Identifying the unique determinants influencing rural families' engagement with an existing tele-assessment approach for autism identification: A qualitative study

It is often difficult for families in rural communities to access autism evaluations for their children when they have concerns. Tele-assessment could make it easier for them to see specialists who give autism diagnoses, but we still need to figure out the best way to carry out these approaches. To understand how rural families view tele-assessment, as well as barriers they may face, we held focus groups with caregivers of children with autism and local service providers in the Southeastern United States. We met with 22 caregivers and 10 providers. We analyzed the discussions and found four key attitudes: (1) questions about whether autism assessment can really be done online; (2) level of trust in the evaluation process, especially tele-assessment; (3) beliefs about whether tele-assessment is practical for families; and (4) worries about privacy. These attitudes and beliefs are shaped by various factors at different stages, indicating that we need to improve tele-assessment by better supporting everyone involved at different stages of the tele-assessment process. This research highlights important areas for improvement to provide fair access to tele-assessment for rural families (e.g. creating education materials, conducting barrier counseling).