A telehealth tool developed at UC Davis Health can reliably assess infant development as well as gold-standard in-person methods, according to a new study.
The findings, published recently in the Journal of Clinical Child and Adolescent Psychology, validate the tool known as TEDI, or Telehealth Evaluation of Development for Infants. The tool could help expand access to developmental monitoring and support for infants with an increased likelihood of autism, ADHD and other developmental conditions, especially in rural or underserved communities.
Addressing a data gap
During the COVID-19 pandemic, many researchers pivoted to telehealth to assess child development. But very few studies have compared data gathered at home with data gathered from an in-person lab setting. The new study is one of the first to do that, by analyzing both methods in the same group of infants.
"We found that overall, measures collected via telehealth in families' homes were very similar to those from traditional laboratory assessments," said Meagan Talbott, who developed TEDI and is the lead author on the paper. Talbott is an associate professor in the Department of Psychiatry and Behavioral Sciences and a UC Davis MIND Institute faculty member.
"This supports the idea that telehealth can be a valid and reliable way to conduct early developmental assessments, so families do not always need to travel to a clinic or research center," she explained.
Several studies, including a 2025 paper from MIND Institute researchers, have compared in-person and remote assessments for autism diagnosis. Generally, they've found that remote telehealth-based autism diagnosis is reliable, but in-person diagnosis is more appropriate for some families.
What sets TEDI apart is its focus on infancy, before most children are old enough to receive a diagnosis. The tool was designed to capture changes in infants who are more likely to have developmental differences, such as those with an autistic sibling or a parent with ADHD.
This supports the idea that telehealth can be a valid and reliable way to conduct early developmental assessments, so families do not always need to travel to a clinic or research center."-Meagan Talbott, associate professor, Department of Psychiatry and Behavioral Sciences
Study methods
The research team enrolled 111 infants: 33 with a family history of autism, 51 with a family history of ADHD and 27 with no family history of either condition. Each infant completed an in-person laboratory assessment and a remote TEDI session within one month of each other. Researchers assessed the children at either 6 or 9 months, 12 months or 18 months of age.
For the 60-minute TEDI assessment, families were given a small kit of toys. An examiner joined the family remotely through video via a computer, cellphone or tablet, and coached parents or caregivers through a series of activities. This included peekaboo, playing with bubbles and singing a song. The examiner evaluated aspects of the child's development such as:
- What type of language infants understood
- How the infants communicated
- Play skills
- Problem solving
- Behaviors associated with autism
- Behaviors associated with ADHD
The researchers found broad consistency in scores from the in-person and telehealth assessments, suggesting that the remote model can provide valid and reliable data.
"It was reassuring that we got a very similar 'picture' of each baby's skills and development no matter where we saw them," Talbott said.
These findings help lay the groundwork for more equitable access to early identification, timely support and services that help infants and their families thrive."-Meghan Miller, director, Center on Disability Studies at the University of Hawai'i at Mānoa
Increasing access to care and support
As part of the study, parents and caregivers were also asked whether the home-based assessment reflected their child's typical behavior, and how they felt about the remote process.
"Many families in our study shared that their babies were more comfortable at home and were more of their 'usual self' than in the lab," Talbott explained.
She added that many families liked the convenience of the remote method.
"This work is an important step toward making early developmental assessments more accessible to families, regardless of where they live," said paper co-author Meghan Miller, director of the Center on Disability Studies at the University of Hawai'i at Mānoa. Miller was previously a professor of psychiatry and behavioral sciences and MIND Institute faculty member.
She noted that reliable access to remote care can have positive lifelong impacts.
"These findings help lay the groundwork for more equitable access to early identification, timely support and services that help infants and their families thrive."
Next steps
The team is currently testing a version of TEDI adapted for Spanish-speaking families. "We hope this will increase the availability of culturally and linguistically appropriate tools for research studies, and ultimately, in community settings too," Talbott said.
