Ryan Coleman

Objective: To evaluate the feasibility and clinical performance of an autism diagnostic e-consult model that embeds asynchronous psychologist review within primary care workflows to support diagnostic decision-making and triage by primary care providers (PCPs). Methods: Eight autism-trained PCPs across 4 clinics recorded brief diagnostic visits for children referred for autism evaluations. They submitted videos plus structured e-consult orders through a secure platform. Psychologists reviewed cases asynchronously and returned structured electronic health record (EHR) documentation indicating whether PCP impressions were supported and whether specialist follow-up was warranted. Diagnostic outcomes, triage decisions, child and visit characteristics, and observational scores were summarized using descriptive statistics, Wilcoxon rank sum tests, and χ ² tests. Results: Across 81 e-consults over 21 months, children had a median age of 2.3 years; the median interval from initial concern to completed e-consult was 73 days, and all reviews were completed within 7 days. Follow-up testing was recommended for 31%. Concordance between PCP global impressions and psychologist review was high, with 74% of diagnosed children rated “obviously consistent with autism” by their PCP. Children diagnosed with autism had higher ASD-PEDS scores on both psychologist and PCP ratings than those not diagnosed. Children referred for specialist follow-up had lower ASD-PEDS scores, and were more likely to have PCP-endorsed medical/social complexity and phrase speech. Conclusion: Pairing PCP training with EHR-integrated e-consults may offer a pragmatic pathway compatible with emerging billing and implementation models for autism assessment in primary care. In this sample, the process was associated with high concordance between PCP and psychologist determinations and appeared to route more complex cases to appropriate specialist follow-up.

Purpose: Adults seeking autism evaluations are often met with significant barriers, including long wait times, high costs, and a lack of access to providers trained in adult autism assessment. In addition, many of the primary assessment tools in adult autism assessment were developed without the input of autistic adults. To help expand diagnostic options for this population, we developed the novel Tele-ASD Diagnostic Assessment Tool for Adults (TADA). This study sought to evaluate the acceptability and feasibility of the TADA’s content, presentation, and scoring, according to autistic adults and clinicians administering the measure. Methods: Participants (n = 32, 22 autistic, 10 non-autistic) attended a tele-health appointment where they were administered the TADA by a licensed psychologist who then scored their clinical impressions on whether participants were reporting and exhibiting behaviors consistent with autism. Results & Conclusion: Both participants and clinicians rated their experience with the TADA favorably and indicated that it would be an acceptable addition to an assessment battery for adults seeking an autism evaluation.

Adhering to PRISMA guidelines, this study systematically reviews the reliability and validity evidence of two prominent sentence completion tests (SCT): the Rotter Incomplete Sentences Blank (RISB) and the Washington University Sentence Completion Test (WUSCT). SCTs have often been conceptualized as projective tests and summarily dismissed as lacking efficacy in psychological assessment, though this characterization is not entirely accurate. Conceptually and methodologically, SCTs are more aptly characterized as performance-based measures. Interest in potential applications of SCTs with clinical populations continues to persist. This review incorporated 51 studies conducted in the United States that met rigorous reliability and validity criteria. Although there is evidence to support the reliability and validity of the RISB and WUSCT, results vary widely depending on sample characteristics (e.g., age, race/ethnicity), study context, and the purpose of score interpretations examined in the study. Therefore, practitioners who utilize results from SCTs should consider these characteristics when engaging in interpretation.