Use of the TELE-ASD-PEDS for Autism Evaluations in Response to COVID-19: Preliminary Outcomes and Clinician Acceptability.
Liliana Wagner, Laura L Corona, Amy S Weitlauf and 8 others
PMID 33125622WHAT IT FOUND
Clinicians diagnosed autism via video in 204 toddlers' homes.
Scores were highest for confirmed cases, but confidence dropped when ruling out autism or for complex presentations. All providers faced tech issues. This is a feasibility report, not proof the method works.
Key findings
01Tele-assessment scores were significantly higher for children diagnosed with ASD than for those without, but diagnostic certainty was lowest when ASD was ruled out or uncertain.
02All nine providers reported technology-related challenges, such as dropped calls and difficulty filming the child, which impacted the ability to observe key behaviors.
03The tool was not validated in home settings prior to this study, and the sample was heavily weighted toward children already flagged for ASD risk.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study is a pilot with no control group or comparison to in-person diagnosis, so it cannot determine accuracy. The TELE-ASD-PEDS had not been validated in home settings prior to this work. The sample was referred specifically for autism concerns, meaning results do not apply to the general population. Caregiver satisfaction and diagnostic outcomes were not systematically collected for all families. Providers were involved in the tool's development, which may bias their acceptability ratings. Technology failures and home environment distractions likely affected the quality of observations.
Declared interests
Funded by the National Institute of Mental Health. No other conflicts of interest were declared.
The easy way to misread this
Do not interpret the high diagnostic scores as evidence that tele-assessment is as accurate as in-person evaluation. The study did not compare diagnoses to a gold standard, and clinicians reported significantly lower certainty when ruling out autism, meaning false negatives are a major risk.