By Danny Bonvissuto

Autism Spectrum Disorder (ASD) affects one in 36 children. Despite evidence that it can be identified in the second year of life, and that early intervention can improve developmental outcomes, families in underserved and rural communities struggle with proximity to tertiary care diagnostic centers, low availability of specialists and long waitlists.

Building on a recent study that showed autism profiles can be identified early with the TELE-ASD-PEDS (TAP) tele-assessment tool created by the Vanderbilt Kennedy center (VKC) and Division of Developmental Medicine, the VKC has received a $3.1 million grant from the Department of Defense to study telehealth deployment across rural areas of Tennessee.

Liliana Wagner

“In the current study, we will partner our state Part C early intervention (EI) system (TEIS) to deploy a tele-assessment program, inclusive of the TAP, across four of the most rural and medically underserved regions of Tennessee,” said Liliana Wagner, PhD, co-investigator and assistant professor of Pediatrics. “This project will allow us to identify the specific factors potentially influencing tele-assessment implementation and success with rural communities by talking directly with community members; adapt certain modifiable aspects of our tele-assessment approach to be more responsive to the needs and limitations of these rural families and service providers and generate individualized implementation plans for specific service districts; and deploy and evaluate tele-assessment’s performance, usability and cost-effectiveness relative to traditional systems of care.”

Each of the four districts — northwest, southwest, south central and upper Cumberland — will be randomly allocated to incorporate ASD tele-assessment into their existing service delivery systems in six-month intervals, with complete coverage after two years.

“Ultimately, this work represents the first rigorous evaluation of the clinical, familial and service system value of a tele-assessment approach for early ASD action in a rural community setting with relevance across the nation,” Wagner said. “If successful, results could help address critical existing barriers to accessing autism diagnostic evaluations, including those affected military families across the globe. Demonstrating the functionality and impact of tele-assessment for young children, as well as understanding the facilitators and barriers to widespread deployment and uptake, has potential to transform the ASD evaluation process and improve access for traditionally underserved regions and populations.”