Preliminary Efficacy of Telehealth Family Navigation for Early Autism Services Access.
Katharine E Zuckerman, Michelle Owens Reinitz, Mohadeseh Solgi and 5 others
PMID 41460569WHAT IT FOUND
The main early autism service-access outcomes showed no clear difference.
The navigation arm, which also received screening training, did not reliably improve eligibility timing, and was less likely to get a medical autism diagnosis within six months.
Key findings
01The primary educational outcomes did not show significant differences: overall EI/ECSE eligibility was 46.7% in navigation and 36.8% in control, while among referred children eligibility was 87.5% in control and 66.7% in navigation (OR 0.29, CI 0.3-2.8), and time to eligibility showed a non-significant trend (120.0 versus 66.5 days; HR 1.62, CI 0.73-3.61).
02Medical autism diagnostic determination within six months was significantly less likely in the navigation arm (10.0%) than in the control arm (42.1%; OR 0.15, CI 0.03-0.69).
03Sensitivity analyses changed the findings: after adjusting for child age, EI/ECSE referral favoured navigation (effect size 3.7, CI 1.04-12.9), but after adjusting for parent age there were no significant differences and the referral effect size decreased to 1.3.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
This was a pilot with 49 children and 7 clinics, and it was not powered to prove effectiveness. Baseline groups differed: navigation children were 5 months older at enrollment, and control parents were older (33.8 versus 28.8 years). Half of navigation families (15 of 30) did not receive the intended minimum of four navigator contacts. Randomization was by clinic, not child, and the study did not know what proportion of children with positive screens were referred to the study. Sensitivity analyses changed the results: child-age adjustment made referral significant, while parent-age adjustment made differences non-significant. The study took place in Oregon from 2021 to 2022, with English or Spanish families and pandemic-related waitlist effects, so generalisability is limited. The analysis focused on educational and medical service utilization data.
Declared interests
The authors reported no competing interests. The project is described as NIH-funded, and Help Me Grow Oregon had Medicaid funding.
The easy way to misread this
Do not conclude that telehealth family navigation improves autism service access. The primary outcomes were not statistically significant, the study was a small pilot, and the navigation arm also received START Autism screening training, so the added effect of navigation alone cannot be separated. The medical diagnosis result also favoured the control arm.
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