Understanding Caregiver Satisfaction With a Telediagnostic Assessment of Autism Spectrum Disorder.

PURPOSE: In light of the COVID-19 pandemic, it is critical to understand the feasibility and acceptability of the use of telediagnostic assessments in clinical settings. This study aimed to characterize caregiver satisfaction with a telediagnostic assessment of autism spectrum disorder (ASD). METHOD: Twelve families completed a telediagnostic assessment of ASD through Illinois' Early Intervention program including a caregiver interview, administration of the TELE-ASD-PEDS, and a feedback visit. Following the evaluation, caregivers rated their satisfaction with the telediagnostic assessment. RESULTS: Caregivers reported that the evaluation met their expectations, and they were satisfied with the assessment and feedback visit. However, caregiver satisfaction with the telehealth platform varied, and the majority of caregivers reported a preference for in-person visits. Qualitative analysis of caregiver responses noted the benefits and areas of improvement of telediagnostic assessment. Thematic analysis revealed the strengths of the telediagnostic assessment, including the logistical convenience of the teleassessment, ease of administration, rapport with and expertise of the clinicians, and qualification for intervention services. Although caregivers' perspectives varied, diagnostic accuracy and the amount of information provided about the diagnosis were reported areas of improvement. CONCLUSIONS: Overall, telediagnostic assessments were well received by families. Caregivers' preference for in-person visits highlights the need to incorporate caregiver-reported areas of improvement in the development and administration of telediagnostic assessments.

Brief Report: What Diagnostic Observation Can Teach Us About Disruptive Behavior in Young Children with Autism.

ABSTRACT: Objective: Approximately 50% of children with autism exhibit severe tantrums, defiance, and/or aggression. We propose that the Disruptive Behavior Diagnostic Observation Schedule (DB-DOS)-a standardized clinical observation modeled after, and complementary to, the Autism Diagnostic Observation Schedule (ADOS)-could enhance earlier identification of disruptive behavior (DB) in autism populations and inform treatment planning. Methods: We adapted the DB-DOS for children with autism based on expert input and preliminary feasibility testing to accommodate varying cognitive and social communication capacities and increase the likelihood of observing DB in this population. Thereafter, we concurrently administered the modified DB-DOS and the ADOS to 12 children with autism aged 36 to 50 months. Results: Overall, children exhibited greater DB, especially behavioral regulation challenges, during the DB-DOS than during the ADOS. Conclusion: The use of a developmentally sensitive standardized observation tool that presses for DB to complement standardized observations such as the ADOS shows promise for enabling more precise research on targeted DB interventions. Such a tool holds promise as a reliable and efficient method of identifying comorbid DB disorders in the autism population.