Validating the RISE Communication Play Protocol as a Diagnostic Tool for Autism in Early Childhood: A Pilot Study.

The study was a pilot with only 38 children, so the diagnostic accuracy numbers need larger replication. Most children in the sample were autistic, which can make sensitivity look higher and specificity look lower than in a more mixed population. The RISE CPP had no clinical scoring algorithm; diagnoses depended on clinician judgment with DSM-5 criteria. Both assessors could review the caregiver diagnostic interview before diagnosing, so the comparison was not a pure test of the RISE CPP observation alone. The remote assessment always occurred before the in-person assessment, so assessment order was not counterbalanced. Only families willing to complete both in-person and telehealth assessments participated, so acceptability may not reflect families who prefer one format or cannot do both. The study provided toys, cameras, and an iPad, so results may not apply if families use materials they already have. One child was diagnosed with autism after the in-person assessment but not the virtual assessment, and the caregiver had professional experience working with children with developmental delays. All clinicians specialized in autism and were trained in the ADOS-2, which may not match settings with less specialized assessors.

Dr. Carter is the co-creator of the ITSEA and BITSEA and receives royalties on their sale; neither tool was used in this study. Drs. Dai, Tagavi, and Stone reported no conflicts of interest. The paper also mentions a parent multisite study with identifier R01MH122728.

Do not treat the RISE CPP as a standalone diagnostic test ready for routine use. It had no scoring algorithm, the sample of 38 was small and mostly autistic, and one child was diagnosed with autism on the in-person assessment but not the virtual assessment.