School of Medicine, Swansea University, Swansea, United Kingdom.
College of Applied Medical Sciences, King Faisal University, Hofuf, Saudi Arabia.
PLoS One. 2020 Jul 23;15(7):e0236415. doi: 10.1371/journal.pone.0236415. eCollection 2020.
There is a significant delay between seeking help and a confirmed diagnosis of Autism Spectrum Disorder (ASD). This delay can lead to poor outcomes for both the families and individuals. Telehealth potentially offers a way of improving the diagnostic pathway for ASD. We conducted a scoping review examining which telehealth approaches are used in the diagnosis and assessment of ASD in children and adults, whether they are feasible and acceptable, and how they compare with face-to-face diagnosis and assessment methods. A search for all peer-reviewed articles, combining the terms of autism and telehealth was conducted from 2000 to 2019. A total of 10 studies were identified for inclusion in the review. This review of the literature found there to be two methods of using telehealth: (a) Real-Time method e.g. video conferencing that enables teams in different areas to consult with the families and to assess the child/adult in real time and (b) A Store-and-Forward method as Naturalistic Observation Diagnostic Assessment (NODA) system to upload videos of child's behaviors to a webportal that enables the clinicians to make an assessment remotely. The findings were positive, finding there to be high agreement in terms of the diagnosis between remote methods and face to face methods and with high levels of satisfaction among the families and clinicians. This field is in the very early stages and so only studies with small sample size using surveys and interviews were identified but the findings suggest that there is potential for telehealth methods to improve access to assessment and diagnosis of ASD used in conjunction with existing methods, especially for those with clear autism traits and adults with ASD. Larger randomised controlled trials of this technology are warranted.
从寻求帮助到确诊自闭症谱系障碍（ASD）之间存在显著的延迟。这种延迟可能会对家庭和个人都产生不良后果。远程医疗有可能改善 ASD 的诊断途径。我们进行了一项范围综述，以检查在儿童和成人中使用哪些远程医疗方法来诊断和评估 ASD，这些方法是否可行和可接受，以及它们与面对面的诊断和评估方法相比如何。从 2000 年到 2019 年，我们结合了自闭症和远程医疗的术语，对所有同行评议的文章进行了搜索。共有 10 项研究被确定纳入综述。这项文献综述发现，有两种使用远程医疗的方法：（a）实时方法，例如视频会议，使不同地区的团队能够与家庭协商，并实时评估儿童/成人；（b）存储和转发方法，例如自然观察诊断评估（NODA）系统，将儿童行为的视频上传到一个网络门户，使临床医生能够远程进行评估。研究结果是积极的，发现远程方法与面对面方法在诊断方面具有高度一致性，并且家庭和临床医生的满意度都很高。这个领域还处于早期阶段，因此只确定了使用调查和访谈的小样本量的研究，但研究结果表明，远程医疗方法有可能改善 ASD 的评估和诊断的可及性，与现有的方法结合使用，特别是对于那些具有明确自闭症特征的儿童和成年 ASD 患者。这项技术的更大规模随机对照试验是有必要的。
