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Provider and Caregiver Perspectives on Telehealth Assessments for Autism Spectrum Disorder in Young Children: A
Katherine S Kellom1, Carina M Flaherty1, Jaclyn Cacia2
1PolicyLab, The Children's Hospital of Philadelphia, Philadelphia, PA.
Insights
Telehealth for autism spectrum disorder (ASD) assessments in young children is highly accepted by providers and families. While beneficial, concerns about equitable access for non-English speaking families remain.
Area of Science:
- Pediatric Healthcare
- Telemedicine
- Autism Spectrum Disorder Assessment
Background:
- COVID-19 pandemic accelerated telehealth adoption in developmental-behavioral pediatrics (DBP).
- Limited understanding of telehealth's acceptability and equity in DBP care for autism spectrum disorder (ASD) assessments.
Purpose of the Study:
- To explore provider and caregiver perspectives on telehealth for early ASD assessment.
- To understand the acceptability, benefits, and concerns regarding telehealth in DBP care.
- To assess telehealth's role in health equity for ASD diagnosis.
Main Methods:
- Multimethod study involving surveys and semistructured interviews.
- Included 13 DBP clinicians and 22 caregivers via surveys.
- 12 DBP clinicians and 14 caregivers participated in interviews.
Main Results:
- High clinician and caregiver acceptance and satisfaction with telehealth for ASD assessments.
- Telehealth offers benefits and drawbacks for assessment quality and care access.
- Providers noted equity concerns, especially for non-English speaking families.
Conclusions:
- Study findings can guide equitable telehealth adoption in DBP post-pandemic.
- Both providers and families prefer choosing telehealth for specific assessment components.
- Telehealth is well-suited for DBP observational assessments in young children.
Background:
Telehealth uptake increased dramatically during the COVID-19 pandemic, including for autism spectrum disorder (ASD) assessment by developmental-behavioral pediatric (DBP) clinicians. However, little is known about the acceptability of telehealth or its impact on equity in DBP care.
Objective:
Engage providers and caregivers to glean their perspectives on the use of telehealth for ASD assessment in young children, exploring acceptability, benefits, concerns, and its potential role in ameliorating or exacerbating disparities in access to and quality of DBP care.
Methods:
This multimethod study used surveys and semistructured interviews to describe provider and family perspectives around the use of telehealth in DBP evaluation of children younger than 5 years with possible ASD between 3/2020 and 12/2021. Surveys were completed by 13 DBP clinicians and 22 caregivers. Semistructured interviews with 12 DBP clinicians and 14 caregivers were conducted, transcribed, coded, and analyzed thematically.
Results:
Acceptance of and satisfaction with telehealth for ASD assessments in DBP were high for clinicians and most caregivers. Pros and cons concerning assessment quality and access to care were noted. Providers raised concerns about equity of telehealth access, particularly for families with a preferred language other than English.
Conclusion:
This study's results can inform the adoption of telehealth in DBP in an equitable manner beyond the pandemic. DBP providers and families desire the ability to choose telehealth care for different assessment components. Unique factors related to performing observational assessments of young children with developmental and behavioral concerns make telehealth particularly well-suited for DBP care.
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