significant developmental concerns in 41 infants aged 6-12 months with parental worries.

Families found the process acceptable and convenient. However, clinical best-estimate ratings showed poor consistency between examiners and across visits, suggesting caution when using single-session remote evaluations for definitive risk classification.

Key findings

01Examiner-rated behaviors were significantly elevated compared to risk cut-offs, with 26 of 30 infants maintaining the same risk classification across two sessions.

02Inter-rater agreement for behavioral scores was high, but agreement for overall clinical best-estimate likelihood ratings was poor.

03Parents reported significant satisfaction with the telehealth process, citing convenience and comfort in the home environment.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

The sample was small (n=41) and recruited via convenience sampling, including word-of-mouth and self-referral. Participants were predominantly Caucasian and of high socio-economic status, limiting generalizability to diverse populations. There were no longitudinal diagnostic outcomes; infants were not followed to see if they were later diagnosed with ASD. Examiners were not blind to family history or parent concerns, which may have influenced their clinical best-estimate ratings. The study was conducted by highly trained PhD-level examiners, so results may not apply to community-based providers with less specialized training.

The easy way to misread this

Do not assume that a single telehealth session provides a reliable overall clinical judgment of ASD risk. While specific behavioral scores were consistent, the examiners' global best-estimate ratings showed poor agreement between colleagues and across visits, indicating that remote global impressions are unstable.

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