Equivalence of the autism spectrum disorders diagnostics in children in telemedicine and face-to-face consultations: a literature review

Abstract

BACKGROUND: The use of remote forms of mental health care has become widespread during the period of epidemiological restrictions due to the COVID-19 pandemic. Methodological and organizational issues remain insufficiently developed, including the level of equivalence of the use of telemedicine technologies in the diagnosis of autistic spectrum disorders.

AIM: Study of the equivalence of diagnostic tools in the framework of telemedicine and face-to-face consultations in children with autistic spectrum disorders according to modern scientific literature.

METHODS: A descriptive review of scientific studies published between January 2017 and May 2023 was carried out. The papers presented in the electronic databases PubMed, Web of Science, and eLibrary were analyzed. Descriptive analysis was used to summarize the obtained data.

RESULTS: The conducted analysis convincingly indicates sufficient equivalence of remote tools used in different countries for level I screening, assessment scales, and structured procedures for diagnosing autistic spectrum disorders with a high level of specificity from 60.0 to 94.4%, sensitivity from 75 dog 98.4%, and satisfaction of patients and their legal representatives.

CONCLUSION: The widespread use of validated telemedicine diagnostic systems in clinical practice contributes to the early detection of autistic spectrum disorders, increasing the timeliness and effectiveness of medical, corrective psychological, pedagogical, and habilitation interventions.

Keywords

telemedicine / equivalence of telemedicine consultations / autism spectrum disorders / childhood

References

[1] Drahota A, Sadler R, Hippensteel C, Ingersoll B, Bishop L. Service deserts and service oases: Utilizing geographic information systems to evaluate service availability for individuals with autism spectrum disorder. Autism. 2020;24(8):2008–20. doi: 10.1177/1362361320931265.

[2] Sutherland R, Trembath D, Hodge MA, Rose V, Roberts J. Telehealth and autism: Are telehealth language assessments reliable and feasible for children with autism? Int J Lang Commun Disord. 2019;54(2):281–91. doi: 10.1111/1460-6984.12440.

[3] Antezana L, Scarpa A, Valdespino A, Albright J, Richey JA. Rural Trends in Diagnosis and Services for Autism Spectrum Disorder. Front Psychol. 2017;8:590. doi: 10.3389/fpsyg.2017.00590.

[4] Hincapié MA, Gallego JC, Gempeler A, Piñeros JA, Nasner D, Escobar MF. Implementation and Usefulness of Telemedicine During the COVID-19 Pandemic: A Scoping Review. J Prim Care Community Health. 2020;11:2150132720980612. doi: 10.1177/2150132720980612.

[5] Raparia E, Husain D. COVID-19 Launches Retinal Telemedicine into the Next Frontier. Semin Ophthalmol. 2021;36(4):258-263. doi: 10.1080/08820538.2021.1893352.

[6] Volkova OA, Budarin SS, Smirnova EV, Elbek YuV. Experience of using telemedicine technologies in healthcare systems of foreign countries and the Russian Federation: systematic review. FARMAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmacoepidemiology. 2021;14(4):549–62. doi: 10.17749/2070-4909/farmakoekonomika.2021.109. Russian.

[7] Chumakov EM, Babin SM, Azarova LA, Petrova NN, Limankin OV. Telemedical technologies in psychiatric and psychotherapeutic care during the COVID-19 pandemic – challenges and perspectives. Bulletin of Psychotherapy. 2021;78 (83):20–35. Russian.

[8] Tarasov VG. The experience of using telemedicine technologies in the National Medical Research Center of Psychiatry and Narcology n.a. V.P. Serbsky. Menthal Health. 2022;17(8):3–9. doi: 10.25557/2074-014X.2022.08.3-9. Russian.

[9] Khairetdinov OZ, Bebchuk MA, Vladzymyrskyy AV, Morozov SP. State and prospects of legal regulation of telemedicine consultation in the patient-specialist format in children’s psychiatric practice. S.S. Korsakov Journal of Neurology and Psychiatry. 2021;121(11):103–7. doi: 10.17116/jnevro20211211 12103. Russian.

[10] Solokhina TA, Kuzminova MV, Mitikhin VG. Telepsychiatry and telepsychology: possibilities and limitations of remote work. Psikhiatriya. 2021;19(3):68–79. doi: 10.30629/2618-6667-2021-19-3-68-79. Russian.

[11] Zwaigenbaum L, Bishop S, Stone WL, Ibanez L, Halladay A, Goldman S, Kelly A, Klaiman C, Lai MC, Miller M, Saulnier C, Siper P, Sohl K, Warren Z, Wetherby A. Rethinking autism spectrum disorder assessment for children during COVID-19 and beyond. Autism Res. 2021;14(11):2251–9. doi: 10.1002/aur.2615.

[12] Sutherland R, Trembath D, Roberts J. Telehealth and autism: a systematic search and review of the literature. Int J Speech Lang Pathol. 2018;20(3):324–36. doi: 10.1080/17549507.2018.1465123.

[13] Ellison KS, Guidry J, Picou P, Adenuga P, Davis TE 3rd. Telehealth and autism prior to and in the age of COVID-19: a systematic and critical review of the last decade. Clin Child Fam Psychol Rev. 2021;24(3):599–630. doi:10.1007/s10567-021-00358-0.

[14] Robins DL, Casagrande K, Barton M, Chen CM, Dumont-Mathieu T, Fein D. Validation of the modified checklist for Autism in toddlers, revised with follow-up (M-CHAT-R/F). Pediatrics. 2014;133(1):37–45. doi: 10.1542/peds.2013-1813.

[15] Pop-Jordanova N, Zorcec T. Does the M-Chat-R give important information for the diagnosis of the autism spectrum disorder? Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2021;42(1):67–75. doi: 10.2478/prilozi-2021-0005.

[16] Rutter M, Bailey A, Lord C. Social Communication Questionnaire (SCQ) Manual. Western Psychological Services; Los Angeles, CA, USA; 2000.

[17] Mayes S. Diagnosing autism with Checklist for Autism Spectrum Disorder (CASD). In: Patel V, Preedy V, Martin C (eds). Comprehensive Guide to Autism. Springer, New York, NY; 2014. doi: 10.1007/978-1-4614-4788-7_11.

[18] Liu M, Ma Z. A systematic review of telehealth screening, assessment, and diagnosis of autism spectrum disorder. Child Adolesc Psychiatry Ment Health. 2022 Oct 8;16(1):79. doi: 10.1186/s13034-022-00514-6.

[19] Constantino JN, Abbacchi AM, Saulnier C, Klaiman C, Mandell DS, Zhang Y, Hawks Z, Bates J, Klin A, Shattuck P, Molholm S, Fitzgerald R, Roux A, Lowe JK, Geschwind DH. Timing of the diagnosis of autism in African American children. Pediatrics. 2020;146(3):e20193629. doi: 10.1542/peds.2019-3629.

[20] Qiu T, Zhang H, Zhou C, Tang Q, Wang L, Ke X. Application of telemedicine for preliminary screening of autism spectrum disorder. Front Pediatr. 2022;9:745597. doi: 10.3389/fped.2021.745597.

[21] Kadam A, Soni IG, Kadam S, Pandit A, Patole S. Video-based screening for children with suspected autism spectrum disorder — experience during the COVID-19 pandemic in India. Res Autism Spectr Disord. 2022;98:102022. doi: 10.1016/j.rasd.2022.102022.

[22] Colombo P, Buo N, Busti Ceccarelli S, Molteni M. Integrating a new online platform in primary care for early detection, referral, and intervention in autism spectrum disorder: the first Italian pivotal project. Brain Sci. 2022;12(2):256. doi: 10.3390/brainsci12020256.

[23] Rutter M, Le Couteur A, Lord C. ADI-R: The Autism Diagnostic Interview—Revised. Los Angeles: Western Psychological Services; 2003.

[24] Lord C, Rutter M, DiLavore PC, Risi S. Autism Diagnostic Observation Schedule. Los Angeles: Western Psychological Services; 2002.

[25] Reese RM, Jamison R, Wendland M, Fleming K, Braun MJ, Schuttler JO, Turek J. Evaluating interactive videoconferencing for assessing symptoms of autism. Telemed J E Health. 2013;19(9):671–7. doi:10.1089/tmj.2012.0312.

[26] Narzisi A. Phase 2 and Later of COVID-19 Lockdown: is it possible to perform remote diagnosis and intervention for Autism Spectrum Disorder? An online-mediated approach. J Clin Med. 2020;9(6):1850. doi: 10.3390/jcm9061850.

[27] Alfuraydan M, Croxall J, Hurt L, Kerr M, Brophy S. Use of telehealth for facilitating the diagnostic assessment of Autism Spectrum Disorder (ASD): a scoping review. PLoS One. 2020;15(7):e0236415. doi: 10.1371/journal.pone.0236415.

[28] Sutantio JD, Pusponegoro HD, Sekartini R. Validity of Telemedicine for Diagnosing Autism Spectrum Disorder: Protocol-Guided Video Recording Evaluation. Telemed J E Health. 2021;27(4):427–31. doi: 10.1089/tmj.2020.0035.

[29] Riva V, Villa L, Fulceri F, Arduino GM, Leonti G, Valeri G, Casula L, Zoccante L, Puttini E, Sogos C, Presicce M, Bentenuto A, Apicella F, Molteni M, Scattoni ML. The teleNIDA: early screening of Autism Spectrum Disorder through a novel telehealth approach. J Autism Dev Disord. 2023:1–11. doi: 10.1007/s10803-023-05927-6.

[30] Nazneen N, Rozga A, Smith CJ, Oberleitner R, Abowd GD, Arriaga RI. A novel system for supporting autism diagnosis using home videos: iterative development and evaluation of system design. JMIR Mhealth Uhealth. 2015;3(2):e68. doi: 10.2196/mhealth.4393.

[31] Smith CJ, Rozga A, Matthews N, Oberleitner R, Nazneen N, Abowd G. Investigating the accuracy of a novel telehealth diagnostic approach for autism spectrum disorder. Psychol Assess. 2017;29(3):245–52. doi: 10.1037/pas0000317.

[32] Dow D, Day TN, Kutta TJ, Nottke C, Wetherby AM. Screening for autism spectrum disorder in a naturalistic home setting using the systematic observation of red flags (SORF) at 18–24 months. Autism Res. 2020;13(1):122–33. doi: 10.1002/aur.2226.

[33] Pileggi ML, Brane N, Bradshaw J, Delehanty A, Day T, McCracken C, Stapel-Wax J, Wetherby AM. Early observation of red flags in 12-month-old infant siblings later diagnosed with Autism Spectrum Disorder. Am J Speech Lang Pathol. 2021;30(4):1846–55. doi: 10.1044/2020_AJSLP-20-00165.

[34] Talbott MR, Dufek S, Zwaigenbaum L, Bryson S, Brian J, Smith IM, Rogers SJ. Brief report: preliminary feasibility of the TEDI: a novel parent-administered telehealth assessment for Autism Spectrum Disorder symptoms in the first year of life. J Autism Dev Disord. 2020;50(9):3432–9. doi: 10.1007/s10803-019-04314-4.

[35] Talbott MR, Dufek S, Young G, Rogers SJ. Leveraging telehealth to evaluate infants with prodromal autism spectrum disorder characteristics using the telehealth evaluation of development for infants. Autism. 2022;26(5):1242–54. doi: 10.1177/13623613211045596.

[36] Kryszak EM, Albright CM, Stephenson KG, Nevill RE, Hedley D, Burns CO, Young RL, Butter EM, Vargo K, Mulick JA. Preliminary validation and feasibility of the Autism Detection in Early Childhood-Virtual (ADEC-V) for autism telehealth evaluations in a hospital setting. J Autism Dev Disord. 2022;52(12):5139–49. doi: 10.1007/s10803-022-05433-1.

[37] Berger NI, Wainer AL, Kuhn J, Bearss K, Attar S, Carter AS, Ibanez LV, Ingersoll BR, Neiderman H, Scott S, Stone WL. Characterizing available tools for synchronous virtual assessment of toddlers with suspected autism spectrum disorder: a brief report. J Autism Dev Disord. 2022;52(1):423–34. doi: 10.1007/s10803-021-04911-2.

[38] Wagner L, Corona LL, Weitlauf AS, Marsh KL, Berman AF, Broderick NA, Francis S, Hine J, Nicholson A, Stone C, Warren Z. Use of the TELE-ASD-PEDS for autism evaluations in response to COVID-19: preliminary outcomes and clinician acceptability. J Autism Dev Disord. 2021;51(9):3063–72. doi: 10.1007/s10803-020-04767-y.

[39] Corona LL, Weitlauf AS, Hine J, Berman A, Miceli A, Nicholson A, Stone C, Broderick N, Francis S, Juárez AP, Vehorn A, Wagner L, Warren Z. Parent perceptions of caregiver-mediated telemedicine tools for assessing autism risk in toddlers. J Autism Dev Disord. 2021;51(2):476–86. doi:10.1007/s10803-020-04554-9.

[40] Stone WL, McMahon CR, Henderson LM. Use of the Screening Tool for Autism in Two-Year-Olds (STAT) for children under 24 months: an exploratory study. Autism. 2008;12(5):557–73. doi: 10.1177/1362361308096403.

[41] McNally Keehn R, Enneking B, Ryan T, James C, Tang Q, Blewitt A, Tomlin A, Corona L, Wagner L. Tele-assessment of young children referred for autism spectrum disorder evaluation during COVID-19: Associations among clinical characteristics and diagnostic outcome. Autism. 2022:13623613221138642. doi: 10.1177/13623613221138642.

[42] Duda M, Daniels J, Wall DP. Clinical Evaluation of a Novel and Mobile Autism Risk Assessment. J Autism Dev Disord. 2016;46(6):1953–61. doi: 10.1007/s10803-016-2718-4.

[43] Duda M, Kosmicki JA, Wall DP. Testing the accuracy of an observation-based classifier for rapid detection of autism risk. Transl Psychiatry. 2014;4(8):e424. doi: 10.1038/tp.2014.65. Erratum in: Transl Psychiatry. 2014;4:e440.

[44] Shahamiri SR, Thabtah F. Autism AI: a new Autism Screening System based on artificial intelligence. Cogn Comput. 2020;12(8):766–77. doi: 10.1007/s12559-020-09743-3.

[45] Kanne SM, Carpenter LA, Warren Z. Screening in toddlers and preschoolers at risk for autism spectrum disorder: Evaluating a novel mobile-health screening tool. Autism Res. 2018;11(7):1038–49. doi: 10.1002/aur.1959.

[46] Abbas H, Garberson F, Glover E, Wall DP. Machine learning approach for early detection of autism by combining questionnaire and home video screening. J Am Med Inform Assoc. 2018;25(8):1000–7. doi: 10.1093/jamia/ocy039.

[47] Abbas H, Garberson F, Liu-Mayo S, Glover E, Wall DP. Multi-modular AI approach to streamline autism diagnosis in young children. Sci Rep. 2020;10(1):5014. doi: 10.1038/s41598-020-61213-w.

[48] Megerian JT, Dey S, Melmed RD, Coury DL, Lerner M, Nicholls CJ, Sohl K, Rouhbakhsh R, Narasimhan A, Romain J, Golla S, Shareef S, Ostrovsky A, Shannon J, Kraft C, Liu-Mayo S, Abbas H, Gal-Szabo DE, Wall DP, Taraman S. Evaluation of an artificial intelligence-based medical device for diagnosis of autism spectrum disorder. NPJ Digit Med. 2022;5(1):57. doi: 10.1038/s41746-022-00598-6.

[49] Stavropoulos KK, Bolourian Y, Blacher J. A scoping review of telehealth diagnosis of autism spectrum disorder. PLoS One. 2022 Feb 10;17(2):e0263062. doi: 10.1371/journal.pone.0263062.

[50] Juárez AP, Weitlauf AS, Nicholson A, Pasternak A, Broderick N, Hine J, Stainbrook JA, Warren Z. Early Identification of ASD Through telemedicine: potential value for underserved populations. J Autism Dev Disord. 2018;48(8):2601–10. doi: 10.1007/s10803-018-3524-y.

[51] Matthews NL, Skepnek E, Mammen MA, James JS, Malligo A, Lyon A, Mitchell M, Kiefer SL, Smith CJ. Feasibility and acceptability of a telehealth model for autism diagnostic evaluations in children, adolescents, and adults. Autism Res. 2021;14(12):2564–79. doi: 10.1002/aur.2591.

[52] Sutantio JD, Pusponegoro HD, Sekartini R. Validity of telemedicine for diagnosing Autism Spectrum Disorder: protocol-guided video recording evaluation. Telemed J E Health. 2021;27(4):427–31. doi: 10.1089/tmj.2020.0035.

[53] Elford R, White H, Bowering R, Ghandi A, Maddiggan B, St John K, House M, Harnett J, West R, Battcock A. A randomized, controlled trial of child psychiatric assessments conducted using videoconferencing. J Telemed Telecare. 2000;6(2):73–82. doi: 10.1258/1357633001935086.

[54] Rubakova LI, Khairetdinov OZ. [Comparative study of early diagnosis of childhood autism in the framework of telemedicine and face-to-face consultations]. In: Semenova NV, editor. Preventive psychiatry: early diagnosis and timely therapy: materials of the conference of the All-Russian scientific and practical conference with international participation; 2022 Sep 22–23. Kazan; 2022. p. 164-8. Russian.

[55] Roid GH, Miller LJ. Leiter international performance scale-revised (Leiter-R). Wood Dale, IL: Stoelting; 1997.

[56] Greene JA, Trujillo S, Isquith PK, Gioia GA, Espy KA. Enhanced interpretation of the Behavior Rating Inventory of Executive Function–Preschool version (BRIEF-P) (white paper) PAR; Lutz, FL, USA; 2019.

[57] Achenbach TM, Rescorla LA Manual for the ASEBA preschool forms and profiles. Burlington, VT: University of Vermont, Research center for children, youth, & families. 2000;30.

[58] Fenson l, Pethick S, Renda C, Cox JL, Dale PS, Reznick J.S. Short-form versions of the MacArthur Communicative Development Inventories. Applied Psycholinguistics. 2000;21(1):95–116. doi: 10.1017/S0142716400001053.

[59] Schopler E, Van Bourgondien ME, Wellman GJ, Love SR. Childhood Autism Rating Scale. 2nd ed. Western Psychological Services; Los Angeles, CA, USA; 2010.

[60] Lam KS, Aman MG. The Repetitive Behavior Scale-Revised: independent validation in individuals with autism spectrum disorders. J Autism Dev Disord. 2007;37:855–66. doi: 10.1007/s10803-006-0213-z.

[61] Rutter M, Bailey A, Lord C. Social Communication Questionnaire (SCQ) Manual. Western Psychological Services; Los Angeles, CA, USA; 2000.

[62] Dunn W. Sensory Profile. Harcourt Assessment; San Antonio, TX, USA; 1999.

[63] Constantino J, Gruber J. Social Responsiveness Scale (SRS) manual. Western Psychological Services; Los Angeles, CA, USA; 2005.

[64] Abidin RR. Parenting Stress Index. 4th ed. PAR; Lutz, FL, USA; 2012.

[65] Sparrow SS, Cicchetti DV, Balla DA. Vineland adaptive behavior scales Vineland-II: Survey forms manual. Minneapolis, MN: Pearson; 2005.

[66] Dow D, Holbrook A, Toolan C, McDonald N, Sterrett K, Rosen N, Kim SH, Lord C. The Brief Observation of Symptoms of Autism (BOSA): development of a new adapted assessment measure for remote telehealth administration Through COVID-19 and Beyond. J Autism Dev Disord. 2022;52(12):5383–94. doi: 10.1007/s10803-021-05395-w.

[67] Grzadzinski R, Carr T, Colombi C, McGuire K, Dufek S, Pickles A, Lord C. Measuring changes in social communication behaviors: preliminary development of the Brief Observation of Social Communication Change (BOSCC). J Autism Dev Disord. 2016;46(7):2464–79. doi: 10.1007/s10803-016-2782-9.

[68] Adamson LB, Bakeman R. The Communication Play Protocol: capturing variations in language development. Perspect ASHA Spec Interest Groups. 2016;1(12):164–71. doi: 10.1044/persp1.SIG12.164.

[69] Bryson SE, Zwaigenbaum L, McDermott C, Rombough V, Brian J. The Autism Observation Scale for Infants: scale development and reliability data. J Autism Dev Disord. 2008;38(4):731–8. doi: 10.1007/s10803-007-0440-y.

[70] Young RL, Autism Detection in Early Childhood (ADEC) Manual. ACER Press; 2007.

[71] Nickel RE. The observation of play screener: Home edition. Oregon Health & Science University; 2020.

[72] Miller J. ASD-DIAL: Diagnostic interview and activities — Lifespan, version 2. Children’s Hospital of Philadelphia; 2020.

[73] Kryszak EM, Albright C. How do we adapt in a time of crisis? APA Division 33 Newsletter. 2020;46(1):4.

[74] Alpern G, Boll T, Shearer M. Developmental Profile — Third Edition (DP-3) Torrance, CA: Western Psychological Services; 2007.

RIGHTS & PERMISSIONS

Khairetdinov O.Z., Rubakova L.I.