We will use the TELE-ASD-PEDS evaluation tool designed by experts in the field of ASD in order to remotely evaluate children from their homes, with the help of their parents. The purpose of this study is to identify the predictive validity of TELE-ASD-PEDS in the diagnosis of ASD and to potentially foster increased use of telemedicine-based practices in the field of ASD.
Our patient population includes pediatric patients from both rural and suburban Iowa, who have been referred to the University of Iowa's Center for Disabilities and Development (CDD) for evaluation of ASD. We will recruit participants by first sending them a letter/email with information about the study. 1-3 days later, we will call families to describe the TELE-ASD-PEDS tool. If the family is interested in participating, we will send the consent form via email (link to REDCap). Assessments will be performed from the patient's home prior to clinic visit (home-based) or from the patient's clinic room at the CDD during initial evaluation (clinic-based). For recording at UIHC, we will use video Voalte phones (HIPAA-compliant device utilized at UIHC for communication, record-keeping) or computers to videotape the child's behavior while the clinician is prompting the parent on the activities. For families recording at home, they may use a smart phone, computer, or tablet to capture their video. Participation is exclusively voluntary and families are given the option to decline participation. Our plan is to perform the TELE-ASD-PEDS evaluation prior to the patient's formal ASD diagnostic evaluation at the CDD. Administration of the TELE-ASD-PEDS assessment should take 15 to 30 minutes. The entire telemedicine visit, inclusive of other elements, will likely take longer. We will use statistical analyses to determine the validity of the TELE-ASD-PEDS results compared with the in-person Autism Diagnostic Observation Schedule (ADOS) and Childhood Autism Rating Scale (CARS-2) evaluations.
We hypothesize that there will be no significant difference in TELE-ASD-PEDS results and ADOS results in determining ASD diagnosis. Our pilot study is unique in that our telemedicine-based tool will be performed on children who have not had an official diagnosis of ASD, thus decreasing selection bias or interviewer bias. The clinician who performs the ADOS will be blinded to the results of the TELE-ASD-PEDS. This study will provide further information about the validity in telemedicine-based evaluations and alternate avenues for ASD diagnoses.