Abstract

There is a significant delay between seeking help and a confirmed diagnosis of Autism Spectrum Disorder (ASD). This delay can lead to poor outcomes for both the families and individuals. Telehealth potentially offers a way of improving the diagnostic pathway for ASD. We conducted a scoping review examining which telehealth approaches are used in the diagnosis and assessment of ASD in children and adults, whether they are feasible and acceptable, and how they compare with face-to-face diagnosis and assessment methods. A search for all peer-reviewed articles, combining the terms of autism and telehealth was conducted from 2000 to 2019. A total of 10 studies were identified for inclusion in the review. This review of the literature found there to be two methods of using telehealth: (a) Real-Time method e.g. video conferencing that enables teams in different areas to consult with the families and to assess the child/adult in real time and (b) A Store-and-Forward method as Naturalistic Observation Diagnostic Assessment (NODA) system to upload videos of child’s behaviors to a webportal that enables the clinicians to make an assessment remotely. The findings were positive, finding there to be high agreement in terms of the diagnosis between remote methods and face to face methods and with high levels of satisfaction among the families and clinicians. This field is in the very early stages and so only studies with small sample size using surveys and interviews were identified but the findings suggest that there is potential for telehealth methods to improve access to assessment and diagnosis of ASD used in conjunction with existing methods, especially for those with clear autism traits and adults with ASD. Larger randomised controlled trials of this technology are warranted.

Highlights

  • Autism Spectrum Disorder (ASD) is a developmental condition characterised by impairment in terms of social communication and social interaction and a repetitive and restricted pattern of interest, behaviour and activity [1]

  • The Autism Diagnostic Interview–Revised (ADI-R) is a semi-structured interview that is conducted by clinician with a parent/carer who is familiar with developmental history as well as child’ current behaviour [5]

  • They enable rural families to be seen at lower cost and reduce the time to diagnosis, for those with more severe autism where there is in good agreement in terms of the diagnosis compared to the face to face methods

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Summary

Introduction

Autism Spectrum Disorder (ASD) is a developmental condition characterised by impairment in terms of social communication and social interaction and a repetitive and restricted pattern of interest, behaviour and activity [1]. In respect of the diagnostic criteria, the latest revision of the Diagnostic and Statistical Manual of Mental Disorders “DSM-5”, published in May 2013, approved the umbrella term ASD without any subtypes. It organised the impairments into two domains: difficulties in social communication and social interaction; and restricted and repetitive behaviour, interests, or activities [1]. The ADOS-2 has 5 modules which involve 40–60 minute protocols of activities that are based on playing, communication and social interactions [6]

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