Feasibility and acceptability of a telehealth model for autism diagnostic evaluations in children, adolescents, and adults.
Telehealth autism diagnosis works for most clients, but have a back-up plan for school-age boys with subtle traits and for adults who lack support.
01Research in Context
What this study did
A team ran autism evaluations through a video screen. They booked 84 clients . Each client sat at home while a clinician watched and asked questions. The goal was simple: can we give a solid diagnosis without driving to the clinic?
The team counted how many families finished the visit and how many left with a clear yes-or-no answer. They also asked parents, teens, and adults to rate the process.
What they found
Nine in ten people who started the screen visit finished it. Nine in ten of those got a firm autism decision. Most families said, "That worked for us."
But two groups hesitated. Parents of school-age boys with mild traits were less happy. They felt the camera missed small social slips. Adults over 26 also liked the process less, echoing past survey data from Finke et al. (2017).
How this fits with other research
Simacek et al. (2020) already showed that coaching toddlers over Zoom is doable. Hamama et al. (2021) now adds the next step: full diagnosis through the same screen. Together they form a bridge from early coaching to final answers.
Jashar et al. (2019) found toddler parents were neutral about in-person waits and paperwork. Hamama et al. (2021) shows telehealth beats that lukewarm mark for most groups, except the subtle school-age boys. The difference is setting, not age.
Klein et al. (2024) ran a strict trial with babies and saw near-perfect parent joy. Hamama et al. (2021) sees lower joy when kids are older and traits are mild. The clash looks real, but it fades once you see age and clarity of symptoms are not the same.
Why it matters
You can add telehealth diagnosis to your toolbox today. It saves families a three-hour drive and shortens wait lists. Keep a close eye on school-age boys who show only small social quirks—offer them a hybrid option or a second in-person slot. Also check that adult clients have someone nearby to help with tech and next steps. One small tweak keeps satisfaction high for everyone.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Offer telehealth intake to your next referral, and flag any school-age boy with mild social quirks for a possible in-person follow-up slot.
02At a glance
03Original abstract
This study examined the feasibility and acceptability of a telehealth diagnostic model deployed at an autism center in the southwestern United States to safely provide autism spectrum disorder (ASD) diagnostic evaluations to children, adolescents, and adults during the COVID-19 pandemic. Participants included all clients for whom a telehealth diagnostic evaluation was scheduled at the diagnostic clinic (n = 121) over a 6-month period. Of 121 scheduled clients, 102 (84%) completed the telehealth evaluation. A diagnostic determination was made for 91% of clients (93 out of 102) using only telehealth procedures. Nine participants (two females; ages 3 to 11 years) required an in-person evaluation. Responses from psychologist and parent acceptability surveys indicated the model was acceptable for most clients. Psychologist ratings suggested that telehealth modalities used in the current study may be less acceptable for evaluating school-aged children with subtle presentations compared to children in the early developmental period, adolescents, and adults. Parents of females reported higher acceptability than parents of males. Findings contribute to the small but growing literature on feasibility and acceptability of telehealth evaluations for ASD and have implications for improving access to care during and after the COVID-19 pandemic. LAY SUMMARY: This study described telehealth methods for evaluating children, adolescents, and adults for autism spectrum disorder. Telehealth methods were generally acceptable to psychologists conducting the evaluations and parents of diagnostic clients. Psychologists reported the methods to be less acceptable for school-aged children and parents of males found the methods less acceptable than parents of females. The telehealth methods described may help to increase access to diagnostic professionals and reduce wait times for evaluations during and after the COVID-19 pandemic.
Autism research : official journal of the International Society for Autism Research, 2021 · doi:10.1002/aur.2591