Preliminary Efficacy of Telehealth Family Navigation for Early Autism Services Access

In-person family navigation accelerates autism diagnosis; however, effectiveness of telehealth autism navigation is unknown. This study tested preliminary efficacy of telehealth autism navigation.

In this site-randomized pilot trial of telehealth autism family navigation, 7 clinics (66 primary care providers) were trained in autism screening and randomized to family navigation versus usual care. 49 children aged 12-54 months enrolled. We used Early Intervention/Early Childhood Special Education (EI/ECSE) and health records to compare navigation intervention and control arms on time from enrollment to EI/ECSE eligibility determination, percent receiving EI/ECSE eligibility determination within 6 months, percent of children receiving EI/ECSE referrals within 6 months, and percent receiving autism educational and medical diagnoses within 6 months.

In intention-to-treat analysis, 46.7% of the navigation (66.7% of those referred to EI/ECSE) and 36.8% of control families (87.5% of those referred to EI/ECSE) had EI/ECSE eligibility determinations. Median time to EI/ECSE eligibility determination was 66.5 days in navigation and 120 days in control. 70% of navigation and 42.1% of control children were referred to EI/ECSE. 23.8% of navigation and 0% of control children received an autism educational eligibility within 6 months, but 10% of navigation children versus 42.1% of control had autism medical diagnostic determination within 6 months. 50% of the navigation arm had < 4 navigator interactions.

Telehealth family navigation shows preliminary promise for improving access to services in EI/ECSE, especially for referral and evaluation. Access to medical diagnostic evaluation may need additional support. A larger trial can investigate longer-term services receipt.

NCT04861740, Registered 4/7/2021.