In-home Tele-assessment for Autism in Toddlers: Validity, Reliability, and Caregiver Satisfaction with the...

Area of Science:

• Child Psychology
• Developmental Pediatrics
• Telehealth Technology

Background:

• Early diagnosis of autism spectrum disorder (ASD) in toddlers is crucial for intervention.
• Families facing barriers to in-person evaluations need accessible diagnostic tools.
• Telehealth offers a potential solution to improve access to autism diagnostic services.

Purpose of the Study:

• To evaluate the psychometric properties of the TELE-ASD-PEDS (TAP) tool for in-home autism diagnosis.
• To assess caregiver experiences and perceptions of feasibility with the TAP tele-assessment.
• To examine the reliability and validity of telehealth-based autism diagnostic tools for young children.

Main Methods:

• 182 children (18-42 months) with screening concerns underwent initial tele-assessment with TAP.
• Participants were randomized to a second TAP via telehealth or in-person evaluation.
• Caregiver surveys assessed technology challenges and telehealth satisfaction.

Main Results:

• 77% of children were diagnosed with ASD.
• High agreement between initial and second evaluations (94% telehealth, 94% in-person).
• Strong test-retest reliability (ICC=0.85) and high caregiver satisfaction (<6% tech issues).

Conclusions:

• In-home use of the TAP tool is valid, reliable, feasible, and acceptable for toddler autism diagnosis.
• Telehealth assessment for autism in toddlers is supported by these findings.
• Telehealth can reduce disparities and improve access to timely autism diagnostic services.