June 13, 2018

Vanderbilt study affirms effectiveness, promise of telemedicine for autism evaluations

Researchers at Vanderbilt University Medical Center have found that autism spectrum disorder (ASD) can be accurately diagnosed in young children via remote, telemedicine assessments, a method that could significantly increase access and reduce wait times for autism services.

In a first-of-its-kind study, the researchers compared the accuracy of rapid telemedicine evaluations to in-person evaluations for ASD and found that in most cases, remote evaluators could accurately identify children with ASD with high levels of confidence.

The remote clinicians accurately identified 78.9 percent of all children who ultimately received ASD diagnoses based on a blinded comprehensive assessment with gold-standard identification tools. No children were inaccurately classified as having ASD based on the telemedicine consultation.

Zachary Warren, PhD, and colleagues had their findings published recently in the Journal of Autism and Developmental Disorders.

ASD is a neurodevelopmental disorder which, according to the U.S. Centers for Disease Control and Prevention (CDC), is identified in one in 59 children, with updated numbers to be released by the CDC this year.

Because an early autism diagnosis is critical, the American Academy of Pediatrics recommends screening for ASD starting at 18 months of age. However, in many parts of the country, the demand for services is so great that waits for an autism evaluation in a specialty clinic may exceed six to 12 months or more.

To address the need in Tennessee, the Treatment and Research Institute for Autism Spectrum Disorders has built its capacity to evaluate children for autism by expanding its telehealth initiatives, which use telecommunications technologies to support long-distance clinical health care.

To test the effectiveness of these telemedicine evaluations, children were evaluated using both in-person and remote diagnostic tools. The assessors, all licensed psychologists with expertise in ASD in young children, used audiovisual equipment that allowed them to observe and communicate with the child.

This study was completed with Vanderbilt Kennedy Center Hobbs Grant funding, support from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (U54 HD08321), and support from the Department of Education Tennessee Early Intervention System.

Additional co-authors from Vanderbilt included Pablo Juarez, MEd; Amy Weitlauf, PhD, Amy Nicholson, MA.; Anna Pasternak, BASc; Neill Broderick, PhD; Jeffrey Hine, PhD, BCBA-D; and J. Alacia Stainbrook, PhD, BCBA-D.

– by Jennifer Wetzel