Early Identification of ASD Through Telemedicine: Potential Value for Underserved Populations

Abstract

Increasing access to diagnostic services is crucial for identifying ASD in young children. We therefore evaluated a telemedicine assessment procedure. First, we compared telediagnostic accuracy to blinded gold-standard evaluations (n = 20). ASD cases identified via telemedicine were confirmed by in-person evaluation. However, 20% of children diagnosed with ASD in-person were not diagnosed via telemedicine. Second, we evaluated telediagnostic feasibility and acceptability in a rural catchment. Children (n = 45) and caregivers completed the telemedicine procedure and provided feedback. Families indicated high levels of satisfaction. Remote diagnostic clinicians diagnosed 62% of children with ASD, but did not feel capable of ruling-in or out ASD in 13% of cases. Findings support preliminary feasibility, accuracy, and clinical utility of telemedicine-based assessment of ASD for young children.

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Funding

This project was completed with Hobbs Foundation funding through the [funding source redacted for blinded review], support from the Eunice Kennedy Shriver National Institute of Child Health and Human Development U54 HD08321, support from the [funding source redacted for blinded review] CTSA award No. UL1TR000445 from the National Center for Advancing Translational Sciences, and support from the [funding source redacted for blinded review] Department of Education/[funding source redacted for blinded review] Early Intervention System. Its contents are solely the responsibility of the authors and do not necessarily represent official views of any funding agency. All procedures performed in studies involving human subjects were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent/assent was obtained from all individual participants included in the study. Conflict of interest: the authors declare that they have no conflict of interest.

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APJ, AS, AW, and ZW conceived of the study and crafted the experimental design. APJ and AS provided oversight of study implementation across Vanderbilt sites. AW, NB, AN, JH, and AS helped design and implement the rapid diagnostic procedure and methods for capturing diagnostic agreement. AP and AS assisted with data collection and analysis for manuscript preparation. APJ, AW, and ZW significantly participated in drafting the article, revising it critically, and providing final approval of the manuscript. All authors are in agreement with accountability for all aspects of the work.

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Correspondence to Zachary Warren.

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Juárez, A.P., Weitlauf, A.S., Nicholson, A. et al. Early Identification of ASD Through Telemedicine: Potential Value for Underserved Populations. J Autism Dev Disord 48, 2601–2610 (2018). https://doi.org/10.1007/s10803-018-3524-y

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Keywords

  • Autism spectrum disorder
  • Diagnosis
  • Telemedicine
  • Young children