TELE-ASD-PEDS (TAP) Telehealth Evaluation Model
Population: CYSHCN Infant
Topic Area: Telehealth Health Screening Care Coordination
NPMs: NPM 6: Developmental Screening NPM 11: Medical Home
Growing evidence supports telemedicine-based approaches to autism spectrum disorder (ASD) screening and assessment for young children, such as activities to assess infant-toddler social communication skills and remote coaching of parents to complete assessment activities. Through a computationally informed, stakeholder driven design process, we created a new ASD tele-assessment tool for toddlers (the TELE-ASD-PEDS or TAP) to be used as part of a telehealth evaluation for young children (under 36 months). In initial evaluation, we demonstrated that many children with ASD can be accurately identified using tele-assessment procedures (both in Part C centers and home settings), that participating families report high levels of satisfaction with tele-assessment services, and that deploying such systems in rural settings has the potential to dramatically reduce wait times for identification and service. Moreover, subsequent unanticipated broad dissemination of the TAP model during COVID-19 demonstrated potential widespread value to providers and families. Importantly, this widescale use has allowed our team to evaluate tele-assessment across heterogenous institutions and providers, providing rich stakeholder data to inform aspects of ongoing development and future deployment. Qualitatively, benefits noted by providers included increased access for families, the value of in-home/naturalistic observation, increased caregiver involvement, and flexibility in deploying resources to accomplish evaluation (limited need for clinic space, scheduling flexibility). By dramatically limiting opportunities for traditional in-person evaluation of ASD, the COVID-19 pandemic has exacerbated historical disparities in diagnostic care related to geography, provider shortages, socioeconomic status, race/ethnicity, and primary language. Diagnostic delays contribute to substantial family stress and restrict access to evidence-based early intervention services. The TAP model could address traditional barriers to care access by enabling prompt identification of many young children with ASD within community settings.
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