Objective: 

The objective of this study was to present clinician and caregiver perspectives regarding telehealth neurodevelopmental evaluation delivered at the onset of the coronavirus disease 2019 (COVID-19) pandemic. Specifically, we sought to describe telehealth neurodevelopmental evaluations, examine associations between child characteristics and diagnostic factors, determine the impact of technology and family barriers, and report on clinician and caregiver satisfaction with telehealth evaluation.

Methods: 

In response to the COVID-19 pandemic, in-person clinical services at a large children's hospital neurodevelopmental clinic were transitioned to telehealth. Data are presented for 254 remote evaluations of children (18–212 months; referral concern: 51% autism spectrum disorder [ASD], 24% developmental delay/intellectual disability, 25% other neurodevelopmental concern) conducted from May to July 2020. Data were gathered from electronic health records as well as clinician and caregiver surveys.

Results: 

A clinical diagnosis was provided in 72% of telehealth evaluations. Clinicians rated diagnostic certainty as “completely” or “somewhat” certain in 74% of evaluations. Certainty ratings were higher for evaluations in which a diagnosis of ASD was provided. Although technology and family challenges were reported, clinicians rarely identified these as disruptive to the evaluation process. Clinicians reported satisfaction with various aspects of delivering telehealth. Caregivers endorsed high satisfaction with receipt of telehealth and reduced travel burden.

Conclusion: 

The COVID-19 pandemic has rapidly transformed service delivery for individuals with neurodevelopmental disabilities and provided an unprecedented opportunity to evaluate the deployment of telehealth evaluation to meet the need for ongoing diagnostic care. Our findings suggest that telehealth holds significant promise for neurodevelopmental assessment both within the context of a global pandemic and beyond.

中文翻译：

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COVID-19 大流行期间儿科神经发育障碍的远程医疗评估：临床医生和护理人员的观点

客观的： 

本研究的目的是提出临床医生和护理人员对 2019 年冠状病毒病 (COVID-19) 大流行爆发时进行的远程医疗神经发育评估的看法。具体来说，我们试图描述远程医疗神经发育评估，检查儿童特征和诊断因素之间的关联，确定技术和家庭障碍的影响，并报告临床医生和护理人员对远程医疗评估的满意度。

方法： 

为了应对 COVID-19 大流行，一家大型儿童医院神经发育诊所的现场临床服务已转变为远程医疗。提供了 2020 年 5 月至 7 月期间对儿童（18-212 个月；转诊问题：51% 自闭症谱系障碍 [ASD]、24% 发育迟缓/智力障碍、25% 其他神经发育问题）进行的 254 项远程评估的数据。从电子健康记录以及临床医生和护理人员调查中收集。

结果： 

72% 的远程医疗评估提供了临床诊断。在 74% 的评估中，临床医生将诊断确定性评为“完全”或“部分”确定。提供 ASD 诊断的评估的确定性评级较高。尽管技术和家庭挑战有所报道，但临床医生很少认为这些挑战会破坏评估过程。临床医生对提供远程医疗的各个方面表示满意。护理人员对远程医疗和减少旅行负担表示高度满意。

结论： 

COVID-19 大流行迅速改变了为神经发育障碍患者提供的服务，并提供了前所未有的机会来评估远程医疗评估的部署，以满足持续诊断护理的需求。我们的研究结果表明，无论是在全球大流行的背景下还是在其他情况下，远程医疗对于神经发育评估都具有重大前景。