# Addressing disparities in ASD diagnosis using a direct-to-home telemedicine tool: Evaluation of diagnostic accuracy, psychometric properties, and family engagement

> **NIH NIH R01** · VANDERBILT UNIVERSITY MEDICAL CENTER · 2021 · $777,927

## Abstract

PROJECT SUMMARY
Although there is evidence that autism spectrum disorder (ASD) can be accurately identified during the second
year of life, and that early intervention can improve developmental outcomes, many children in the United States
are not diagnosed with ASD until much later. Families seeking ASD evaluation often face barriers such as low
availability of specialists, lengthy waitlists, and long distances to tertiary care diagnostic centers. This is
especially true for children from traditionally underserved groups and communities. Without an innovative
approach for prompt identification of ASD in young children, families and clinicians will continue to struggle with
accessing and providing care. Telemedicine offers tremendous potential for addressing this need. However,
there are few psychometrically sound, validated tools that can be administered remotely, via telehealth platforms,
in order to guide service and action. We recently developed and evaluated a novel parent-administered/clinician-
guided tele-assessment tool, the TAP (previously the TELE-ASD-PEDS; R21 MH118539). Initial successful
studies within a controlled laboratory context yielded very high levels of family satisfaction with the experience,
perceived utility by clinicians, and agreement regarding ASD risk classification with blinded comprehensive
evaluation. Although promising, this work was limited by its reliance on controlled laboratory settings, a relatively
small homogeneous sample, and use within a single research group. We have not yet validated the TAP for in-
home use in a broader community sample, with novel groups of diagnostic clinicians, nor have we adequately
demonstrated its value and impact for families representing traditionally underserved populations and areas. The
current proposal represents the first rigorous evaluation of a tele-assessment tool for ASD with a large, diverse
sample of children within their homes. In the current study, across two sites, we will recruit 360 toddlers (18-42
months) to participate in a home-based telemedicine evaluation using an ASD assessment tool explicitly
developed for this purpose (i.e., the TAP). The sample will include children from the community who have
screened positive on an ASD screener, as well as those referred from primary care and state early intervention
systems. We will randomize families to receive assessment based on telemedicine alone or telemedicine plus
an in-person evaluation, and then follow families over a 6-month time interval. This methodology will allow us to
conduct rigorous psychometric evaluation of the TAP and comparison to widely used diagnostic tests,
longitudinally evaluate service access and family engagement, and examine factors that affect diagnostic
decision-making and family outcomes. This work has potential to transform the ASD evaluation process and
dramatically improve access for traditionally underserved groups.

## Key facts

- **NIH application ID:** 10277413
- **Project number:** 1R01MH127228-01
- **Recipient organization:** VANDERBILT UNIVERSITY MEDICAL CENTER
- **Principal Investigator:** Sally Ozonoff
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $777,927
- **Award type:** 1
- **Project period:** 2021-08-04 → 2026-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10277413

## Citation

> US National Institutes of Health, RePORTER application 10277413, Addressing disparities in ASD diagnosis using a direct-to-home telemedicine tool: Evaluation of diagnostic accuracy, psychometric properties, and family engagement (1R01MH127228-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10277413. Licensed CC0.

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