Tangkilisan Gabriella, Vazquez Luis Rivas, Fuchu Plyce, Sanders Benjamin, Dolata Jill K, Bedrick Steven, Fombonne Eric, Broder-Fingert Sarabeth, Zuckerman Katharine E
Oregon Health & Science University, USA.
Portland State University, USA.
Autism. 2025 Aug 12:13623613251360276. doi: 10.1177/13623613251360276.
Mobile health (mHealth; online phone or tablet-based) screening tools for autism are being increasingly used by parents, health care, and educational providers. However, it is unclear whether mHealth autism screening will improve the inequalities in autism or further help individuals already advantaged in autism care. To try to improve equity in mHealth autism screening, we conducted a modified Delphi consensus panel process with 14 panelists who were medical providers, parents, tool developers, and educational providers. Panelists participated in three asynchronous online voting rounds followed by online discussions. Panelists were provided a preliminary list of 28 recommendations for autism-screening tools that were compiled from previous qualitative interviews in the larger project. In each round, panelists were asked to vote for up to 10 recommendations from the preliminary list and discuss the voting results. After the third round of asynchronous voting, a final round of discussion with all the panelists was held live through Zoom to discuss the final asynchronous voting results. All voting and discussion took place on an online app called Slack. Voting and discussion yielded 19 recommendations in five conceptual categories: transparency, equity, access, product design and user experience, and development process. Tools adhering to these recommendations may increase equitable service use after screening.Lay abstractFamilies may use information online to learn more about autism. Families, health care, and educational providers may use online tools like checklists or web apps to screen for autism (measure whether a young child has autism symptoms or behaviors). However, we do not know whether the online autism-screening tools can be easily used by families and providers. It is possible that families who are culturally diverse, have lower education, or have lower income have trouble using online autism-screening tools. We conducted an online consensus panel with medical/educational providers, parents, and tool developers, asking them to vote and have discussions on suggestions for online screening tools for autism. The voting and discussions resulted in 19 suggestions for changes to make the tools easier to use. The top recommendations included directly linking to sources of information about autism, reading level that is less than or equal to fifth grade, and focusing on the diverse behavior/needs/strengths associated with autism.
家长、医疗保健人员和教育工作者越来越多地使用移动健康（mHealth；基于在线手机或平板电脑）自闭症筛查工具。然而，尚不清楚移动健康自闭症筛查能否改善自闭症方面的不平等状况，还是会进一步帮助那些在自闭症护理方面已经具有优势的个体。为了努力提高移动健康自闭症筛查的公平性，我们与14位专家组成了一个经过改进的德尔菲共识小组，这些专家包括医疗服务提供者、家长、工具开发者和教育工作者。专家们参与了三轮异步在线投票，随后进行在线讨论。专家们收到了一份针对自闭症筛查工具的28条建议的初步清单，这些建议是从之前较大项目中的定性访谈中整理出来的。在每一轮中，专家们被要求从初步清单中最多选出10条建议并讨论投票结果。在三轮异步投票之后，与所有专家进行了最后一轮现场讨论，通过Zoom讨论最终的异步投票结果。所有投票和讨论都在一个名为Slack的在线应用程序上进行。投票和讨论产生了五个概念类别中的19条建议：透明度、公平性、可及性、产品设计和用户体验以及开发过程。遵循这些建议的工具可能会在筛查后增加公平的服务使用。
摘要
家庭可能会利用网上信息来更多地了解自闭症。家庭、医疗保健人员和教育工作者可能会使用清单或网络应用程序等在线工具来筛查自闭症（测量幼儿是否有自闭症症状或行为）。然而，我们不知道在线自闭症筛查工具是否能被家庭和服务提供者轻松使用。文化背景多样、教育程度较低或收入较低的家庭可能在使用在线自闭症筛查工具时遇到困难。我们与医疗/教育服务提供者、家长和工具开发者进行了一次在线共识小组讨论，要求他们就自闭症在线筛查工具的建议进行投票和讨论。投票和讨论产生了19条关于改进工具以便更易于使用的建议。首要建议包括直接链接到自闭症相关信息来源、阅读水平不高于五年级，以及关注与自闭症相关的多样化行为/需求/优势。
