Autism Diagnostic Assessments With Children, Adolescents, and Adults Prior to and During the COVID-19 Pandemic: A Cross-Sectional Survey of Professionals

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Spain, D., Stewart, G. R., Mason, D., Robinson, J., Capp, S. J., Gillan, N., Ensum, I., & Happé, F. (2022). Autism Diagnostic Assessments With Children, Adolescents, and Adults Prior to and During the COVID-19 Pandemic: A Cross-Sectional Survey of Professionals. Frontiers in Psychiatry, 13, 789449-789449. https://doi.org/10.3389/fpsyt.2022.789449

Publication date: 28 Apr 2022 Added to AutiHub: 18 Sep 2026 Type: Article Article language: English
Publisher source (DOI) Full text OpenAlex source

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Authors

Publication authors
8
Publication authors identified as autistic
1 / 8 (12.5%)
  1. Debbie Spain
  2. Gavin Robert Stewart
  3. David Mason *
  4. Janine Robinson
  1. Simone J. Capp
  2. Nicola Gillan
  3. Ian Ensum
  4. Francesca Happé

Abstract

Background Access to timely high quality autism diagnostic assessments has traditionally been patchy; many individuals wait months, if not years, for an appointment. The onset of the COVID-19 pandemic has likely impacted autism diagnostic services. This study investigated professionals' experiences of, and thoughts about: (1) how autism diagnostic assessments were conducted before the pandemic; (2) adaptations to service provision because of the pandemic; and (3) challenges, risks, advantages and opportunities associated with autism assessments conducted via online platforms (telehealth). Method Fifty-two professionals, based in different autism diagnostic services and working with children, adolescents and/or adults, completed an online cross-sectional survey in August and September 2020. This comprised demographic questions (about professionals' roles and experiences), and closed and open questions about service provision and telehealth autism assessments. Results There was substantial variation in how autism assessments were conducted prior to and during the pandemic; for example, in relation to the number of professionals involved in the assessment and types of structured, semi-structured and unstructured measures used to conduct this. Fifty-two percent of participants (n = 27) reported some service disruption (e.g., full closure, substantial reduction in provision, and/or pausing of in person appointments). Waiting times for assessment had become longer for 58% of services (n = 30), due to pandemic-related disruption. Six themes emerged from thematic analysis of open responses: (1) the autism diagnostic pathway, pre-pandemic; (2) initial impact of the pandemic on service delivery; (3) conducting autism assessments during the pandemic; (4) working remotely; (5) improving service design and delivery; and (6) post-diagnostic support. Views about the accessibility, validity, and reliability of conducting telehealth autism assessments were polarized. Some participants considered this efficient, flexible, and adequate; others viewed this as unethical and inappropriate. What constitutes good practice in telehealth autism assessments remains unclear, but there is a general openness to using this method (potentially in a hybrid telehealth—in person model), provided rigor and standardization are enhanced. Conclusions The pandemic has potentially compounded existing bottlenecks to the autism diagnostic pathway. Future research should seek to improve timeliness, standardization, accessibility and robustness of this pathway, and the validity and reliability of telehealth autism assessments.

Bibliography cited by this reference

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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: 2 Oct 2026 01:01.

Cited references
40
With a DOI
38
Without a DOI, from raw bibliography text
2
1 / 40 (2.5%) cited references include at least one author identified as autistic.
References with data to complete
2 / 40 (5.0%)
References with detected author names
38 / 40 (95.0%)
Without detected author names
2
Without a structured title
1
Without a stable identifier
2
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
219
From DOI or external metadata
219
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
0
80 / 219 (36.5%) names are linked to an author already present in AutiHub. 139 / 219 (63.5%) names are not yet linked.
Names linked to a person identified as autistic
1 / 219 (0.5%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 1 / 80 (1.2%). Distinct people identified as autistic: 1 / 196 (0.5%).
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