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Telemedicine is increasingly utilized as a means to provide health care to underserved areas, including rural and urban areas without providers. The current research explores the accuracy of diagnosis, parent satisfaction and the use of two ?gold standard? measures, the Autism Diagnostic Observation Schedule (ADOS) and the Autism Diagnostic Interview-Revised (ADI-R) in their use in the assessment and diagnosis of children via telemedicine. Participants were children ages 3-5 with a previous diagnosis of an autism spectrum disorder (n=11), or developmental delays acting as control subjects (n=10). Participants were randomly assigned to interact with a lead psychologist through telemedicine or in person. One pair of clinicians observed in the room with families (Live) while one pair of clinicians simultaneously observed via telemedicine (Telemedicine). Each pair of clinicians provided scores on the ADOS and the ADI, as well as an overall diagnosis for the child. Inter rater agreement was computed for each pair of clinicians (item by item) and then compared to the inter rater agreement (item by item) of the other pair of clinicians with results indicating clinicians are able to score autism measures equally well in person or via telemedicine. Family satisfaction indicated families were highly satisfied in both conditions.

Objective: The aim of this study was to study valproate efficacy and safety for aggression in children and adolescents with pervasive developmental disorders (PDD). Methods: In this prospective double-blind, placebo-controlled study, 30 subjects (20 boys, 10 girls) 6–20 years of age with PDD and significant aggression were randomized and received treatment with valproate (VPA) or placebo (PBO) for 8 weeks as outpatients. Mean VPA trough blood levels were 75.5 mcg/mL at week 4 and 77.8 mcg/mL at week 8. Results: No treatment difference was observed statistically between VPA and PBO groups. The Aberrant Behavior Checklist—Community Scale (ABC-C) Irritability subscale was the primary outcome measure (p = 0.65), and CGI—Improvement (p = 0.16) and OAS (p = 0.96) were secondary outcome measures. Increased appetite and skin rash were significant side effects. Only 1 subject was dropped from the study owing to side effects, notably a spreading skin rash, which then resolved spontaneously. Two subjects receiving VPA developed increased serum ammonia levels, one with an associated parent report of slurred speech and mild cognitive slowing. Poststudy, of 16 VPA and PBO subjects receiving VPA, 10 subjects demonstrated sustained response, 4 of whom later attempted taper, with significant relapse of aggression. Conclusion: The present negative findings cannot be viewed as conclusive, partly owing to the large placebo response, subject heterogeneity, and size of the groups. Larger studies are needed to expand upon these findings.