Telehealth Use in Children with Autism Spectrum Disorder Shows Mixed Health Outcomes
Study Explores Telehealth Impact on Youth with Autism
A recent analysis examined how telehealth (TH) usage relates to health outcomes among children and adolescents diagnosed with autism spectrum disorder (ASD). Researchers compared clinical data from thousands of young patients who either used telehealth services or received traditional in-person care.
Research Design and Patient Groups
The study aggregated electronic health records from 112 healthcare organizations, focusing on patients aged 5 to 18 years diagnosed with autistic disorder (ICD-10 code F84.0). Using propensity score matching to balance for 14 categories of co-occurring conditions, the researchers created two cohorts: one with documented telehealth use and a matched group without telehealth involvement. The analysis included 12,380 patients per group at 6 months and 15,689 per group at 12 months.
Key Findings at 6 and 12 Months
Within the first six months, telehealth users showed a lower likelihood of starting antipsychotic medications (risk ratio [RR]=0.81) and fewer hospitalizations (RR=0.69) compared to those without telehealth. However, telehealth was linked to increased emergency department visits (RR=1.39), more encounters related to irritability (RR=2.49), and substantially higher engagement in adaptive behavior treatment (RR=5.17).
At the 12-month mark, some differences persisted: telehealth users continued to have more irritability-related visits (RR=2.29) and greater use of adaptive behavior therapy (RR=3.40). Additionally, they were more likely to initiate antidepressants (RR=1.17) and ADHD medications (RR=1.12), and demonstrated higher rates of medical noncompliance (RR=1.84).
Interpreting the Results
These findings suggest that telehealth may reduce certain acute interventions, such as hospitalizations and antipsychotic starts, in the short term. However, increased irritability-related encounters and medication initiation over time indicate complex care needs that may not be fully addressed through telehealth alone. The elevated adaptive behavior treatment usage among telehealth users points to greater engagement in behavioral therapies.
Implications for Families and Providers
For families and clinicians, the study underscores the potential benefits and limitations of telehealth in managing ASD. While telehealth can offer accessible care and possibly reduce some hospital-based interventions, it may also coincide with challenges such as increased irritability symptoms and medication adjustments. These findings highlight the importance of developing hybrid care models that combine telehealth with in-person services tailored to individual needs.
Limitations and Considerations
The study is observational and cannot establish causation between telehealth use and outcomes. Differences in patient characteristics, healthcare access, and treatment preferences may influence results despite matching efforts. Further research is needed to explore how telehealth can be optimized for young people with ASD.
For more detailed information, see the original study published in Psychiatric Services: Associations of Telehealth Use With Health Outcomes Among Young People With Autism Spectrum Disorder.
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