Tele-Assessment of Young Children Referred for Autism Spectrum Disorder Evaluation during COVID-19: Associations among Clinical Characteristics and Diagnostic Outcome

Since the onset of the COVID-19 pandemic, there has been a rapid acceleration of innovative research on health services delivery, including real-world clinical implementation and evaluation of tele-assessment for the diagnosis of autism spectrum disorder. Extending this promising work, the present study examined clinical characteristics and diagnostic outcome for young children receiving autism spectrum disorder tele-assessment during the COVID-19 pandemic. The standard tele-assessment procedure included caregiver clinical interview, administration of the TELE-ASD-PEDS (TAP; a novel caregiver-mediated remote autism spectrum disorder observational assessment tool), Vineland-3, and diagnostic feedback and family counseling. Overall, our findings suggest that a definitive autism spectrum disorder diagnosis can be determined for most young children evaluated using standard tele-assessment procedures. While TAP scores and measures of adaptive functioning and "Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition" autism spectrum disorder symptoms are highly associated with autism spectrum disorder diagnostic outcome, a specific pattern of Restricted and Repetitive Behaviors independently predicted differential autism spectrum disorder outcome. Furthermore, our findings suggest that the TAP is useful for evaluation of at-risk children above 36 months of age with delayed language. These results add to an increasing body of research supporting use of tele-assessment, and specifically the TAP, for diagnosis of young children referred for autism spectrum disorder evaluation.