Comparison of Laboratory- Versus Home-Based Assessments for Infants at Elevated Likelihood for Neurodevelopmental Disabilities.

Abstract

Objective: While many studies pivoted to telehealth and distance methods in response to the COVID-19 pandemic, few studies have directly and systematically compared data obtained from home and lab settings. Our goal was to evaluate the impact of these contextual and methodological differences across multiple developmental domains.

Method: Participants included 111 infants (33 infants with a family history of autism, 51 with a family history of Attention-Deficit/Hyperactivity Disorder (ADHD), and 27 infants with no family history of either diagnosis) who participated in a laboratory-based assessment and a paired telehealth session at 6 or 9, 12 and/or 18 months of age. Both sessions included multiple measures of infant skills across multiple developmental domains (e.g. receptive and expressive language, play, cognition), and autism- and ADHD-specific measures. Mixed models for repeated measures compared scores across contexts and timepoints and validity was evaluated via multitrait-multimethod matrix. Caregiver ratings of representativeness and acceptability were also evaluated.

Results: Convergent validity was supported by significant positive correlations between language, social-communication, and developmental measures across the two contexts, ranging from moderate (0.37) to high (0.80). Multilevel models revealed that developmental trajectories were broadly comparable across settings, though significant cross-context differences were observed, particularly for the 18-month timepoint.

Conclusions: We found broad consistency in scores obtained across the two contexts, suggesting that remote assessments can provide valid and reliable developmental data. The high parent satisfaction ratings also suggest remote assessments are feasible and acceptable to families.