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

A Pablo Juárez1,2,3, Amy S Weitlauf1,2, Amy Nicholson1,2

  • 1Vanderbilt Kennedy Center/Treatment and Research Institute for Autism Spectrum Disorders, Vanderbilt University Medical Center, Nashville, TN, USA.

Journal of Autism and Developmental Disorders
|March 13, 2018
PubMed

Insights

Telemedicine shows promise for diagnosing autism spectrum disorder (ASD) in young children. While accurate in confirming cases, some children diagnosed in-person were missed via remote assessment, indicating room for improvement in early autism diagnosis.

Area of Science:

  • Developmental Pediatrics
  • Child Psychiatry
  • Telehealth and Digital Health

Background:

  • Early identification of autism spectrum disorder (ASD) is critical for timely intervention and improved outcomes in young children.
  • Access to diagnostic services, particularly in rural areas, remains a significant barrier to early ASD identification.
  • Telemedicine offers a potential solution to overcome geographical limitations and increase access to specialized diagnostic evaluations.

Purpose of the Study:

  • To evaluate the accuracy of a telemedicine assessment procedure for diagnosing ASD in young children compared to gold-standard evaluations.
  • To assess the feasibility and acceptability of a telemedicine-based ASD diagnostic procedure among families in a rural setting.
  • To determine the clinical utility of remote diagnostic clinicians in identifying and assessing young children for ASD.

Main Methods:

  • A comparative study evaluated telediagnostic accuracy against blinded, in-person gold-standard evaluations for ASD (n=20).
  • A feasibility and acceptability study involved children (n=45) and caregivers undergoing telemedicine ASD assessment in a rural area.
  • Data collected included diagnostic concordance, clinician confidence, and caregiver satisfaction with the telemedicine procedure.

Main Results:

  • Telemedicine correctly identified ASD cases confirmed by in-person evaluations, but missed 20% of children diagnosed with ASD in-person.
  • Remote clinicians diagnosed 62% of children with ASD, with 13% of cases deemed inconclusive for ruling in or out ASD.
  • Caregivers reported high satisfaction with the telemedicine procedure, indicating good feasibility and acceptability in a rural catchment.

Conclusions:

  • Telemedicine-based ASD assessment demonstrates preliminary feasibility, accuracy, and clinical utility for young children, especially in underserved areas.
  • While promising, the current telemedicine approach requires refinement to improve sensitivity in detecting all ASD cases.
  • Further research is warranted to optimize telediagnostic protocols and enhance clinician confidence in remote ASD evaluations.

Keywords:
Autism spectrum disorderDiagnosisTelemedicineYoung children

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