Development of a Novel Telemedicine Tool to Reduce Disparities Related to the Identification of Preschool Children with Autism / Liliana WAGNER ; Alison VEHORN ; Amy S. WEITLAUF ; Ambar Munoz Lavanderos ; Joshua WADE ; Laura CORONA ; Zachary WARREN in Journal of Autism and Developmental Disorders, 55-1 (January 2025)  

Public ISBD [article]  inJournal of Autism and Developmental Disorders > 55-1 (January 2025) . - p.30-42 Titre : Development of a Novel Telemedicine Tool to Reduce Disparities Related to the Identification of Preschool Children with Autism : Journal of Autism and Developmental Disorders Type de document : Texte imprimé et/ou numérique Auteurs : Liliana WAGNER, Auteur ; Alison VEHORN, Auteur ; Amy S. WEITLAUF, Auteur ; Ambar Munoz Lavanderos, Auteur ; Joshua WADE, Auteur ; Laura CORONA, Auteur ; Zachary WARREN, Auteur Article en page(s) : p.30-42 Langues : Anglais (eng) Index. décimale : PER Périodiques Résumé : The wait for ASD evaluation dramatically increases with age, with wait times of a year or more common as children reach preschool. Even when appointments become available, families from traditionally underserved groups struggle to access care. Addressing care disparities requires designing identification tools and processes specifically for and with individuals most at-risk for health inequities. This work describes the development of a novel telemedicine-based ASD assessment tool, the TELE-ASD-PEDS-Preschool (TAP-Preschool). We applied machine learning models to a clinical data set of preschoolers with ASD and other developmental concerns (n = 914) to generate behavioral targets that best distinguish ASD and non-ASD features. We conducted focus groups with clinicians, early interventionists, and parents of children with ASD from traditionally underrepresented racial/ethnic and linguistic groups. Focus group themes and machine learning analyses were used to generate a play-based instrument with assessment tasks and scoring procedures based on the child?s language (i.e., TAP-P Verbal, TAP-P Non-verbal). TAP-P procedures were piloted with 30 families. Use of the instrument in isolation (i.e., without history or collateral information) yielded accurate diagnostic classification in 63% of cases. Children with existing ASD diagnoses received higher TAP-P scores, relative to children with other developmental concerns. Clinician diagnostic accuracy and certainty were higher when confirming existing ASD diagnoses (80% agreement) than when ruling out ASD in children with other developmental concerns (30% agreement). Utilizing an equity approach to understand the functionality and impact of tele-assessment for preschool children has potential to transform the ASD evaluation process and improve care access. En ligne : https://doi.org/10.1007/s10803-023-06176-3 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=546 [article] Development of a Novel Telemedicine Tool to Reduce Disparities Related to the Identification of Preschool Children with Autism : Journal of Autism and Developmental Disorders [Texte imprimé et/ou numérique] / Liliana WAGNER, Auteur ; Alison VEHORN, Auteur ; Amy S. WEITLAUF, Auteur ; Ambar Munoz Lavanderos, Auteur ; Joshua WADE, Auteur ; Laura CORONA, Auteur ; Zachary WARREN, Auteur . - p.30-42. Langues : Anglais (eng) in Journal of Autism and Developmental Disorders > 55-1 (January 2025) . - p.30-42 Index. décimale : PER Périodiques Résumé : The wait for ASD evaluation dramatically increases with age, with wait times of a year or more common as children reach preschool. Even when appointments become available, families from traditionally underserved groups struggle to access care. Addressing care disparities requires designing identification tools and processes specifically for and with individuals most at-risk for health inequities. This work describes the development of a novel telemedicine-based ASD assessment tool, the TELE-ASD-PEDS-Preschool (TAP-Preschool). We applied machine learning models to a clinical data set of preschoolers with ASD and other developmental concerns (n = 914) to generate behavioral targets that best distinguish ASD and non-ASD features. We conducted focus groups with clinicians, early interventionists, and parents of children with ASD from traditionally underrepresented racial/ethnic and linguistic groups. Focus group themes and machine learning analyses were used to generate a play-based instrument with assessment tasks and scoring procedures based on the child?s language (i.e., TAP-P Verbal, TAP-P Non-verbal). TAP-P procedures were piloted with 30 families. Use of the instrument in isolation (i.e., without history or collateral information) yielded accurate diagnostic classification in 63% of cases. Children with existing ASD diagnoses received higher TAP-P scores, relative to children with other developmental concerns. Clinician diagnostic accuracy and certainty were higher when confirming existing ASD diagnoses (80% agreement) than when ruling out ASD in children with other developmental concerns (30% agreement). Utilizing an equity approach to understand the functionality and impact of tele-assessment for preschool children has potential to transform the ASD evaluation process and improve care access. En ligne : https://doi.org/10.1007/s10803-023-06176-3 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=546

Enhancing developmental-behavioral pediatric rotations by teaching residents how to evaluate autism in primary care / Jeffrey F. HINE in Autism, 25-5 (July 2021)  

Public ISBD [article]  inAutism > 25-5 (July 2021) . - p.1492-1496 Titre : Enhancing developmental-behavioral pediatric rotations by teaching residents how to evaluate autism in primary care Type de document : Texte imprimé et/ou numérique Auteurs : Jeffrey F. HINE, Auteur ; Liliana WAGNER, Auteur ; Rachel GOODE, Auteur ; Verity RODRIGUES, Auteur ; Julie LOUNDS TAYLOR, Auteur ; Amy WEITLAUF, Auteur ; Zachary WARREN, Auteur Article en page(s) : p.1492-1496 Langues : Anglais (eng) Mots-clés : Autism Spectrum Disorder/diagnosis  Autistic Disorder/diagnosis  Curriculum  Humans  Internship and Residency  Primary Health Care  Surveys and Questionnaires  autism spectrum disorder  primary care  resident training  interest with respect to research, authorship, and/or publication of this  article. Index. décimale : PER Périodiques Résumé : Most physician preparation programs do not provide enough practical experiences in autism-related care. This is especially true for how to assess for and diagnose autism. Without this training, many pediatricians are not well prepared to implement appropriate care for children with autism and their families. We designed a curriculum to improve training for medical residents that involved explicit hands-on training in diagnostic identification and care coordination for toddlers at risk for autism. We collected data to assess whether our enhanced curriculum led to increased comfort level across recommended practice behaviors. Almost all the residents were able to complete the training within their rotation and our surveys indicated significant increases in residents feeling more comfortable identifying symptoms of autism, providing feedback about diagnostic decisions, and effectively connecting families with services. A significant majority of residents considered it appropriate or very appropriate for children to receive a diagnosis solely from a primary care provider. Our results suggest feasibility of the enhanced model, and this project reflects the first step in advancing incorporation of autism training into pediatric residency programs. En ligne : http://dx.doi.org/10.1177/1362361320984313 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=475 [article] Enhancing developmental-behavioral pediatric rotations by teaching residents how to evaluate autism in primary care [Texte imprimé et/ou numérique] / Jeffrey F. HINE, Auteur ; Liliana WAGNER, Auteur ; Rachel GOODE, Auteur ; Verity RODRIGUES, Auteur ; Julie LOUNDS TAYLOR, Auteur ; Amy WEITLAUF, Auteur ; Zachary WARREN, Auteur . - p.1492-1496. Langues : Anglais (eng) in Autism > 25-5 (July 2021) . - p.1492-1496 Mots-clés : Autism Spectrum Disorder/diagnosis  Autistic Disorder/diagnosis  Curriculum  Humans  Internship and Residency  Primary Health Care  Surveys and Questionnaires  autism spectrum disorder  primary care  resident training  interest with respect to research, authorship, and/or publication of this  article. Index. décimale : PER Périodiques Résumé : Most physician preparation programs do not provide enough practical experiences in autism-related care. This is especially true for how to assess for and diagnose autism. Without this training, many pediatricians are not well prepared to implement appropriate care for children with autism and their families. We designed a curriculum to improve training for medical residents that involved explicit hands-on training in diagnostic identification and care coordination for toddlers at risk for autism. We collected data to assess whether our enhanced curriculum led to increased comfort level across recommended practice behaviors. Almost all the residents were able to complete the training within their rotation and our surveys indicated significant increases in residents feeling more comfortable identifying symptoms of autism, providing feedback about diagnostic decisions, and effectively connecting families with services. A significant majority of residents considered it appropriate or very appropriate for children to receive a diagnosis solely from a primary care provider. Our results suggest feasibility of the enhanced model, and this project reflects the first step in advancing incorporation of autism training into pediatric residency programs. En ligne : http://dx.doi.org/10.1177/1362361320984313 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=475

Enhancing developmental-behavioral pediatric rotations by teaching residents how to evaluate autism in primary care / Jeffrey F. HINE in Autism, 26-5 (July 2022)  

Public ISBD [article]  inAutism > 26-5 (July 2022) . - p.1492-1496 Titre : Enhancing developmental-behavioral pediatric rotations by teaching residents how to evaluate autism in primary care Type de document : Texte imprimé et/ou numérique Auteurs : Jeffrey F. HINE, Auteur ; Liliana WAGNER, Auteur ; Rachel GOODE, Auteur ; Verity RODRIGUES, Auteur ; Julie LOUNDS TAYLOR, Auteur ; Amy WEITLAUF, Auteur ; Zachary WARREN, Auteur Article en page(s) : p.1492-1496 Langues : Anglais (eng) Mots-clés : Autism Spectrum Disorder/diagnosis  Autistic Disorder/diagnosis  Curriculum  Humans  Internship and Residency  Primary Health Care  Surveys and Questionnaires  autism spectrum disorder  primary care  resident training  interest with respect to research, authorship, and/or publication of this  article. Index. décimale : PER Périodiques Résumé : Most physician preparation programs do not provide enough practical experiences in autism-related care. This is especially true for how to assess for and diagnose autism. Without this training, many pediatricians are not well prepared to implement appropriate care for children with autism and their families. We designed a curriculum to improve training for medical residents that involved explicit hands-on training in diagnostic identification and care coordination for toddlers at risk for autism. We collected data to assess whether our enhanced curriculum led to increased comfort level across recommended practice behaviors. Almost all the residents were able to complete the training within their rotation and our surveys indicated significant increases in residents feeling more comfortable identifying symptoms of autism, providing feedback about diagnostic decisions, and effectively connecting families with services. A significant majority of residents considered it appropriate or very appropriate for children to receive a diagnosis solely from a primary care provider. Our results suggest feasibility of the enhanced model, and this project reflects the first step in advancing incorporation of autism training into pediatric residency programs. En ligne : http://dx.doi.org/10.1177/1362361320984313 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=484 [article] Enhancing developmental-behavioral pediatric rotations by teaching residents how to evaluate autism in primary care [Texte imprimé et/ou numérique] / Jeffrey F. HINE, Auteur ; Liliana WAGNER, Auteur ; Rachel GOODE, Auteur ; Verity RODRIGUES, Auteur ; Julie LOUNDS TAYLOR, Auteur ; Amy WEITLAUF, Auteur ; Zachary WARREN, Auteur . - p.1492-1496. Langues : Anglais (eng) in Autism > 26-5 (July 2022) . - p.1492-1496 Mots-clés : Autism Spectrum Disorder/diagnosis  Autistic Disorder/diagnosis  Curriculum  Humans  Internship and Residency  Primary Health Care  Surveys and Questionnaires  autism spectrum disorder  primary care  resident training  interest with respect to research, authorship, and/or publication of this  article. Index. décimale : PER Périodiques Résumé : Most physician preparation programs do not provide enough practical experiences in autism-related care. This is especially true for how to assess for and diagnose autism. Without this training, many pediatricians are not well prepared to implement appropriate care for children with autism and their families. We designed a curriculum to improve training for medical residents that involved explicit hands-on training in diagnostic identification and care coordination for toddlers at risk for autism. We collected data to assess whether our enhanced curriculum led to increased comfort level across recommended practice behaviors. Almost all the residents were able to complete the training within their rotation and our surveys indicated significant increases in residents feeling more comfortable identifying symptoms of autism, providing feedback about diagnostic decisions, and effectively connecting families with services. A significant majority of residents considered it appropriate or very appropriate for children to receive a diagnosis solely from a primary care provider. Our results suggest feasibility of the enhanced model, and this project reflects the first step in advancing incorporation of autism training into pediatric residency programs. En ligne : http://dx.doi.org/10.1177/1362361320984313 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=484

Parent Perceptions of Caregiver-Mediated Telemedicine Tools for Assessing Autism Risk in Toddlers / Laura L. CORONA in Journal of Autism and Developmental Disorders, 51-2 (February 2021)  

Public ISBD [article]  inJournal of Autism and Developmental Disorders > 51-2 (February 2021) . - p.476-486 Titre : Parent Perceptions of Caregiver-Mediated Telemedicine Tools for Assessing Autism Risk in Toddlers Type de document : Texte imprimé et/ou numérique Auteurs : Laura L. CORONA, Auteur ; Amy S. WEITLAUF, Auteur ; Jeffrey HINE, Auteur ; Anna BERMAN, Auteur ; Alexandra MICELI, Auteur ; Amy NICHOLSON, Auteur ; Caitlin STONE, Auteur ; Neill A. BRODERICK, Auteur ; Sara FRANCIS, Auteur ; A Pablo JUAREZ, Auteur ; Alison VEHORN, Auteur ; Liliana WAGNER, Auteur ; Zachary WARREN, Auteur Article en page(s) : p.476-486 Langues : Anglais (eng) Mots-clés : Autism spectrum disorder  Diagnosis  Telemedicine  Young children Index. décimale : PER Périodiques Résumé : Telemedicine tools have potential for increasing access to diagnostic services for children with autism spectrum disorder (ASD). Past work has utilized tele-assessment procedures in which remote psychologists observe administration of interactive screening instruments by trained, on-site providers. Although promising, this approach relies on two clinicians, limiting its efficiency and scalability. The present study examined the use, acceptability, and parents' perceptions of two caregiver-mediated tools for assessing ASD risk in toddlers, in which remote clinicians guided parents to complete interactive screening activities with their children. Most parents found tele-assessment to be comfortable, and many reported liking the parent-led nature of these tools. Parents also offered constructive feedback, which was used to modify the tele-assessment process for future study. En ligne : http://dx.doi.org/10.1007/s10803-020-04554-9 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=440 [article] Parent Perceptions of Caregiver-Mediated Telemedicine Tools for Assessing Autism Risk in Toddlers [Texte imprimé et/ou numérique] / Laura L. CORONA, Auteur ; Amy S. WEITLAUF, Auteur ; Jeffrey HINE, Auteur ; Anna BERMAN, Auteur ; Alexandra MICELI, Auteur ; Amy NICHOLSON, Auteur ; Caitlin STONE, Auteur ; Neill A. BRODERICK, Auteur ; Sara FRANCIS, Auteur ; A Pablo JUAREZ, Auteur ; Alison VEHORN, Auteur ; Liliana WAGNER, Auteur ; Zachary WARREN, Auteur . - p.476-486. Langues : Anglais (eng) in Journal of Autism and Developmental Disorders > 51-2 (February 2021) . - p.476-486 Mots-clés : Autism spectrum disorder  Diagnosis  Telemedicine  Young children Index. décimale : PER Périodiques Résumé : Telemedicine tools have potential for increasing access to diagnostic services for children with autism spectrum disorder (ASD). Past work has utilized tele-assessment procedures in which remote psychologists observe administration of interactive screening instruments by trained, on-site providers. Although promising, this approach relies on two clinicians, limiting its efficiency and scalability. The present study examined the use, acceptability, and parents' perceptions of two caregiver-mediated tools for assessing ASD risk in toddlers, in which remote clinicians guided parents to complete interactive screening activities with their children. Most parents found tele-assessment to be comfortable, and many reported liking the parent-led nature of these tools. Parents also offered constructive feedback, which was used to modify the tele-assessment process for future study. En ligne : http://dx.doi.org/10.1007/s10803-020-04554-9 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=440

A Randomized Trial of the Accuracy of Novel Telehealth Instruments for the Assessment of Autism in Toddlers / Laura L. CORONA in Journal of Autism and Developmental Disorders, 54-6 (June 2024)  

Public ISBD [article]  inJournal of Autism and Developmental Disorders > 54-6 (June 2024) . - p.2069-2080 Titre : A Randomized Trial of the Accuracy of Novel Telehealth Instruments for the Assessment of Autism in Toddlers Type de document : Texte imprimé et/ou numérique Auteurs : Laura L. CORONA, Auteur ; Liliana WAGNER, Auteur ; Madison HOOPER, Auteur ; Amy WEITLAUF, Auteur ; Tori E. FOSTER, Auteur ; Jeffrey HINE, Auteur ; Alexandra MICELI, Auteur ; Amy NICHOLSON, Auteur ; Caitlin STONE, Auteur ; Alison VEHORN, Auteur ; Zachary WARREN, Auteur Article en page(s) : p.2069-2080 Langues : Anglais (eng) Index. décimale : PER Périodiques Résumé : Purpose: Telemedicine approaches to autism (ASD) assessment have become increasingly common, yet few validated tools exist for this purpose. This study presents results from a clinical trial investigating two approaches to tele-assessment for ASD in toddlers. Methods: 144 children (29% female) between 17 and 36 months of age (mean = 2.5 years, SD = 0.33 years) completed tele-assessment using either the TELE-ASD-PEDS (TAP) or an experimental remote administration of the Screening Tool for Autism in Toddlers (STAT). All children then completed traditional in-person assessment with a blinded clinician, using the Mullen Scales of Early Learning (MSEL), Vineland Adaptive Behavior Scales, 3rd Edition (VABS-3), and Autism Diagnostic Observation Schedule (ADOS-2). Both tele-assessment and in-person assessment included a clinical interview with caregivers. Results: Results indicated diagnostic agreement for 92% of participants. Children diagnosed with ASD following in-person assessment who were missed by tele-assessment (n = 8) had lower scores on tele- and in-person ASD assessment tools. Children inaccurately identified as having ASD by tele-assessment (n = 3) were younger than other children and had higher developmental and adaptive behavior scores than children accurately diagnosed with ASD by tele-assessment. Diagnostic certainty was highest for children correctly identified as having ASD via tele-assessment. Clinicians and caregivers reported satisfaction with tele-assessment procedures. Conclusion: This work provides additional support for the use of tele-assessment for identification of ASD in toddlers, with both clinicians and families reporting broad acceptability. Continued development and refinement of tele-assessment procedures is recommended to optimize this approach for the needs of varying clinicians, families, and circumstances. En ligne : https://doi.org/10.1007/s10803-023-05908-9 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=530 [article] A Randomized Trial of the Accuracy of Novel Telehealth Instruments for the Assessment of Autism in Toddlers [Texte imprimé et/ou numérique] / Laura L. CORONA, Auteur ; Liliana WAGNER, Auteur ; Madison HOOPER, Auteur ; Amy WEITLAUF, Auteur ; Tori E. FOSTER, Auteur ; Jeffrey HINE, Auteur ; Alexandra MICELI, Auteur ; Amy NICHOLSON, Auteur ; Caitlin STONE, Auteur ; Alison VEHORN, Auteur ; Zachary WARREN, Auteur . - p.2069-2080. Langues : Anglais (eng) in Journal of Autism and Developmental Disorders > 54-6 (June 2024) . - p.2069-2080 Index. décimale : PER Périodiques Résumé : Purpose: Telemedicine approaches to autism (ASD) assessment have become increasingly common, yet few validated tools exist for this purpose. This study presents results from a clinical trial investigating two approaches to tele-assessment for ASD in toddlers. Methods: 144 children (29% female) between 17 and 36 months of age (mean = 2.5 years, SD = 0.33 years) completed tele-assessment using either the TELE-ASD-PEDS (TAP) or an experimental remote administration of the Screening Tool for Autism in Toddlers (STAT). All children then completed traditional in-person assessment with a blinded clinician, using the Mullen Scales of Early Learning (MSEL), Vineland Adaptive Behavior Scales, 3rd Edition (VABS-3), and Autism Diagnostic Observation Schedule (ADOS-2). Both tele-assessment and in-person assessment included a clinical interview with caregivers. Results: Results indicated diagnostic agreement for 92% of participants. Children diagnosed with ASD following in-person assessment who were missed by tele-assessment (n = 8) had lower scores on tele- and in-person ASD assessment tools. Children inaccurately identified as having ASD by tele-assessment (n = 3) were younger than other children and had higher developmental and adaptive behavior scores than children accurately diagnosed with ASD by tele-assessment. Diagnostic certainty was highest for children correctly identified as having ASD via tele-assessment. Clinicians and caregivers reported satisfaction with tele-assessment procedures. Conclusion: This work provides additional support for the use of tele-assessment for identification of ASD in toddlers, with both clinicians and families reporting broad acceptability. Continued development and refinement of tele-assessment procedures is recommended to optimize this approach for the needs of varying clinicians, families, and circumstances. En ligne : https://doi.org/10.1007/s10803-023-05908-9 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=530

Tele-assessment of young children referred for autism spectrum disorder evaluation during COVID-19: Associations among clinical characteristics and diagnostic outcome / Rebecca MCNALLY KEEHN in Autism, 27-5 (July 2023)  

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Transitioning to Telemedicine During COVID-19: Impact on Perceptions and Use of Telemedicine Procedures for the Diagnosis of Autism in Toddlers / Liliana WAGNER in Journal of Autism and Developmental Disorders, 52-5 (May 2022)  

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Use of telemediated caregiver coaching to increase access to naturalistic developmental behavioral interventions within a statewide early intervention system / Kathleen SIMCOE in Autism, 29-1 (January 2025)  

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