Telehealth and autism: Are telehealth language assessments reliable and feasible for children with autism?
R Sutherland, D Trembath, MA Hodge, V Rose, J Roberts
Background: Access to timely and appropriate speech–language pathology (SLP) services is a significant challenge for many families. Telehealth has been used successfully to treat a range of communication disorders in children and adults. Research examining the use of telehealth for children with autism has focused largely on diagnosis, parent‐implemented interventions, and behavioural interventions involving interactions between clinicians and parents. There is, however, very limited research into the use of telehealth directly to assess or intervene with children with autism. This paper reports the outcomes of a study of telehealth language assessments with primary school‐aged children with autism.
Aims: To evaluate the reliability and feasibility of telehealth language assessments for school‐aged children with autism.
Methods & Procedures: The language skills of 13 children with autism aged 9–12 who attended mainstream schools or support classes were assessed using the Clinical Evaluation of Language Fundamentals—4th Edition. An SLP delivered and scored four subtests of the assessment via telehealth from a remote location. A second SLP at the same location as the child co‐scored the online subtests to provide a measure of reliability and delivered the remaining subtests. The local SLP completed checklists in both conditions to provide observations regarding behaviour. Parent feedback was elicited via survey.
Outcomes & Results: There was strong interrater reliability between the telehealth and face‐to‐face conditions (correlation coefficients ranged from r = 0.919 to 0.990 across the subtests and Core Language Score) and good agreement between clinicians on all measures. Analysis using the Wilcoxon Signed Rank test indicated no significant differences in children's behaviour between the telehealth and face‐to‐face conditions, although variation between individuals was observed. Parents provided generally positive feedback about the use of telehealth for the assessments.
Conclusions & Implications: The findings of this study provide preliminary support the use of telehealth assessments of school‐aged children with autism. Comparison of telehealth and face‐to‐face assessment scores showed high agreement and correlation, and while the children showed individual differences in their behaviour during the telehealth sessions, there was no clear difference between the conditions at the group level. The findings suggest that telehealth may present a reliable and feasible approach to the assessment of language for children with autism in some circumstances as a primary or adjunct service model, while acknowledging that individual differences among these children may be important to consider when planning both assessment and intervention via telehealth.