The undersigned petitioners respectfully request that the New Zealand Government reviews their strict approach of the use of the Autism NZ Guidelines Diagnostic Criteria (last reviewed in 2011) to ensure the inclusion of provisions for:

Telehealth Diagnoses: The ability for individuals in rural areas to access autism diagnoses through telehealth services, ensuring equitable access to diagnostic services across New Zealand, regardless of geographic location.

Client's Right to Telehealth Choice: The right for clients to choose telehealth as a diagnostic option, promoting flexibility and respecting individual needs, preferences, and circumstances, including accessibility concerns and personal comfort.

Summary: 

The rejection of technological communication breaches the fundamental right to medical diagnosis and treatment for those looking for an autism diagnosis.

 

Case for Petition:

The 2022 Aotearoa New Zealand Autism Guideline: He Waka Huia Takiwātanga Rau, Third Edition (the Guideline) provides an updated, evidence-based framework for supporting and diagnosing individuals with autism in New Zealand. It includes recommendations for best practices in health, education, and community settings, emphasising culturally responsive care, particularly for Māori and Pasifika communities. The Guideline covers various aspects of autism care, such as early identification, assessment, intervention, and ongoing support, and encourages a person-centred approach that respects individual differences. It also highlights the need for coordinated services and equitable access to autism assessments and support, particularly in under-served populations, such as rural communities. The goal is to improve outcomes for individuals with autism by promoting holistic, accessible, and culturally appropriate care across all stages of life.

We acknowledge that the Guideline is independent of government and does not dictate policy. The Ministries consider a range of factors in deciding policies around service delivery and assessment of eligibility for services, and the Guideline is one of the many resources they use in forming their decisions, however we believe that the current guideline, does not provide adequate information on telehealth practices, and fails to include the voices of our autistic community in providing accessible services. The most recent review on the diagnostic instruments for ASD was in 2011 (https://www.whaikaha.govt.nz/assets/Autism-Guideline/autism_instruments_summary.pdf). However this review only covers the assessment tools, and highlights the reliance on traditional in-person assessments, creating barriers for those in rural or underserved areas.  While there have also been other reviews of the diagnostic process (https://www.autismcrc.com.au/sites/default/files/reports/1-058_NZ-Diagnostic-Practices_Final-Report_2021.pdf), the process has remained unchanged, despite suggestions of creating a clearer, more consistent pathway across the public and private sectors. Additionally, these reviews account for limitations in geographic locations, and the barriers to accessing in-person assessments (with consideration for wait times across the region). We believe that the telehealth processes, in addition to the current diagnostic process should be reviewed, and will greatly improve access to autism diagnoses and support for rural communities, while also promoting client autonomy in how they receive healthcare services.

Impact of Reduced Access to Telehealth for Autism Assessments

Reduced access to telehealth services for autism assessments disproportionately affects several key groups, creating barriers to equitable healthcare access and worsening health disparities. The following groups are particularly impacted by this limitation:

Individuals with Autism in Rural or Remote Areas

Without access to telehealth, individuals in rural or remote areas face significant challenges in receiving timely autism assessments and support. This often results in long delays for diagnosis, which can hinder access to critical services and early interventions, negatively affecting developmental outcomes and overall well being.

Families and Caregivers

Families, particularly those in rural communities, must shoulder the financial and logistical burden of travelling long distances to access in-person services. Reduced access to telehealth places increased stress on caregivers, making it harder for them to provide necessary support to their autistic family members. This is particularly concerning for low-income families who may struggle with travel costs.

Māori and Pasifika Communities

Māori and Pasifika individuals are already disproportionately affected by healthcare access issues. Reduced availability of telehealth further exacerbates these inequalities by limiting their ability to access autism assessments and culturally responsive care. This widens the gap in health outcomes for these communities, perpetuating disparities in diagnosis and support services.

Healthcare Providers

Clinicians and specialists, particularly those serving rural populations, face increased workloads and longer waiting times when telehealth services are not available. This lack of access to remote services limits the ability of healthcare providers to deliver equitable, timely care to all individuals, particularly those in hard-to-reach areas.

Educational Settings

Schools and educators rely on timely autism diagnoses and expert consultations to provide appropriate learning strategies and accommodations for autistic students. Reduced access to telehealth delays assessments, which in turn delays the implementation of necessary educational support for students, affecting their academic and social development.

Vulnerable Populations

Individuals with mobility issues, severe anxiety, or other disabilities may find it extremely difficult to attend in-person assessments. For these individuals, telehealth provides an essential alternative, minimising stress and logistical barriers. Reduced access to telehealth severely limits their ability to obtain an autism diagnosis and the ongoing support they require.

Without provisions for telehealth in autism assessments, many individuals and families are denied equitable access to essential diagnostic services. This limitation disproportionately affects rural communities, Māori and Pasifika populations, vulnerable individuals, and caregivers, worsening existing healthcare inequalities and delaying critical interventions.

We urge that the Autism NZ Guidelines (2022) be reviewed to include telehealth provisions for autism assessments, ensuring that all New Zealanders have the right to timely and accessible diagnostic services, regardless of location or circumstance.

What is at Stake?

Delayed Autism Diagnoses

Without telehealth, individuals, especially those in rural or remote areas, face longer wait times for autism assessments. This delay can prevent early intervention, which is crucial for improving outcomes in communication, social skills, and overall quality of life. Early diagnosis is essential for accessing support services, therapies, and educational accommodations that can significantly impact an autistic individual's development.

Increased Health Inequities

The absence of telehealth options widens the gap in healthcare access, particularly for Māori, Pasifika, and rural communities. These populations already experience significant health disparities, and limiting their access to autism services deepens this inequity, depriving them of timely and culturally responsive care.

Financial and Emotional Strain on Families

Families in rural areas are forced to bear the costs of travel, accommodation, and time off work to attend in-person assessments, placing them under significant financial and emotional strain. Telehealth would alleviate these burdens, making it easier for families to access diagnostic services without additional stress.

Under-diagnosis and Misdiagnosis

Without equitable access to autism assessments, many individuals may remain undiagnosed or misdiagnosed, particularly in underserved communities. This can lead to the lack of appropriate support services and accommodations in education, employment, and healthcare settings, severely impacting an individual’s long-term wellbeing and success. 

Limited Educational Support

Delayed diagnoses mean that children may miss out on crucial learning support and interventions. Educators rely on formal autism diagnoses to implement appropriate accommodations, such as individualised education plans (IEPs). Without timely assessments, children may struggle unnecessarily in school, affecting their academic and social development.

Compromised Mental Health and Wellbeing

Access to timely diagnosis and support is closely linked to an individual’s mental health. Without telehealth services, individuals may face increased anxiety, depression, and social isolation due to a lack of understanding and support for their condition. Delayed or inaccessible assessments can exacerbate these mental health challenges, leading to long-term negative consequences.

What’s at stake is the health, wellbeing, and future prospects of autistic individuals and their families who cannot access timely, equitable, and culturally appropriate diagnostic services. 

Without the inclusion of telehealth in autism assessments, many New Zealanders, especially those in rural areas, risk being left without the support they need, further entrenching health inequities and increasing the social and economic burdens on families and communities.

The Guideline is considered to be the gold standard approach to diagnostic assessments. It states “Much of the literature on autism centres on the early diagnosis and early intervention of young autistic children. However, there are also undiagnosed young people and adults on the autism spectrum. Some seem to manage well while other undiagnosed people and their families and whānau endure great stress, and they can be misunderstood, blamed, teased, bullied, poorly supported and miss out on effective support options, or receive inappropriate medical, psychiatric, and educational support programmes. Some receive psychiatric or intellectual disability services or both, yet without the recognition of their autism/takiwātanga, services are not appropriately tailored to their individual needs. For some individuals who have not received a formal ASD diagnosis, their behaviour may lead to legal difficulties. Should their difficulties not be appropriately identified and taken into account as a mitigating factor, an inappropriate custodial sentence may result”. This has been a pattern observed in many clients, who have experienced trauma, or have been misdiagnosed throughout their lives. We also acknowledge many clients have engaged in high levels of masking, to fit into societal expectations, and to meet the demands of adult life, by masking and assimilating into social settings, but have frequently commented on not fitting in, and the exhaustion, in addition to other mental health challenges, from masking their behaviours throughout their lives. 

Whaikaha’s guidelines for young people and adults state, “Currently, within Aotearoa New Zealand, there is no formal referral pathway for ASD assessment and diagnosis of adults.” They further state “Although it is possible for a single clinician with experience evaluating ASD to make a diagnosis in very young children, assessment and diagnosis by a team of health care practitioners experienced in the autism spectrum is recommended for older individuals.” The DSM and ICD do not require any specific diagnostic tool to be used in diagnosing autism, and it is not a requirement for a team of providers to assign a diagnosis. Autism can be accurately diagnosed by a single practitioner with adequate training. Requiring a multidisciplinary team increases the cost of an assessment significantly, making it inaccessible to those who most need support. It additionally goes against the diagnostic criteria.  Despite this statement, they have recommended a multidisciplinary team consisting of “at least two or three members drawn from the following professions: paediatricians, child and adolescent psychiatrists, clinical or educational psychologists, speech-language therapists and occupational therapists.”

The NZ Guideline includes suggestions for gathering observational data in natural settings (i.e. school, home) and the preference for in-person assessments, and consideration for cultural implications. This is consistent with the recently published Australian diagnostic Guideline's 2nd edition (2023). However, the Australian Guidelines, include more acknowledgement of telehealth in assessments, and the importances of settings, when minimising harm, distress and anxiety experienced by clients. 

• “The setting/s chosen must be helpful in terms of gathering relevant information, including the opportunity to observe relevant behavioural characteristics and learn from the client’s sharing of experiences.”
• “Reduce costs and wait times by co-locating practitioners and minimising practitioner travel”

The Australian guideline specifies that the assessment process should include an in-person assessment “where possible” leaving space for full telehealth assessments where necessary. 

• “When deciding whether assessments are conducted in-person or via telehealth, practitioners should consult with clients and consider their comfort, convenience, and privacy, as well as practical considerations such as location, suitability of spaces (e.g., ambient noise, client and occupational safety, distractions), and in the case of telehealth, access to appropriate and reliable equipment and connectivity.”
• “Evidence is emerging regarding the accuracy, feasibility, and acceptability of telehealth in assessment and diagnosis of autism is emerging, including for contexts in which it is less, more, or equally effective than in-person consultation, and practitioners should make decisions about its use within an evidence-based practice decision-making framework.”

The Australian Autism guideline also acknowledges emerging evidence in telehealth:

• “Telehealth can be an effective, feasible, and acceptable way of conducting aspects of an Assessment of Functioning and Diagnostic Evaluation.”
• “There can be benefits to telehealth over in-person consultation, including in relation to cost, time, and accessibility.”
• “There can be barriers to telehealth, including having access to appropriate equipment and internet connectivity, challenges observing behaviours and understanding contexts, privacy, and rapport building (for some clients).”
• “Clients will differ in terms of their preferences for in-person versus telehealth delivery.”

Telehealth assessments is an area attracting growing clinical and research attention, particularly since the pandemic, and especially due to significant disparities in access to diagnostic services in rural areas, a lack of assessment for adults through the public system, with private assessments being expensive, with long waiting lists. There is extensive research from the last four years (See Appendix A) showing that telehealth psychological assessments yield accurate diagnoses, with equal validity to in-person assessments as long as the psychologist has appropriate training in this method of service delivery. As telehealth assessments yield accurate diagnostic information, rejecting these assessments does not make sense based on current research around standards of care. Despite the recommendation of having a multidisciplinary team being in place since 2008 (the first edition of the Autism Guidelines), this appears to be more enforced as of this year.  Previously, these assessments were considered sufficient, given the COVID 19 pandemic, which resulted in a significant increase in telehealth practices with no concern, until very recently (September 2024). As a mental health organisation, primarily specialising in telehealth, we have noticed the increase in adults seeking support around autism diagnoses, many of which prefer the telehealth platform. Many autistic individuals struggle to attend in-person evaluations due to co-occurring mental health, physical disabilities, or medical conditions. This is not to mention those who are located in a geographic area where an in-person assessment is not accessible. Telehealth solves both the issue of being able to attend appointments in-person and access care in rural areas. Our clients have been our biggest supporters, and have consistently acknowledged the accessibility of our services, and the level of detail that our evaluations have provided (sometimes, more so than in-person assessments). While more research is recommended (and more research is always recommended!), the existing studies show that appropriately qualified clinicians can accurately diagnose autism via telehealth across the lifespan. 

While the general Autism Guideline has been recently updated in 2022, and the Australian Guideline being more recently updated in 2023, the New Zealand Psychologists Board (NZPB) Guidelines on Telepsychology was last updated in 2012, and provides more insight into the use and benefits of telepsychology or telehealth:

(https://psychologistsboard.org.nz/wp-content/uploads/2023/08/BPG_The_Practice_of_Telepsychology_FINAL_131212.pdf)

“Increased access for both clients and psychologists,” including accessibility for clients in remote locations, physical disabilities, areas with limited services. Furthermore this guideline acknowledges individuals who have experienced trauma from other services, or the potential stigma from in-person assessments.
“A therapeutic activity for those who experience the process of writing as helpful. The act of writing may enhance self-reflection by allowing opportunities for review of what has been written and thereby increase the ownership of issues.” Many of our clients have the opportunity to send in additional information, reports, and observations from whānau, friends, and colleagues, which adds to our robust assessments.
“Enhanced client autonomy by increasing choice and control. For some the internet relationship may reduce the power difference between client and psychologist.” Many of our clients have expressed their own anxiety and apprehension about the assessments, and how validating their experiences has been. As many members of our clinical team have experiences of working in-person and remotely, we can attribute this to the difference in observational data that can be collected via telehealth assessments. We have more insight into the client's environment, and how they interact in a space that they feel safe in. This includes client’s dressed in clothing that meet their sensory needs, having comfort items (or pets), being able to walk around or fidget or stim, and most importantly feeling like they can present authentically as themselves, without judgement. 

Reduced access to assessments could potentially violate the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), particularly in relation to several key articles within the Convention that emphasise equal access to healthcare, including diagnostic services, and the right to be free from discrimination on the basis of disability. Failure to provide equitable access to diagnostic services, such as autism assessments, could be interpreted as a violation of these rights. Introducing telehealth options could help ensure that people with disabilities, especially in rural areas, are not disadvantaged and can access essential health services, consistent with the UNCRPD's principles of equality, accessibility, and non-discrimination.

(https://www.un.org/disabilities/documents/convention/convoptprot-e.pdf)

1. Article 9: Accessibility
“To enable persons with disabilities to live independently and participate fully in all aspects of life, States Parties shall take appropriate measures to ensure to persons with disabilities access, on an equal basis with others, to the physical environment, to transportation, to information and communications, including information and communications technologies and systems, and to other facilities and services open or provided to the public, both in urban and in rural areas.”  This highlights the obligation of States to ensure that services, including health-related services like diagnostic assessments, are equally accessible in rural areas. This article requires states to ensure that people with disabilities have access to services, including health services, on an equal basis with others. Lack of access to autism assessments, particularly in rural areas where services may be limited, could be seen as a failure to meet this obligation, especially when telehealth could be a viable solution.

2. Article 25: Health
“States Parties recognize that persons with disabilities have the right to the enjoyment of the highest attainable standard of health without discrimination on the basis of disability. States Parties shall take all appropriate measures to ensure access for persons with disabilities to health services that are gender-sensitive, including health-related rehabilitation. In particular, States Parties shall: (a) Provide persons with disabilities with the same range, quality and standard of free or affordable health care and programmes as provided to other persons, including in the area of sexual and reproductive health and population-based public health programmes; (b) Provide those health services needed by persons with disabilities specifically because of their disabilities, including early identification and intervention as appropriate, and services designed to minimize and prevent further disabilities, including among children and older persons; (c) Provide these health services as close as possible to people’s own communities, including in rural areas.” This section directly addresses health services and requires that these services, including assessments, be accessible “as close as possible to people’s own communities,” which supports the argument for telehealth assessments for rural access. States are obligated to provide persons with disabilities the same range, quality, and standard of healthcare as provided to others, including diagnostic services. Restricting access to assessments based on  geographical location could result in unequal treatment, as individuals in urban areas might have easier access to services.

3. Article 26: Habilitation and Rehabilitation
““States Parties shall take effective and appropriate measures, including through peer support, to enable persons with disabilities to attain and maintain maximum independence, full physical, mental, social and vocational ability, and full inclusion and participation in all aspects of life. To that end, States Parties shall organize, strengthen and extend comprehensive habilitation and rehabilitation services and programmes, particularly in the areas of health, employment, education and social services, in such a way that these services and programmes: (a) Begin at the earliest possible stage, and are based on the multidisciplinary assessment of individual needs and strengths; (b) Support participation and inclusion in the community and all aspects of society, and are voluntary.” This provision underscores the importance of early and accessible services to support individuals in achieving maximum independence. Inaccessibility to autism diagnoses can prevent individuals from receiving early intervention and support.This article stresses the need for states to provide services that enable persons with disabilities to attain and maintain maximum independence, full physical, mental, social, and vocational ability, and full inclusion in all aspects of life. Limiting access to assessments, which are foundational for receiving necessary support services, can hinder a person’s ability to achieve this.

4. Article 19: Living Independently and Being Included in the Community
“States Parties to this Convention recognize the equal right of all persons with disabilities to live in the community, with choices equal to others, and shall take effective and appropriate measures to facilitate full enjoyment by persons with disabilities of this right and their full inclusion and participation in the community, including by ensuring that: (a) Persons with disabilities have the opportunity to choose their place of residence and where and with whom they live on an equal basis with others and are not obliged to live in a particular living arrangement; (b) Persons with disabilities have access to a range of in-home, residential and other community support services, including personal assistance necessary to support living and inclusion in the community, and to prevent isolation or segregation from the community.” This article can be interpreted to support the idea that lack of access to autism assessments may lead to segregation or isolation due to the absence of necessary support systems, preventing full inclusion in the community. This article emphasises the right of people with disabilities to live independently and to be fully included in the community. Timely access to diagnostic services, including autism assessments, is crucial to securing appropriate support, resources, and interventions that allow for full community participation.

5. Article 5: Equality and Non-Discrimination
“States Parties recognize that all persons are equal before and under the law and are entitled without any discrimination to the equal protection and equal benefit of the law. States Parties shall prohibit all discrimination on the basis of disability and guarantee to persons with disabilities equal and effective legal protection against discrimination on all grounds.” Limiting access to autism assessments for those in rural areas could be viewed as a form of indirect discrimination, as it prevents equal access to necessary health services.The principle of non-discrimination ensures that individuals with disabilities are not subjected to discriminatory practices. If those in rural areas have limited access to assessments, it could be seen as a form of indirect discrimination, as they would be denied equal opportunities for diagnosis and, by extension, support.
Limitations around telehealth, directly conflict with client rights under the Code of Health and Disability Services Consumers’ Rights (the Code) which outlines the rights of all people using health and disability services. If autism assessments are not readily available in rural areas or there is no option for telehealth diagnoses, this could violate several rights under the Code of Health and Disability Services Consumers' Rights, particularly the right to services of an appropriate standard (Right 4), and the right to make an informed choice (Right 7).

(https://www.hdc.org.nz/your-rights/about-the-code/code-of-health-and-disability-services-consumers-rights/): 

Right 1: Right to be Treated with Respect
“Every consumer has the right to be treated with respect.” A respectful approach would involve the provider listening to the person’s concerns, explaining all the available options (including telehealth), and working collaboratively to find a solution that meets the person’s needs and preferences. This could include offering telehealth as a flexible alternative to meet the consumer’s needs while maintaining the quality of care. 

Right 4: Right to Services of an Appropriate Standard
“Every consumer has the right to have services provided with reasonable care and skill.” If individuals in rural areas do not have access to autism assessments, it could be argued that they are not receiving services that meet the appropriate standard of care, which should be equally available to all consumers. Telehealth services could help bridge this gap and ensure that the same level of service is available regardless of geographic location. 
“Every consumer has the right to have services provided that comply with legal, professional, ethical, and other relevant standards.” By not providing telehealth services, the healthcare provider may be failing to comply with both professional and ethical standards of providing equitable and accessible care, potentially violating the consumer's right to appropriate service standards under the Code. If telehealth could reasonably be provided, but the provider doesn't offer it, they may not be meeting the required standards for delivering care, particularly in ensuring accessibility and fairness in service provision.
“Every consumer has the right to have services provided in a manner consistent with his or her needs.” The right to have services provided in a manner consistent with his or her needs means that healthcare services should be tailored to meet the individual requirements and circumstances of each consumer. This includes taking into account factors such as geographic location, disability, personal preferences, and specific healthcare needs to ensure that care is accessible and appropriate for the individual. Meaning that individuals who prefer telehealth or require it as a disability accommodation have the right to this method of service.
“Every consumer has the right to have services provided in a manner that minimises the potential harm to, and optimises the quality of life of, that consumer.” The right to have services provided in a manner that minimises potential harm and optimises the quality of life means that healthcare providers are responsible for ensuring that the services they deliver reduce risks, avoid unnecessary stress or difficulties, and enhance the consumer’s overall wellbeing. This includes considering the physical, emotional, and practical impact of healthcare decisions on the consumer. If the healthcare provider offers a telehealth autism assessment, they would be providing the service in a way that minimises harm by reducing the need for long, costly travel and potential emotional stress from arranging logistics. Telehealth allows the consumer to be assessed from the comfort of their home, avoiding unnecessary challenges while still ensuring the same quality of care. 

Right 7: Right to Make an Informed Choice and Give Informed Consent
“Every consumer has the right to make an informed choice and give informed consent.” This right supports the inclusion of a client's right to choose telehealth for their assessment, as it affirms that clients should be allowed to make decisions about their healthcare based on a full understanding of their options. If the consumer decides to proceed with a telehealth assessment because it fits better with their needs (e.g., due to geographic distance or anxiety about in-person visits), they would provide their informed consent for this option. The right to give informed consent means that the consumer must be empowered with all necessary information to make a decision that best suits their personal circumstances, needs, and preferences.
“Every consumer has the right to express a preference as to who will provide services and have that preference met where practicable.” This right ensures that consumers have a say in who delivers their care, promoting comfort, trust, and personalised healthcare experiences. Providers should make reasonable efforts to meet these preferences, unless there are practical limitations that prevent this (e.g., availability of specialists, geographic constraints). Telehealth allows clients to choose their provider even if the provider is not located in their immediate geographic area. This could help reduce anxiety and ensure that the consumer feels respected and supported throughout the assessment process.

Right 8: Right to Support
“Every consumer has the right to have one or more support persons of his or her choice present, except where safety may be compromised or another consumer's rights may be unreasonably infringed.” For many people, especially those in rural areas, telehealth services allow for the presence of support persons during an assessment. For instance, a family member or caregiver can be present more easily during a virtual consultation than in a distant clinical setting, supporting a more comfortable and accessible process.

Right 10: Right to Complain
“Every consumer has the right to complain about a provider in any form appropriate to the consumer.” If rural individuals feel that their right to equitable healthcare is being violated by not having access to telehealth services for autism assessments, they can use this right to lodge a complaint. Additionally many clients who have physical disabilities or are unable to access transport. The lack of telehealth provisions could be considered a failure to provide adequate services, especially if it causes delays in diagnosis and treatment.
Autism diagnoses have been steadily increasing in New Zealand, placing immense pressure on existing services. Long waiting lists for in-person assessments, particularly in rural areas, have resulted in significant delays. Historically, individuals in rural areas, along with Māori and Pasifika communities, have faced significant barriers to healthcare access. The demand for autism services is rising, and telehealth has proven its value in healthcare delivery. The opportunity to improve equity in healthcare access has never been more critical, especially for the autistic community.

By updating the NZ Autism Guidelines to include telehealth provisions, we can ensure the voices of the autistic community are considered and that all New Zealanders, regardless of location, have timely access to the services they need. Telehealth can be a powerful tool in dismantling barriers, offering flexibility and accessibility to those who would otherwise face prolonged delays or complete inaccessibility to autism assessments. Delayed access to autism diagnoses and services has long-term consequences for individuals, families, and communities, including missed early interventions, limited educational support, and increased mental health challenges. By addressing these barriers now, we can ensure that individuals receive the help they need sooner, ultimately improving their quality of life and future outcomes.

Appendix A:

Here is a sampling of just some of the research showing the efficacy of telehealth for diagnosing autism, showing that telehealth can effectively and accurately diagnose autism, is preferred by many clients, reduces wait times for an assessment, and makes evaluations more accessible for marginalised clients:

https://www.tandfonline.com/doi/abs/10.1080/17549507.2018.1465123 "A range of services were provided via telehealth, including diagnostic assessments, early intervention and language therapy. Results suggested that services delivered via telehealth were equivalent to services delivered face to face."

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0236415 Diagnosing children via telehealth "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."

https://link.springer.com/article/10.1007/s10803-022-05435-z "Themes identified through qualitative analyses included factors related to confidence in diagnosis (impressions of in-home observation; child and family factors that affected diagnostic confidence; changes in rapport); patient and family factors related to telehealth (perceived family benefits of and barriers to telehealth; factors related to healthcare disparities; factors specific to non-native English speakers); and institutional and workplace factors related to transitioning to telehealth (institutional support; changes to efficacy, attendance, and work satisfaction). Results suggest that telehealth has potential to be an effective tool in autism assessment practice."

https://www.tandfonline.com/doi/abs/10.1080/13854046.2021.1970228  "At our Institute, telehealth services have provided an invaluable opportunity to continue to confirm (or rule out) an ASD diagnosis when appropriate to facilitate access to services during this time. Future research examining the utility of telehealth in the differential diagnosis of ASD is imperative given the potential advantages of telehealth services beyond the COVID-19 pandemic for some patients."

https://link.springer.com/article/10.1007/s40474-020-00214-w “Telehealth offers innovative intervention delivery options by increasing intervention access, overcoming barriers such as geography and costs of service delivery for young children with ASD.”

https://link.springer.com/article/10.1007/s40617-021-00603-6 “The evidence suggests that telehealth is a modality that is effective and can be considered for all patients when assessing the appropriate location of treatment.”

https://consensus.app/papers/descriptive-review-telehealth-individuals-with-autism-kane/f3d1ecdf268951ebbc71fd363ab10562/: “Telehealth is an effective service-delivery option for individuals with autism spectrum disorder, but more research is needed on participant prerequisite skills, implementer training, and technology variables.”

https://consensus.app/papers/accelerating-autism-diagnosis-using-telehealth-reischl/bba1189dece553d89eb60c1e4b3a55cf/: “Asynchronous telehealth technology significantly reduces the time from referral to diagnosis for autism, offering easier access for families in remote areas.”

https://consensus.app/papers/integrated-telehealth-system-administration-adult-parmanto/c63ef6ea419a5c5192ff9b4423c8c018/: “The developed telehealth system effectively administers adult autism assessments remotely, providing a solution to the lack of trained clinicians in underserved areas.”

https://consensus.app/papers/implementation-telehealth-services-assess-monitor-treat-valentine/dfa64b052ca558569edf41ee0fa91179/: “Telehealth has the potential to increase treatment availability, decrease diagnosis waiting times, and aid in neurodevelopmental disorder monitoring, but more robust and cost-effective research is needed.”

https://consensus.app/papers/telehealth-approaches-care-coordination-autism-spectrum-solomon/81ba6a8c5a695a8983cc0ea3a118b6a7/: “Telehealth can improve diagnosis, treatment, and care coordination for children with Autism Spectrum Disorder (ASD), despite barriers to access.”

https://consensus.app/papers/exploring-telehealth-covid-assessing-autism-spectrum-stavropoulos/c1a029f703845e52ad9292d4367baf6c/: “Telehealth assessments for autism spectrum disorder during COVID-19 are acceptable, convenient, and provide caregivers with satisfaction, potentially aiding in decision-making for school-based services and placement.”

https://consensus.app/papers/telehealth-autism-telehealth-language-assessments-sutherland/313e00a43cd75daba29230de8ece0bcb/: “Telehealth assessments are a reliable and feasible approach for assessing language skills in school-aged children with autism, with high agreement and correlation between telehealth and face-to-face conditions.”

https://consensus.app/papers/review-remote-telehealth-assessments-signs-autism-dahiya/ec2ee005195b5da3aed8b54b54bd2f34/: “Telehealth assessments using video and mobile applications show promise for identifying early autism spectrum disorder in remote communities, but more sustainable research is needed.”