Project Summary The overall goal of this proposal is to develop a telehealth procedure for screening infants 6-12 months of age for early autism spectrum disorder (ASD) symptoms. While some promising biomarkers have been identified for infants in this age range, neurobiological methods are not feasible for widespread implementation, especially in rural and low-resource service systems. Families with early concerns are faced with long waitlists for an evaluation and often must travel long distances for evaluations at centers with appropriate expertise. Telehealth has been used as a cost-effective approach for increasing access to services across many disciplines, and there is some initial use of telehealth treatment approaches in ASD, but there are currently no established telehealth screening procedures to screen infants for ASD. Developing a telehealth screening protocol would provide families an opportunity to access highly trained clinicians and researchers with specialized expertise for initial screening before undertaking the cost and effort required to travel to a center. The first six months of funding will be used to develop, refine, and pilot test this parent-administered protocol in a sample of diverse infants 6-12 months (Aim 1). Feedback from parents and experts will inform final adaptations. The resulting protocol will subsequently be tested via telehealth in a pilot feasibility phase (Aim 2). 30 infants 6-12 months with early ASD symptoms and their caregivers will be recruited nationally, and will complete the telehealth screener quarterly for one year. We will examine the reliability of telehealth-derived measures of infant behavior across consecutive administrations, and compare these measures to existing parent-report measures to assess their validity. Acceptability to parents and feasibility of this telehealth approach to screening will also be evaluated. The overall goal of this project is to develop a protocol for systematically screening, assessing, and monitoring symptomatic infants from a distance. Doing so will increase families' access to specialized evaluations and decrease the significant waiting time between parents' first concerns and infants' first evaluation. It will also lay the groundwork for future efforts to conduct screening and intervention trials and will ultimately help to increase access to high-quality interventions and improve the developmental outcomes of many more underserved children with ASD.