820 Evaluation of clinician and parent/carer views of remote autism assessments during Covid-19 pandemic in a London autism assessment service

Abstract

<h3>Background</h3> Remote autism assessment has been shown to be valid and have a high level of parental satisfaction (Juarez et al., 2018). Social distancing required during the Covid-19 pandemic meant that in order to continue providing a diagnostic autism service with minimal impact on waiting times, a redesign of our assessment pathway with some remote elements was required. <h3>Objectives</h3> This study aimed to evaluate clinician and parent/carer views of remote autism assessments in order to inform design of our autism assessment pathway for future pandemic waves and beyond. <h3>Methods</h3> An online survey about clinicians’ experience of remote autism assessments was created with a separate online survey for parent/carers (including additional questions for a child or young person [CYP], if able to participate) about their views. Some questions required a scaled response (for example, a five point scale ranging from ‘very dissatisfied’ to ‘very satisfied’); other questions required a free-text response. The online link to both surveys was sent by email to all clinicians in the assessment team. Clinicians were asked to complete a survey for every child for whom they were case coordinator, for any autism assessment started between 1.4.20 to 30.9.20. The clinician was asked to email the parent/carer survey online link to the parents/carers of each child. Responses of both clinician and parent/carer surveys were analysed. <h3>Results</h3> There were 37 clinician responses, ten parent/carer responses and two CYP responses. The ethnic spread of parents/carers matched that of the local population. 76% of parents/carers had English as their first language. Three out of 37 parents/carers (8%) did not agree to having a remote assessment. The part of the assessment most often carried out remotely was the parent interview (30 out of 37 cases) followed by the assessment feedback (28 out of 37 cases). A diagnostic conclusion was reached in 94% assessments. There were technological issues in 16% assessments. 90% parents/carers were ‘very satisfied’ with assessment process. 90–100% parents/carers were comfortable with video technology and said it was easy to carry out assessments tasks remotely. Parents/carers described being pleased that their child’s assessment could proceed without delay due to social distancing. Parents/carers and CYP respondents described being more relaxed in their own home while being assessed. Others described avoiding the inconvenience of travelling to the clinic. However, when asked, ‘If you could choose again, would you choose remote or face-to-face?’, families were split 50/50. <h3>Conclusions</h3> This study provides evidence that remote autism assessments had a high level of diagnostic conclusiveness with little technological difficulty. There was a high level of parental satisfaction. However, parents are split as to whether they would choose remote assessments over face-to-face if given the choice again. In future, parents/carers may be offered a choice over some remote aspects of autism assessments. Financial and time implications of remote autism assessments require further evaluation.