Telehealth Autism Diagnostic Assessments With Children, Young People, and Adults: Qualitative Interview Study With England-Wide Multidisciplinary Health Professionals

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Spain, D., Stewart, G. R., Mason, D., Milner, V., Fairhurst, B., Robinson, J., Gillan, N., Ensum, I., Stark, E., & Happé, F. (2022). Telehealth Autism Diagnostic Assessments With Children, Young People, and Adults: Qualitative Interview Study With England-Wide Multidisciplinary Health Professionals. JMIR Mental Health, 9(7), e37901. https://doi.org/10.2196/37901

Publication date: 27 Apr 2022 Added to AutiHub: 16 Sep 2026 Type: Article Article language: English
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Authors

Publication authors
10
Publication authors identified as autistic
2 / 10 (20.0%)
  1. Debbie Spain
  2. Gavin R. Stewart
  3. David Mason *
  4. Victoria Milner
  5. Bryony Fairhurst
  1. Janine Robinson
  2. Nicola Gillan
  3. Ian Ensum
  4. Eloise Stark *
  5. Francesca Happé

Abstract

Background Autism spectrum disorder (hereafter, autism) is a common neurodevelopmental condition. Core traits can range from subtle to severe and fluctuate depending on context. Individuals can present for diagnostic assessments during childhood or adulthood. However, waiting times for assessment are typically lengthy, and many individuals wait months or even years to be seen. Traditionally, there has been a lack of standardization between services regarding how many and which multidisciplinary health professionals are involved in the assessment and the methods (diagnostic tools) that are used. The COVID-19 pandemic has affected routine service provision because of stay-at-home mandates and social distancing guidelines. Autism diagnostic services have had to adapt, such as by switching from conducting assessments in person to doing these fully via telehealth (defined as the use of remote technologies for the provision of health care) or using blended in-person or telehealth methods. Objective This study explored health professionals’ experiences of and perspectives about conducting telehealth autism diagnostic assessments, including barriers and facilitators to this, during the COVID-19 pandemic; potential telehealth training and supervision needs of health professionals; how the quality and effectiveness of telehealth autism diagnostic services can be enhanced; and experiences of delivering postdiagnostic support remotely. Methods A total of 45 health professionals, working in varied settings across England, participated in one-off, in-depth semistructured qualitative interviews. These were conducted via videoconferencing or telephone. Altogether, participants represented 7 professional disciplines (psychiatry, medicine, psychology, speech and language therapy, occupational therapy, nursing, and social work). The data were then analyzed thematically. Results Thematic analysis indicated the following 7 themes: practicalities of telehealth, telehealth autism diagnostic assessments, diagnostic conclusions, clinical considerations, postdiagnostic support, future ways of working, and health professionals’ experiences and needs. Overall, telehealth autism diagnostic assessments were deemed by many participants to be convenient, flexible, and efficient for some patients, families, and health professionals. However, not all patients could be assessed in this way, for example, because of digital poverty, complex clinical presentation, or concerns about risk and safeguarding. Working remotely encouraged innovation, including the development of novel assessment measures. However, some participants expressed significant concerns about the validity and reliability of remotely assessing social communication conditions. Conclusions A shift to telehealth meant that autism diagnostic services remained operational during the COVID-19 pandemic. However, this method of working has potentially affected the parity of service, with people presenting with clinical complexity having to potentially wait longer to be seen or given a diagnostic opinion. There is also a lack of standardization in the provision of services. Further research should identify evidence-based ways of enhancing the timeliness, accessibility, and robustness of the autism diagnostic pathway, as well as the validity and reliability of telehealth methods.

Bibliography cited by this reference

Cited references are imported from external metadata sources when they are available. The list may be partial.

Cited bibliography overview

These indicators describe the bibliography cited by this publication. An author name is counted each time it appears in one cited reference, so the same person can be counted more than once. Names not yet linked to an author already present in AutiHub are treated as unknown, not as non-autistic. Last computed: 19 Sep 2026 01:01.

Cited references
39
With a DOI
33
Without a DOI, from raw bibliography text
6
2 / 39 (5.1%) cited references include at least one author identified as autistic.
References with data to complete
7 / 39 (17.9%)
References with detected author names
33 / 39 (84.6%)
Without detected author names
6
Without a structured title
6
Without a stable identifier
6
References with raw author names still to review
0
References with external metadata lookup issues
0
These indicators apply to cited references displayed on this page, after technical duplicates have been merged. A reference without a DOI can still support author statistics when a title and author names are available.
Author names detected in the cited bibliography
149
From DOI or external metadata
149
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
0
47 / 149 (31.5%) names are linked to an author already present in AutiHub. 102 / 149 (68.5%) names are not yet linked.
Names linked to a person identified as autistic
2 / 149 (1.3%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 2 / 47 (4.3%). Distinct people identified as autistic: 1 / 138 (0.7%).
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