Autism On Tape: Using Video To End Dx Delays, Boost Service Access

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March 5, 2019
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  As diagnostic tools improve, the CDC estimates that about 1 in 59 children has an autism spectrum disorder (ASD), but don’t listen to the hype about an epidemic. Rather than growing numbers, the current diagnostic rate indicates improved testing sensitivity and perhaps even intensiveness, and, in turn, a greater demand for services. The problem is, in order to receive services, children need a formal diagnosis, and the lines are long. That’s why providers are turning to video technology to end diagnostic delays and get services to children sooner, and at a lower cost.

Assessing The Wait List

Just how long does it take for a child to get an autism diagnosis? The answer varies widely depending on where a family lives and, especially, how much money they have. One Missouri woman reports waiting 18 months and traveling over 100 miles to see the specialist who would diagnose her son. Wealthier families, on the other hand, may be able to get an appointment with weeks with an expensive specialist if they don’t plan to use insurance. Since research shows that early intervention services, such as speech and occupational therapy, are an important part of improving outcomes for children with ASD, timely diagnosis is vital.

Evaluating Via Video

Typically, in-person evaluations, often taking place over hours or even days, are considered the gold standard when evaluating children for ASD, but what researchers are finding is that video can also be used as part of the diagnostic process. At Stanford University School of Medicine, for example, researchers have been developing an algorithm that assesses home videos to diagnose autism. The algorithm can identify key behaviors based on videos of many children on the spectrum and then uses that self-generated list to score new videos. One of the benefits of using home videos to assess children with autism, besides making the process less expensive and more accessible, is that it can be less stressful for the children involved. Children with ASD can be rigid about routines and highly anxious in unfamiliar situations, which can make the evaluation process difficult. Home video can give doctors a view of the child in their natural environment, so behaviors tend to be more typical of the child.

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Research And Rewind

Another benefit of using video when working with children with ASD is that video recordings can be used to train new clinicians and generate new research into the condition. In fact, this is one of the key advantages of Intelligent Video Solutions’ VALT technology; researchers can record participant interviews using VALT and tag them with important information. Additionally, since VALT is easily adapted for use in home settings, it can used to monitor therapies at home to ensure they’re being performed correctly and to determine a child’s progress.

Therapy On Video

Children with ASD typically receive a variety of therapies, such as occupational therapy to improve social skills and manage sensory processing difficulties, and speech therapy for language delays and to teach alternative communication tools, and these therapies can consume many non-school hours and are typically reinforced at home. This can be difficult for any parent, since it forces them to be a therapist rather than just mom or dad, but it’s especially challenging for low-income, minority, and immigrant families. These families typically have less access to services, fewer hours to work with their children at home, and may experience discrimination from providers. Children of color with ASD are also typically diagnosed later than their white peers. By bringing therapy into the home via video and training parents to provide many of these interventions, video can make these services more accessible to families at all income levels and can help build parent confidence in providing interventions. For example, when parents can regularly review interventions on video and record themselves performing therapies, they reinforce those skills. Depending on the task at hand, some children with ASD will also benefit from viewing the videos themselves; this can be especially true for social and emotional interventions. The sooner families have access to proper diagnostic and intervention services, the more likely their children are to thrive. Research shows that children with ASD who receive behavioral interventions by age 3 develop better language skills in the long term than those who don’t receive services until age 4. This is in sharp contrast to children with a generic language delay; many of those children don’t require services and will catch up with their peers regardless of intervention. Because ASD can result in global delays, however, early intervention is critical. It will take time to normalize the use of video in autism diagnosis and therapy, but it is making headway, and that alone is transformative. For families in rural areas, families who don’t speak English, or those with limited income, video services could help bridge diagnostic gaps, cut waiting lists, and give children the tools they need to thrive.