Telehealth may improve autism diagnosis

Online tools may be able to improve diagnosis of autism spectrum disorder, according to results of a survey study published in PLOS ONE.

“There seems to be some evidence to indicate that parents of children with ASD and adults face difficulties in getting ASD diagnosis,” Manahil Alfuraydan, a PhD student at Swansea University Medical School in the U.K., and colleagues wrote. “Therefore, more information is needed as to how to improve diagnostic services to address the well-being of the child and improve the experiences of the parents and adults with ASD. Telehealth can provide help and support to populations with specific health and well-being needs.”

Results of previous studies suggested approximate delays of 20 months to 5 years between seeking help and a confirmed ASD diagnosis, which may result in access to early interventions services that are critical for positive outcomes. Other studies showed initial evidence for the effectiveness, acceptability and feasibility of telehealth technologies as models for delivery of parental training; however, overall research is sparse regarding the use of telehealth in ASD.

Alfuraydan and colleagues conducted the current scoping review with the aim of determining which telehealth approaches are used in ASD diagnosis and assessment among children and adults, their feasibility and acceptability and how they compare with in-person diagnostic and assessment methods. They searched databases for all peer-reviewed articles that combined the terms telehealth and autism between 2000 and 2019, identifying 10 for inclusion.

Results showed two primary methods for telehealth use: the real-time method, such as videoconferencing, that enables teams of health professionals from different areas to meet with the family to assess the child or adults; and the store-and-forward method as Naturalistic Observation Diagnostic Assessment, which allows parents/caregivers to upload videos of a child’s behavior to an online portal to enable clinicians to view the child in his or her usual environment. According to the investigators, both approaches were acceptable to clinicians and families, provided high diagnostic accuracy, enabled families from a wider area to have access to professionals, reduced costs for accessing care, enabled observation of natural home behaviors and enabled both parents of a divorced family to partake in the diagnostic process.

“This is the first step in examining the potential of using telehealth in conjunction with the current practices in order to improve the time to diagnosis for people with ASD,” the researchers wrote. “Larger studies with a randomized design will be needed to confirm that telehealth can improve the diagnosis times.

“Early evidence about the use of telehealth for ASD diagnosis suggests that the systems available to date are acceptable to the families and clinicians,” they added. “These systems have the potential to improve the time to diagnosis for the families and the people with ASD but warrant further study.”