Telehealth assessment of infant development reliable when compared to gold standard in-person methods

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.

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.

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.

In addition, Talbott is launching a study to pair telehealth assessments with parent coaching, working with families to find activities and learning strategies to support their babies' development. Families interested in taking part can email [email protected] or get more information on the TEDI website.

A complete list of co-authors is available in the study.

Study funding

Funding for this research was supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development (R21HD105161) and the National Institute of Mental Health (R01MH121416).

From Labs to Lives

This work was supported by federal research funding, which helps transform promising discoveries into real-world breakthroughs that save lives and improve quality of life. Learn more about how public investment in UC Davis research powers innovation, strengthens the economy and advances human health in From Labs to Lives.

Related Resources

TEDI study