Short answer: yes! For many children and adults, remote (telehealth) assessments are a reliable, evidence-based option that can capture the same core areas clinicians look for in person. 

What the research says about telehealth autism evaluations

  • Multiple systematic reviews and studies find that high quality telehealth methods for autism assessment show strong agreement with in-person evaluations — typically in the range of about 80–90% diagnostic agreement in published studies.
  • Several clinician-administered and caregiver-mediated tools have been adapted and validated for home use (for example, TELE-ASD-PEDS and online adaptations of ADOS-2), and research shows these remote tools can produce reliable diagnostic impressions when used by trained clinicians.
  • Families generally report high satisfaction and clinicians report reasonable confidence in many telehealth assessments.
  • Telehealth evaluation approaches are also emerging and showing promise for ADHD and executive-function assessment, with studies supporting feasibility and acceptable reliability for many remote measures.

What does a thorough and reliable assessment include?  

Before proceeding with a telehealth diagnostic evaluation, it is important to be sure that the process will be comprehensive and reliable. Below are questions to ask, as well as a description of what this looks like at Avela Health. 

1. Evaluation should be completed by a skilled diagnostician

The person conducting the diagnostic evaluation should be licensed to practice in their discipline and have expertise in conducting diagnostic evaluations and in doing these evaluations via telehealth. You can ask questions such as how long a practitioner has been conducting diagnostic evaluations and what age groups they work with.

The diagnostician also should have deep expertise in autism, and the varied ways that autism can present. This means being familiar with different levels of autism and the variations in how autism presents at different ages. In addition, the diagnostician should be skilled at differentiating between autism and other conditions and recognizing and diagnosing co-occurring conditions such as anxiety, depression, or OCD.

2. Clinical interview (teleconference)

A developmental history should be gathered to learn more about the person’s infancy and early childhood, developmental milestones, educational history, etc. 

A diagnostic interview should be conducted to gather information about the extent to which a person’s way of being aligns with characteristics of autism. For children, this often is a semi-structured caregiver interview. For older children, the diagnostician may also talk with the youth. For adults, the interview generally is done with the adult. This captures developmental history, social milestones, language, routines, sensory issues, and concerns.

3. Standardized rating scales and questionnaires (sent electronically or completed with the diagnostician over telehealth)

Standardized rating scales allow the diagnostician to compare a person’s responses to a large, representative sample of peers of the same age. This allows diagnosticians to determine whether a behavior, skill, or difficulty is typical or atypical for that developmental level—something that cannot be done with clinical observation alone.

There are several different measures for this purpose and a diagnostician should be able to explain to you what assessments they are asking you to complete and why. 

4. Observations

Observation is a critical component of the diagnostic evaluation, allowing the diagnostician to see how the individual engages, communicates, and regulates attention and behavior in real time. For both children and adults, observation provides information that cannot be fully captured through interviews or questionnaires—highlighting strengths, coping strategies, and challenges in natural interaction. Observed behaviors are essential for interpreting test results, informing diagnostic impressions, and identifying supports that best promote success across settings.

For adults, this observation may occur during the interview as well as during semi-structured roleplays.

For children, the observation may occur during conversation. In addition, the diagnostician should guide the caregiver through a set of brief play/interaction tasks on camera (e.g., play with a small toy set, “peek-a-boo,” book reading, turn-taking games). During this time, the diagnostician will watch and code social communication and other behaviors in real time. There are reliable and valid observational tools developed specifically for this purpose such as the TELE-ASD-PEDS and BOSA both have documented reliability and validity.

5. Home video samples

Caregivers often are asked to record short clips of their child during typical routines (e.g., child playing, snack time, responding to name) to supplement the observation. These can be especially helpful when the child was nervous, sleepy, or not acting as they typically do during observations. 

6. Cognitive and/or achievement testing or screening

A cognitive evaluation often is a vital part of a comprehensive diagnostic assessment for autism and ADHD because it helps clarify how a person thinks, learns, and processes information. These insights can be key for accurate diagnosis, interpretation of behaviors, and individualized recommendations. Importantly, there are cognitive evaluations and achievement tests that can be conducted remotely and that have excellent reliability and validity. If this is not part of the diagnostic evaluation, ask your diagnostician to explain why. 

7. Collateral information

Obtaining rating scales from someone who knows the individual well, such as a parent, teacher, partner, or close friend, is an important part of a comprehensive diagnostic evaluation. These people can provide valuable perspectives on the person’s everyday behavior, communication, attention, and emotional functioning across settings and situations. Because many characteristics of autism and ADHD vary depending on context, input from someone familiar with the individual’s typical functioning helps ensure accuracy and balance in interpretation. Collateral ratings also allow the clinician to compare perspectives, identify consistent patterns, and understand how strengths and challenges appear in daily life, supporting a more complete and valid diagnostic picture.

8. Team consensus and report

All information gathered, including interviews, observations, standardized testing, and collateral rating scales, is synthesized by the diagnostician to create a comprehensive understanding of the individual’s strengths, needs, and experiences. Rather than focusing solely on diagnostic labels, the evaluation should emphasize how the person thinks, learns, communicates, and relates to others in their everyday environments. 

Findings should be interpreted through a neurodiversity-affirming lens, recognizing that differences in attention, communication, and social interaction reflect natural human variation. 

Recommendations should be individualized and practical, highlighting ways to build upon strengths, support areas of challenge, and create environments—at home, school, work, and in the community—that promote autonomy, connection, and well-being.

Practical tips for preparing for a remote assessment

  1. Check tech ahead of time. Use the device the clinician recommends (tablet or laptop is often easiest), ensure you hve a strong internet connection, test your video and audio, and have a phone backup nearby.
  2. Create a quiet, well-lit space. For children, a familiar play area with favorite toys and few distractions works best. 
  3. Confirm who should be present. For children, the diagnostician should have let you know if they want your child to be present or not for your first appointment and also whether you should have any specific items available or put away.

Bibliography (peer-reviewed sources and reviews)

  • Wren, Y., et al. A systematic review of telehealth screening, assessment, and diagnosis of autism spectrum disorder. Child and Adolescent Psychiatry and Mental Health. (2022). PMC
  • Wetherby, A., et al. In-home tele-assessment for autism in toddlers: validity and reliability of TELE-ASD-PEDS. (PMC article). (2025). PMC
  • Dow, D., et al. The Brief Observation of Symptoms of Autism (BOSA) and telehealth adaptations for ASD assessment. (2021; development/validation literature). medRxiv
  • [Systematic review] Diagnostic Assessment of Autism in Children Using Telehealth in a Pandemic and Beyond — diagnostic agreement 80–88.2% across studies. (2023 review). SpringerLink
  • Sutherland, R., et al. Telehealth autism diagnostic assessments with children, young people and adults: experiences and perspectives. JMIR Mental Health (2022). Mental Health Journal
  • Seixas, M., et al. Reliability of telepsychiatry assessments using the Attention-Deficit … (remote ADHD testing feasibility). JMIR (2024). JMIR Publications