title: Usability and reliability of a remotely administered adult autism assessment, the autism diagnostic observation schedule (ADOS) module 4.
abstract: BACKGROUND
  The Autism Diagnostic Observation Schedule (ADOS) Module 4 is an autism assessment designed for verbally fluent adolescents and adults. Because of a shortage of available clinical expertise, it can be difficult for adults to receive a proper autism spectrum disorder (ASD) diagnostic assessment. A potential option to address this shortage is remote assessment. The objective of this study was to examine the feasibility, usability, and reliability of administering the ADOS Module 4 remotely using the Versatile and Integrated System for Telerehabilitation (VISYTER).
  
  
  METHODS
  VISYTER consists of computer stations at the client site and clinician site for video communication and a Web portal for managing and coordinating the assessment process. Twenty-three adults with an ASD diagnosis participated in a within-subject crossover design study in which both a remote ADOS and a face-to-face ADOS were administered. After completing the remote ADOS, participants completed a satisfaction survey.
  
  
  RESULTS
  Participant satisfaction with the remote ADOS delivery system was high. The kappa value was greater than 0.61 on 21 of 31 ADOS items. There was substantial agreement on ADOS classification (i.e., diagnosis) between assessments delivered face-to-face versus assessments delivered remotely (interclass coefficient=0.92). Non-agreement may have been due to outside factors or practice effect despite a washout period.
  
  
  CONCLUSIONS
  The results of this study demonstrate that an autism assessment designed to be delivered face to face can be administered remotely using an integrated Web-based system with high levels of usability and reliability.
authors.affiliation: 1 Department of Rehabilitation Science and Technology, University of Pittsburgh , Pittsburgh, Pennsylvania.
authors.forename: Jamie L
authors.initials: JL
authors.lastname: Schutte
authors.forename: Michael P
authors.initials: MP
authors.lastname: McCue
authors.forename: Bambang
authors.initials: B
authors.lastname: Parmanto
authors.forename: John
authors.initials: J
authors.lastname: McGonigle
authors.forename: Benjamin
authors.initials: B
authors.lastname: Handen
authors.forename: Allen
authors.initials: A
authors.lastname: Lewis
authors.forename: I Wayan
authors.initials: IW
authors.lastname: Pulantara
authors.forename: Andi
authors.initials: A
authors.lastname: Saptono
mesh_terms: D000293:Adolescent; D000328:Adult; D001321:Autistic Disorder / Q000175:diagnosis* / Q000534:rehabilitation*; D018592:Cross-Over Studies; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D018579:Patient Selection; D011369:Professional-Patient Relations; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013685:Telecommunications / Q000295:instrumentation / Q000706:statistics & numerical data*; D000069350:Telerehabilitation / Q000295:instrumentation / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: assessment; autism; e-health; reliability; technology; tele-assessment; telehealth; telemedicine; telepsychiatry; telerehabilitation