Telehealth diagnosis of autism spectrum disorder through clinical cases.

A diagnosis of autism spectrum disorder (ASD) provides access to interventions that are important for fostering development and improving quality of life. Thus, the timeliness of a diagnosis should not be limited by social-distancing limitations whenever possible. Despite this, clear guidance for transitioning autism diagnostic services to a telehealth model of care in the era of the COVID-19 pandemic is lacking. At our Institute, we have adapted our approach to ASD evaluation to promote continued access to evaluation services during this unprecedented time. The purpose of this case series is to provide examples of three different approaches to ASD differential diagnostic services via telehealth that we have taken at our Institute.We illustrate our methods and clinical decision-making, based on patient characteristics and referral aims, in providing telehealth diagnostic services and discuss the advantages and limitations of telehealth utilization in the differential diagnosis of ASD.At our Institute, telehealth services have provided an invaluable opportunity to continue to confirm (or rule out) an ASD diagnosis when appropriate to facilitate access to services during this time. Future research examining the utility of telehealth in the differential diagnosis of ASD is imperative given the potential advantages of telehealth services beyond the COVID-19 pandemic for some patients.

Evidence for impairments in using static line drawings of eye gaze cues to orient visual-spatial attention in children with high functioning autism.

We examined the ability to use static line drawings of eye gaze cues to orient visual-spatial attention in children with high functioning autism (HFA) compared to typically developing children (TD). The task was organized such that on valid trials, gaze cues were directed toward the same spatial location as the appearance of an upcoming target, while on invalid trials gaze cues were directed to an opposite location. Unlike TD children, children with HFA showed no advantage in reaction time (RT) on valid trials compared to invalid trials (i.e., no significant validity effect). The two stimulus onset asynchronies (200 ms, 700 ms) did not differentially affect these findings. The results suggest that children with HFA show impairments in utilizing static line drawings of gaze cues to orient visual-spatial attention.

First grade emotion knowledge as a predictor of fifth grade self-reported internalizing behaviors in children from economically disadvantaged families.

In this longitudinal study, we examined the relations between emotion knowledge in first grade, teacher reports of internalizing and externalizing behaviors from first grade, and children's self-reported internalizing behaviors in fifth grade. At Time 1, we assessed emotion knowledge, expressive vocabulary, caregiver-reported earned income, and teacher-rated internalizing and externalizing behaviors in 7-year-old children from economically disadvantaged families (N = 154). At Time 2, when the children were age 11, we collected children's self-reports of negative emotions, depression, anxiety, and loneliness. First grade teacher-reported externalizing behaviors, but not first grade internalizing behaviors, were positively related to children's self-reports of internalizing behaviors in fifth grade. First grade emotion knowledge accounted for a significant amount of variance in children's self-reports of internalizing symptoms 4 years later, after controlling for per capita earned income, expressive vocabulary, and teacher-reported internalizing and externalizing behaviors in first grade.

Modeling emotional, cognitive, and behavioral predictors of peer acceptance.

Integrating principles of differential emotions theory and social information-processing theory, this study examined a model of emotional, cognitive, and behavioral predictors of peer acceptance in a sample of 201 early elementary school-age children (mean age = 7 years, 5 months). A path analytic model showed that social skills mediated the effect of emotion knowledge on both same- and opposite-sex social preference, but social skills and verbal ability were more strongly related to opposite-sex peer acceptance. These findings suggest that adaptive social skills constitute a mechanism through which children express their emotion knowledge and achieve peer acceptance. Results also supported findings of previous studies that showed that emotion knowledge mediated the effect of verbal ability on social skills. Findings from the present study have specific implications for emotion-centered prevention programs that aim to improve children's socioemotional competence and enhance the likelihood of peer acceptance.