Use of Telehealth in Autism Spectrum Disorder Assessment in Children: Evaluation of an Online Diagnostic Protocol Including the Brief Observation of Symptoms of Autism

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Authors

STROUPKOVÁ Lucie VYHNALOVÁ Martina KOLÁŘ Senad KNEDLÍKOVÁ Lenka PACKANOVA Ivona BITTNEROVA Anna Marie NOVÁKOVÁ Nela PŘIKRYLOVÁ KUČEROVÁ Hana HORÁK Ondřej OŠLEJŠKOVÁ Hana THEINER Pavel DANHOFER Pavlína

Year of publication 2024
Type Article in Periodical
Magazine / Source Journal of Autism and Developmental Disorders
MU Faculty or unit

Faculty of Medicine

Citation
Web https://link.springer.com/article/10.1007/s10803-024-06524-x
Doi http://dx.doi.org/10.1007/s10803-024-06524-x
Keywords Autism; Autism spectrum disorders; Autism assessment; Assessment tools; Telehealth; Telehealth assessment; Psychodiagnostics; Neurodevelopmental disorders
Description The COVID-19 pandemic revealed the need to develop the field of remote assessment for autism spectrum disorders (ASD). The purpose of the study was to evaluate an online assessment protocol that includes the Brief Observation of Symptoms of Autism (BOSA). The online protocol consisting of BOSA and the Autism Diagnostic Interview-Revised (ADI-R) was administered by experienced examiners to 29 children with suspected ASD. The participants were then evaluated by clinical psychologists in a standard clinical setting using the Autism Diagnostic Observation Schedule-2 (ADOS-2) and other methods, and the ASD diagnosis was confirmed or ruled out. The results show substantial to moderate inter-rater agreement between the online and face-to-face raters with the value of Cohen's Kappa = 0.66 (P < 0.001); this corresponds with 79.8% agreement. The sensitivity of the protocol was approx. 94.7%, the specificity was 70%, the positive predictive value was 85.7%, and the negative predictive value was 87.5%. Further, direct false positive or false negative diagnostic conclusions based on the online protocol were absent when the possible conclusion of "I cannot decide" was included. The items B9 Showing, B10 Spontaneous Initiation of Joint Attention, B1 Unusual Eye Contact, B3 Facial Expressions Directed to Others, and C2 Imagination/Creativity were shown to be well observable in BOSA when related to ADOS-2 scoring. The results indicate that the protocol consisting of BOSA and ADI-R administered by an experienced examiner is a promising combination of tools for remote autism assessment.
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