The number of video visits with a physician exploded during the pandemic, and they have become a suitable, convenient complement to many in-person doctor appointments, although there are limitations. For example, the doctor still can’t perform cardiac stress tests, radiologic imaging, and many gynecologic and urologic tests over a computer screen.
But there’s at least one medical condition that pediatric specialists have found where a video visit is much more preferable to a physical one: autism.
“I feel video visits are ideal for autism in 90% of the visits I do,” said Michael Chez, M.D., a leading Northern California autism expert and author of the book, “Autism and Its Medical Management: A Guide for Parents and Professionals.” “Video enables us to see a patient in their home environment and see home behaviors that are not available in an office visit. This has mostly been beneficial.”
Dr. Chez, who is a Sutter pediatric neurologist and a medical director with the Sutter Neuroscience Institute for Epilepsy and Autism Medical Research, says seeing the children at home allows him to see what treatment tools the parents are using and how the children with autism interact with toys, pets and the family.
“In the office, it’s a change in their normal environment, and they may shut down or be overstimulated and stressed,” he said. “It’s also stressful on the family to pack up and drive to the doctor.”
Dr. Chez said he often hears parents discuss a child’s behavior at home, but doesn’t often see it in the office, when the child may be on their best behavior.
“We’re able to see a child acting out at home and can advise the parents how to manage it in that physical and social setting,” he said. “And if a child is destructive, I also can see what they did.”
During a video visit, Dr. Chez can assist in giving parents and other caregivers advice on how to solve problems, such as helping to set up a place for time-outs when the child may become unruly.
“In one case,” he said, “we offered advice on how to behaviorally change where the child wanted to sleep to where the parents wanted the child to sleep. By seeing the physical situation and making behavioral advice, rearrangements in the child’s daily schedule were made to make being in his room less negative and more positive for him.”
Dr. Chez also is able to see the care being given by the specialized autism therapists who use Applied Behavior Analysis, also called ABA, and how they interact with the child. “This allows me to give real-time feedback,” he said.
But, will in-office visits entirely be a thing of the past? Not so fast, Dr. Chez says.
“Some kids miss their ‘outing’ going to the doctor,” he said. “It’s a social-skill event for them.”
And with a disorder characterized, in part, by challenges with social skills, that is a positive thing, too.