Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, California, USA.
Autism Res. 2021 Nov;14(11):2251-2259. doi: 10.1002/aur.2615. Epub 2021 Sep 22.
The COVID-19 pandemic has posed unique challenges for families and caregivers, as well as for autism-focused clinicians, who are faced with providing a thorough and accurate evaluation of children's specific needs and diagnoses in the absence of in-person assessment tools. The shift to telehealth assessments has challenged clinicians to reconsider approaches and assumptions that underlie the diagnostic assessment process, and to adopt new ways of individualizing standard assessments according to family and child needs. Mandates for physical distancing have uncovered deficiencies in diagnostic practices for suspected autism and have illuminated biases that have posed obstacles preventing children and families from receiving the services that they truly need. This Commentary outlines several considerations for improving diagnostic practices as we move forward from the current pandemic and continue to strive to build an adaptable, sustainable, equitable, and family-centered system of care. LAY SUMMARY: Physical distancing and the abrupt end to in-person services for many children on the autism spectrum has forced clinicians to examine the existing challenges with autism spectrum disorder (ASD) diagnostic assessment and consider things they want to keep and things that should be changed in the years ahead. New approaches such as telehealth both alleviated and exacerbated existing disparities, and brought into stark focus the importance of equitable and timely access to family-centered care. This commentary suggests ways of improving clinical practices related to ASD assessment to continue along this path.
COVID-19 大流行给家庭和护理人员以及专注于自闭症的临床医生带来了独特的挑战，因为他们在没有面对面评估工具的情况下，需要全面准确地评估儿童的特定需求和诊断。向远程医疗评估的转变使临床医生不得不重新考虑诊断评估过程背后的方法和假设，并根据家庭和儿童的需求采用新的方法对标准评估进行个性化处理。为保持身体距离而颁布的命令揭示了疑似自闭症诊断实践中的缺陷，并凸显了阻碍儿童和家庭获得所需服务的偏见。本评论概述了在从当前大流行中向前推进并继续努力建立一个具有适应性、可持续性、公平性和以家庭为中心的护理系统的过程中，改善诊断实践的一些考虑因素。
对于许多自闭症谱系障碍（ASD）儿童来说，保持身体距离和突然结束许多面对面服务，迫使临床医生检查现有的 ASD 诊断评估挑战，并考虑在未来几年中保留和改变的事项。远程医疗既缓解了也加剧了现有的差距，并鲜明地凸显了公平和及时获得以家庭为中心的护理的重要性。本评论提出了一些改善与 ASD 评估相关的临床实践的方法，以继续沿着这条道路前进。
