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Improving Autism Detection Through Telemedicine in China: A Comparative Analysis of Multitool-Combined Screening
Weiqin Wang1, Zhongling Liu1, Dan Wu1
1Child Health Care Medical Division, School of Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China.
Summary
This study developed an effective telemedicine protocol for early autism spectrum disorder (ASD) screening in young children. Combining specific screening tools improved accuracy and efficiency in remote settings.
Area of Science:
- Pediatric neurology
- Developmental psychology
- Public health
Background:
- Global rise in autism spectrum disorder (ASD) prevalence necessitates improved screening methods.
- Traditional face-to-face screening faces logistical challenges, amplified by events like the COVID-19 pandemic.
- Telemedicine presents a viable solution for remote ASD detection and screening.
Purpose of the Study:
- To enhance the efficiency of early autism spectrum disorder (ASD) screening using telemedicine.
- To integrate and compare the efficacy of multiple early screening tools within a telemedicine framework in China.
- To develop and validate a novel combined screening protocol for ASD.
Main Methods:
- A cross-sectional, observational, multicenter study involving 1,102 children aged 18-36 months in Shanghai.
- Utilized a telemedicine system incorporating the Warning Signs Checklist (WSC), Early Behavioral Markers of Autism-Five No's, and CHAT-23-A.
- Evaluated individual and combined tool performance using sensitivity, specificity, and diagnostic accuracy metrics, with the Childhood Autism Rating Scale as the diagnostic standard.
Main Results:
- The Warning Signs Checklist (WSC) and Five No's behavior showed high sensitivity (90.9%).
- The Modified Checklist for Autism in Toddlers-23 (CHAT-23-A) demonstrated higher specificity (88.6%) but lower sensitivity (63.6%).
- Serial testing of a triple-tool combination (WSC, Five No's, CHAT-23-A) achieved high specificity (97.6%), with the WSC and Five No's combination showing the best overall performance metrics in serial application.
Conclusions:
- A novel telemedicine-based ASD screening protocol combining WSC and Five No's in serial testing demonstrates good sensitivity and specificity.
- This validated protocol is poised to improve the accuracy and efficiency of early autism screening.
- Enhanced early detection through this telemedicine approach can lead to better long-term outcomes for children with ASD.
