6235 Home-based video observations for autism assessments in children – a new approach

Objectives Paediatric autism assessment waiting times are at an all-time high. Timely diagnosis and early interventions are key to improving long term functioning and outcomes for children. vCreate¹ is an NHS approved web-based service which allows parents to share videos of behaviour of children from home. Videos are uploaded from smartphones to a secure cloud which can be accessed by the clinical team. This poster presentation demonstrates how we have used vCreate to assist with autism assessments in our service. Videos are requested of behaviours from home and reviewed by members of the multidisciplinary team. These removed the need for direct observations in a hospital setting and reduced pressure of numbers on some parts of diagnostic pathways (i.e. ADOS-2 waiting lists). Videos can be uploaded to the child's electronic clinical record as evidence of observations for the assessment alongside other information gathered. Methods Children were identified from community paediatric clinics with concerns about possible autism. These children would also be those that would be added to a multidisciplinary (MDA) waiting list for direct observations in the hospital setting. Clinicians would consider if videos from home would help in documenting the observational information required as part of the diagnostic assessment. If videos from home were felt to provide enough observations that fit with the criteria for an autism diagnosis (using a video review system that allowed documentation as part of the clinical record), then the assessment could be concluded on that basis. Results Data over 1 year for 1 consultant patch (10 consultants in department): 50% of clinic cohort may benefit from this method of collecting observations. 25% of families actually used the service when it was offered 18 assessments concluded – 16 children autism diagnosis, 1 inconclusive and review, 1 not autism and discharged 13 of 18 children diagnosed with observations through videos did not have an ADOS (those that did were due to their place on waiting list) Time taken to conclude autism assessment 3–6 months vCreate alone; 12–18 months with use of ADOS Parents 65% – vCreate very easy or easy to use, 26% neutral Clinicians 93% – vCreate very easy or easy to use Conclusion Home-based video observations in autism assessment pathways can shorten time to diagnosis. The service is easy to use as rated by parents and clinicians with information easily interpretable. Next steps: staff training to increase utilisation and develop use as triage tool for new referrals awaiting 1st appointments. Reference UK NHS Trusted Asynchronous Secure Clinical Video Service (vcreate.tv).