Reliability and Validity of Autism Assessments and Diagnosis Using Telemedicine

摘要

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.