Use of a Novel Tele-Assessment Tool for the Identification of Autism in Preschool-Aged Children.
Telehealth autism assessments work, yet we must redesign them to be fair and family-friendly.
01Research in Context
What this study did
Fradet et al. (2025) wrote a position paper about telehealth autism assessments for preschool kids.
They looked at what the pandemic taught us and asked for fairer, family-friendly tools.
What they found
The paper says telehealth can open doors, but only if we redesign it with equity in mind.
It argues that quick pandemic fixes left many families behind and urges lasting reforms.
How this fits with other research
Sutherland et al. (2025) recently showed 90% agreement between telehealth and in-person autism diagnosis in toddlers. Their data extends L et al.'s call by proving the TELE-ASD-PEDS tool already works when used thoughtfully.
Meimei et al. (2022) reviewed 17 tele-ASD tools and found good sensitivity but mixed specificity. Fradet et al. (2025) builds on this by saying we must now make these tools fairer, not just faster.
Stainbrook et al. (2019) and Bogenschutz et al. (2015) both found that rural telemedicine clinics boost access and match in-person decisions. Fradet et al. (2025) agrees, yet warns that access alone is not equity.
Why it matters
You can keep using telehealth for autism assessments, but check that your protocol is family-centered. Offer flexible scheduling, send parents clear prep videos, and ask what tech barriers they face. Small moves like mailing toy kits or using phone data stipends can close equity gaps the earlier studies missed.
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02At a glance
03Original abstract
The COVID-19 pandemic has posed unique challenges for families and caregivers, as well as for autism-focused clinicians, who are faced with providing a thorough and accurate evaluation of children's specific needs and diagnoses in the absence of in-person assessment tools. The shift to telehealth assessments has challenged clinicians to reconsider approaches and assumptions that underlie the diagnostic assessment process, and to adopt new ways of individualizing standard assessments according to family and child needs. Mandates for physical distancing have uncovered deficiencies in diagnostic practices for suspected autism and have illuminated biases that have posed obstacles preventing children and families from receiving the services that they truly need. This Commentary outlines several considerations for improving diagnostic practices as we move forward from the current pandemic and continue to strive to build an adaptable, sustainable, equitable, and family-centered system of care. LAY SUMMARY: Physical distancing and the abrupt end to in-person services for many children on the autism spectrum has forced clinicians to examine the existing challenges with autism spectrum disorder (ASD) diagnostic assessment and consider things they want to keep and things that should be changed in the years ahead. New approaches such as telehealth both alleviated and exacerbated existing disparities, and brought into stark focus the importance of equitable and timely access to family-centered care. This commentary suggests ways of improving clinical practices related to ASD assessment to continue along this path.
Journal of autism and developmental disorders, 2025 · doi:10.1111/jcpp.13271