Years before COVID-19, autism experts at Vanderbilt University Medical Center noticed a need for a remote assessment tool to give families who live far from medical centers quick answers to early concerns.
A large team of psychologists, clinicians and researchers within the Vanderbilt Kennedy Center (VKC) and Division of Developmental Medicine created the TELE-ASD-PEDS (TAP), a tool that asks caregivers to complete several play activities with their toddlers during a telehealth visit while a psychologist observes.
A trial for TAP was underway in 2020 when most autism centers around the country, including VUMC, closed for in-person care. Within two weeks, a group of VKC psychologists virtually trained 2,000 practitioners to use TAP, making it the foremost way to remotely assess autism in children in the country. A study published in the Journal of Autism and Developmental Disorders offers compelling data that many autism profiles can be identified early via tele-assessment.
“This is the first rigorous study of the accuracy of early telemedicine-based assessment of autism in young children,” said Zachary Warren, PhD, professor of Pediatrics and principal investigator of the study. “And the first well-controlled trial of a tele-medicine tool created by Vanderbilt researchers.”
Over a three-year period, including a four-month pause during the pandemic, 144 children ages 17-36 months participated in the study.
“Families first completed a telemedicine visit, during which a psychologist guided them through play activities and asked questions about the child’s development,” said Laura Corona, PhD, assistant professor of Pediatrics and a co-investigator for the study. “Families then completed a traditional, in-person autism evaluation with a different psychologist. We compared the results of in-person and tele-assessments to understand how accurately the tele-assessment identified or ruled out autism for these children.”
For 92% of participants, the results of tele-assessment matched the results of in-person assessment.
“The results of this study provide strong evidence that we can accurately and confidently use tele-assessment for autism evaluations for many families who prefer this option,” Corona said. “This study has been a jumping-off point for additional autism tele-assessment work: We continue to study this tool in larger, more diverse samples of families and have built it into clinical practice, including partnering with the state early intervention system to increase the availability of tele-assessments.”
Corona also noted that the study is the result of many years of work from a team who “developed the tool, designed a way to evaluate it, recruited and evaluated families, and troubleshooted telemedicine technology before many people were doing it.”
“Vanderbilt is now leading initiatives understanding how best to move this instrument into optimal real-world use across a variety of care systems,” said Warren, whose team has received four grants, two from the National Institutes of Health and two from the Department of Defense, to conduct a larger trial to understand telemedicine use and impact in traditionally underserved groups; develop a new telemedicine tool for preschool-age children; understand tele-assessment’s impact on early intervention services and pediatric systems of care; and develop a tele-assessment tool to identify adolescents and young adults with autism.