Smith Christopher J, Rozga Agata, Matthews Nicole, Oberleitner Ron, Nazneen Nazneen, Abowd Gregory
Southwest Autism Research and Resource Center.
School of Interactive Computing, Georgia Institute of Technology.
Psychol Assess. 2017 Mar;29(3):245-252. doi: 10.1037/pas0000317. Epub 2016 May 19.
Research indicates that a substantial amount of time elapses between parents' first concerns about their child's development and a formal diagnosis of autism spectrum disorder (ASD). Telehealth presents an opportunity to expedite the diagnostic process. This project compared a novel telehealth diagnostic approach that utilizes clinically guided in-home video recordings to the gold standard in-person diagnostic assessment. Participants included 40 families seeking an ASD evaluation for their child and 11 families of typically developing children. Children were between the ages of 18 months and 6 years 11 months; mean adaptive behavior composite = 75.47 (SD = 15.94). All parent participants spoke English fluently. Families completed the Naturalistic Observation Diagnostic Assessment (NODA) for ASD, which was compared to an in-person assessment (IPA). Agreement between the 2 methods, as well as sensitivity, specificity, and interrater reliability, were calculated for the full sample and the subsample of families seeking an ASD evaluation. Diagnostic agreement between NODA and the IPA was 88.2% (κ = 0.75) in the full sample and 85% (κ = 0.58) in the subsample. Sensitivity was 84.9% in both, whereas specificity was 94.4% in the full sample and 85.7% in the subsample. Kappa coefficients for interrater reliability indicated 85% to 90% accuracy between raters. NODA utilizes telehealth technology for families to share information with professionals and provides a method to inform clinical judgment for a diagnosis of ASD. Due to the high level of agreement with the IPA in this sample, NODA has potential to improve the efficiency of the diagnostic process for ASD. (PsycINFO Database Record
研究表明，从父母首次对孩子的发育感到担忧到正式诊断出自闭症谱系障碍（ASD）之间会经过相当长的时间。远程医疗为加快诊断过程提供了一个机会。本项目将一种利用临床指导下的家庭视频记录的新型远程医疗诊断方法与金标准的面对面诊断评估进行了比较。参与者包括40个为孩子寻求ASD评估的家庭以及11个发育正常儿童的家庭。孩子们的年龄在18个月至6岁11个月之间；平均适应性行为综合得分 = 75.47（标准差 = 15.94）。所有参与的家长都能流利地说英语。家庭完成了针对ASD的自然观察诊断评估（NODA），并将其与面对面评估（IPA）进行比较。计算了这两种方法之间的一致性以及敏感性、特异性和评分者间信度，针对整个样本以及寻求ASD评估的家庭子样本进行了计算。在整个样本中，NODA与IPA之间的诊断一致性为88.2%（κ = 0.75），在子样本中为85%（κ = 0.58）。两者的敏感性均为84.9%，而在整个样本中特异性为94.4%，在子样本中为85.7%。评分者间信度的Kappa系数表明评分者之间的准确率在85%至90%之间。NODA利用远程医疗技术让家庭与专业人员共享信息，并提供了一种为ASD诊断提供临床判断依据的方法。由于在这个样本中与IPA的一致性水平较高，NODA有潜力提高ASD诊断过程的效率。（PsycINFO数据库记录
