Warning use of video technology could compromise autism assessments
A senior psychologist is urging families to think carefully before undergoing online assessments for autism, which could result in an incorrect diagnosis.
Clinical Psychologist Dr Lisa Williams has more than 14 years’ experience and is a specialist in the area of autism and mental health.
She said that with the outbreak of COVID-19, many businesses and organisations have had to change the way they work, but that autism diagnostic assessments are not something that should be switched to an online service.
“Autism is a disorder of social communication and interaction. To diagnose it, you need to observe and assess how a person communicates and interacts.
“Now, as soon as you put a video camera between two people – with or without autism – communication and interaction are distorted.
“The simplest example of this is eye contact. How can you assess eye contact when no one is sure where to look? In my professional opinion, you can’t.”
Dr Williams, who has experience of working in three different autism teams in the NHS and has led on diagnoses for preschool children all the way to older adults, is also the Clinical Director of The Autism Service.
The service did not switch to offering diagnostic assessments for autism online when restrictions were imposed. Instead, all appointments were postponed.
“The gold-standard tools that we have available to us, such as the ADOS-2, are not validated for use online, and rightly so. So, you would have to use a home-made alternative – something that is just not acceptable to us,” adds Dr Williams.
“There is also the issue of patient experience. We want it to be positive and the additional pressure and social demands created by use of a video camera only heighten anxiety.
“Which in turn affects social skills, further lessening the accuracy of the assessment.
“At the very least, families should be informed about how the use of video technology might compromise the assessment and of any resulting uncertainty. A position that is supported by a recent statement made by the British Psychological Society.”
Dr Williams said that with improved public understanding of autism, The Autism Service is receiving more enquiries from people who are questioning if a diagnosis they received previously from an online assessment is correct.
“As a psychologist, this is concerning. It is very distressing for all involved. I would say that in the case of diagnosing autism, no assessment is better than an online assessment.”
