With telehealth’s use on the rise, it has inevitably been increasingly used to reach out, diagnose, and treat children with Autism Spectrum Disorders (ASD). Telehealth.org briefly discussed this movement back in 2020 in Route to Expanding State Telehealth Medicaid Programs Post-COVID-19. Despite the early work in autism telehealth, the perception held by many professionals remains that in-person services are the better option for autistic children and their families. It could be important for parents and clinicians to evaluate the accuracy of this long-held belief, particularly in families dealing with disparities as well as the everyday challenges of managing an autistic child.
To do so, we must first consider whether autism telehealth can match in-person visits for the accuracy of detecting and diagnosing ASD in children. If it does indeed prove accurate in doing so, we then need to figure out whether telehealth can be used to provide effective levels of care to children with an autism diagnosis. Lastly, is it not only an effective but sensible way to treat children with ASD?
Diagnosing Autism Via Telehealth
The first question has been the subject of several recent studies that preceded the pandemic. Thus, the data answers the question well for not just emergencies where in-person visits could prove dangerous to clinicians and clients alike. Instead, it applies to times when telehealth’s use stems from a lack of availability of services in a client’s area, access to transportation, or a simple need for convenience. This makes it useful information for now and going forward.
As with any client, therapy begins with diagnosis. Is telehealth able to allow clinicians to properly assess children with Autism Spectrum Disorders as accurately as in-person evaluations? A 2018 study from the International Journal of Language and Communication Disorders found that language assessments to diagnose autism by telehealth and those done in-person were significantly positively correlated. Therefore, children assessed using autism telehealth tools were just as likely as their in-person peers to receive an accurate assessment.
Another 2018 study from the Journal of Autism and Developmental Disorders pursued a similar question about assessments beyond those of language. They too concluded that telehealth assessments strongly positively correlated with those of in-person evaluations. Once again, this argues positively for the ongoing use of autism telehealth tools for trained clinicians to diagnose and treat children with ASD.
Treating Autism via Telehealth
To confirm that autism telehealth works effectively to diagnose and treat autistic children and their families, we turn to a study from the journal Pediatrics in 2016. This study looked at whether there were noticeable differences in care provided for children using three comparison groups: a) in-person care versus b) care using telehealth services located in a clinic where the family needed to travel to the clinic to receive care, versus c) in-home telehealth services were delivered to children and families who were in their homes, their natural environments. The study concluded that all three comparison groups, when properly administered according to protocols, were equally effective. The study also found that both telehealth options were noticeably less costly than the in-person option. Ultimately, in-home telehealth care demonstrated itself to be the most cost-efficient of all three approaches. Their findings mirror those of another study that focused on trained clinicians using telehealth to deliver care equal to in-person care for a wider range of disorders.
Advocacy Call For Action to Support Autism Telehealth
These results all assert that telehealth is not only a workable delivery mechanism for diagnosing and treating children with ASD but that, in many cases, it may be a preferred model. It costs less, allowing providers to offer less expensive services to the children and their families. Autism telehealth is less disruptive to family routines which can be crucial for these families. It enables those who might be geographically disadvantaged to receive a level of timely care compared to those living in areas with more specialists available. Finally, the results argue that children and their families did not suffer a loss of accuracy in diagnosis or loss of effectiveness in treatment. Articles such as Telehealth.org’s more recent Autism Telehealth: Engaging Autistic Children through Telehealth can give evidence-based as well as COVID-proven-effective strategies to clinicians who seek to traverse this difficult terrain with children and families dealing with the many harsh realities of autism.
All clinicians working with autistic children and families have a story to tell legislators who are currently deciding the fate of telehealth on a state-by-state basis this month. Taking a moment to write a simple, 1-page letter outlining why you need telehealth to continue being funded by insurance companies and Medicaid is crucial right now. Send the letter to your elected officials – all of them. You may also want to send the same letter to your licensing board if your board is overly restrictive with regard to telehealth.
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Introduction to Telehealth Theory & Practice
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