Screen to Screen Versus Face to Face: Evaluating Telehealth Autism Diagnostic Assessments for Young Children in a Diverse Clinical Setting
Live-video autism exams using TELE-ASD-PEDS match in-person results 90 percent of the time for toddlers who speak little or not at all.
01Research in Context
What this study did
The team compared two ways to diagnose autism in toddlers. One way was the usual in-person exam. The other was a live video visit using the TELE-ASD-PEDS tool.
All kids were under four and mostly non-speaking. The clinicians gave each child both types of exam and then checked if the answers matched.
What they found
The two methods gave the same yes-or-no answer for 19 out of 21 children. That is 90 percent agreement.
The scores from each method also moved up and down together with a strong link. Parents saved travel time and the clinic reached more families.
How this fits with other research
Bogenschutz et al. (2015) saw the same high agreement in rural preschoolers using early video gear. The new study widens the idea to city toddlers and newer software.
Meimei et al. (2022) looked at many small telehealth tests and found mixed accuracy. This single-case paper adds one clear data point that lands near the best-case end of their range.
Stainbrook et al. (2019) showed that adding tele-diagnosis lifts referral and show-up rates. Sutherland et al. now show the label you give during those visits is almost always the same one you would give in person.
Why it matters
You can feel safe using TELE-ASD-PEDS for intake evaluations when families cannot come in. The 90 percent match means only one in ten cases may need a follow-up visit. Start the session the same way you would on site: use a parent coach, keep toys in view, and score live. This single move can cut wait lists and reach rural or home-bound families without losing accuracy.
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02At a glance
03Original abstract
Access to autism diagnostic assessments continues to be problematic for many families and children. While telehealth assessments have been shown to be feasible and reliable in research settings, less is known about the agreement between telehealth autism assessments compared with in‐person evaluations in clinical settings with linguistic, cultural, and social diversity. Twenty‐one minimally verbal children (between 23.9 and 51.7 months, mean = 36.5 months, SD = 8 months) participated in a telehealth autism assessment (the TELE‐ASD‐PEDS; TAP) with a parent, and then in an in‐person, multidisciplinary team assessment. Telehealth clinicians were blinded to history and questionnaire information; in‐person clinicians were blinded to the telehealth results. Assessment results in each setting, along with diagnostic impression (telehealth) and diagnostic outcome (in‐person), were compared. Assessment scores across the settings showed very good agreement and were strongly correlated (r = 0.75, p < 0.001). There was diagnostic agreement (either autism/autism or no‐autism/no‐autism) for 19/21 children, or 90% of the participants. This study adds to the growing literature on autism diagnostic assessments administered via telehealth. Our research builds on previous work by comparing telehealth findings directly with in‐person assessment and diagnostic results. The results of the present study yielded high rates of diagnostic agreement as well as strong agreement between telehealth and in‐person assessment scores for young children with limited language and high levels of autism symptoms, which to our knowledge, have not to date been directly compared.
Autism Research, 2025 · doi:10.1002/aur.70113