Feasibility and acceptability of a telehealth model for autism diagnostic evaluations in children, adolescents, and adults.

This study examined the feasibility and acceptability of a telehealth diagnostic model deployed at an autism center in the southwestern United States to safely provide autism spectrum disorder (ASD) diagnostic evaluations to children, adolescents, and adults during the COVID-19 pandemic. Participants included all clients for whom a telehealth diagnostic evaluation was scheduled at the diagnostic clinic (n = 121) over a 6-month period. Of 121 scheduled clients, 102 (84%) completed the telehealth evaluation. A diagnostic determination was made for 91% of clients (93 out of 102) using only telehealth procedures. Nine participants (two females; ages 3 to 11 years) required an in-person evaluation. Responses from psychologist and parent acceptability surveys indicated the model was acceptable for most clients. Psychologist ratings suggested that telehealth modalities used in the current study may be less acceptable for evaluating school-aged children with subtle presentations compared to children in the early developmental period, adolescents, and adults. Parents of females reported higher acceptability than parents of males. Findings contribute to the small but growing literature on feasibility and acceptability of telehealth evaluations for ASD and have implications for improving access to care during and after the COVID-19 pandemic. LAY SUMMARY: This study described telehealth methods for evaluating children, adolescents, and adults for autism spectrum disorder. Telehealth methods were generally acceptable to psychologists conducting the evaluations and parents of diagnostic clients. Psychologists reported the methods to be less acceptable for school-aged children and parents of males found the methods less acceptable than parents of females. The telehealth methods described may help to increase access to diagnostic professionals and reduce wait times for evaluations during and after the COVID-19 pandemic.

Toward the identification of adaptive functioning intervention targets for intellectually-able, transition-aged youth with autism: An examination of caregiver responses on the Vineland-II.

Little is known about specific adaptive functioning impairments in intellectually-able individuals with autism spectrum disorder. In adolescents (n = 22) and young adults (n = 22) matched on composite IQ scores, this study examined profiles of cognitive and adaptive functioning, and caregiver responses on individual Vineland-II items. Adaptive functioning standard scores were significantly lower than IQ scores, and the adult group had significantly lower adaptive functioning standard scores than the adolescent group. Examination of caregiver responses to individual Vineland-II items identified more than 100 potential intervention targets. Differences favoring the adult group were observed on only 16 items across all three adaptive functioning domains, suggesting that little skill development is occurring during the transition to adulthood. Future research will examine the relevance of identified intervention targets to optimal outcomes. Autism Res 2017, 10: 2023-2036. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Adolescents and young adults with autism spectrum disorder (ASD) without intellectual disability demonstrated impaired adaptive functioning skills (i.e., age appropriate skills necessary for independent living). Development of adaptive functioning skills appears to slow with age among individuals without intellectual disability. Findings clarify the specific adaptive functioning skills that transition-aged youth with ASD have difficulty completing independently and will inform the development of interventions to increase the likelihood of independent living in adulthood.

Adaptive Functioning in Autism Spectrum Disorder During the Transition to Adulthood.

There is a dearth of research regarding adaptive functioning during the transition to adulthood in autism spectrum disorder (ASD). Profiles on the Vineland Adaptive Behavior Scales, Second Edition were examined by age and intellectual ability in 75 participants with ASD (16-58 years). Results extend previous reports of a cognitive advantage over adaptive functioning in children by demonstrating a similar pattern in an older sample. Daily living skills were a relative strength compared to communication and socialization in adults, but not adolescents. In general, highest subdomain scores were observed in writing skills and lowest scores were observed in interpersonal skills. Regardless of cognitive ability, all standard scores were well below average, indicating a need for lifelong intervention that targets adaptive functioning.

Revisiting cognitive and adaptive functioning in children and adolescents with autism spectrum disorder.

Profiles of performance on the Stanford Binet Intelligence Scales (SB5) and Vineland Adaptive Behavior Scales (VABS) were examined in 73 children and adolescents with autism spectrum disorder. SB5 cognitive profiles were observed to be similar between participants with and without early language delay, but different between participants with and without intellectual disability. With few exceptions, the distribution and cognitive profiles of participants with specific nonverbal IQ-verbal IQ and abbreviated IQ-full scale IQ discrepancy patterns paralleled previous reports. A cognitive functioning advantage over adaptive functioning was observed to be strongest in participants without intellectual disability and older participants. The previously reported VABS "autism profile" was not observed. Current findings clarify previous research and will inform the diagnostic process and treatment planning.