**4. Conclusions**

Our telemedicine working models represent a union between synchronous transmission (i.e., live video conferencing as two-way video and audio interactions between the therapists and parents/child for interviews and other behavioral observation of the child) and asynchronous transmission (i.e., "store and forward" transmissions of recorded video, data, and questionnaires/checklists) [45].

Telemedicine should not totally take the place of in-person clinical services; however, in this moment, it could be required to provide answers to families who are concerned about the health of their children with ASD. The described working model for diagnosis has the purpose of carrying out a preliminary assessment which does not have the purpose of replacing preferable in-person assessment. The described working model for diagnosis may not be suitable for all families, and in some cases, it could be even contraindicated (i.e., low confidence with technology). For some of them, it is difficult to perform a remote evaluation. Therefore, in some cases, the in-person evaluation cannot be replaced even partially by the remote one. However, for other children, this working model for diagnosis can provide useful indications and suggest the start of an individualized intervention. It is our decision that all the children who carry out the remote evaluation with telemedicine have an in-person appointment when phase 3 of the lockdown begins, in order to conclude the evaluation and to check the effect of the suggested psychoeducational intervention. The presented working model represents a scheme which obviously can be flexible; therefore, it is possible, in some cases, to increase the number of expected days to complete the evaluation. The presented working model for diagnosis could permit clinicians to look at otherwise inaccessible children's behaviors in their natural setting, and to observe parent–child reciprocity [7]. The proposed working model for diagnosis makes it possible for parents to register videos in their home, during their daily activities, which permits the capture of natural expressions of child behavior that are broadly recognized as essential to a precise and comprehensive assessment [6]. The background of the presented working model for diagnosis is based on previous studies that showed that a telemedicine procedure could be adequate for acquiring children's diagnostic profiles in

a way that parents report as easy and acceptable [4]. Currently, the clinical judgment of the professional must establish the adequacy of telemedicine on a case-by-case basis.

The described working model for intervention with ASD children is not exhaustive and it needs to be tried out; however, it is supported from preliminary research findings in this field [14,46]. The telemedicine approach is accepted by parents [13], increases their sense of competence [47], increases the parent intervention accuracy, and improves the socio-communicative competencies of children with ASD [41,48].

Because of distancing and lockdowns, a functional use of telemedicine is pivotal. Clinical services are moving to digitalization and remote approaches to respond current patients' needs [49,50]. During COVID-19 phase 2 and later, telemedicine and in-person diagnosis and intervention must alternate.

In the future, even when the COVID-19 alert expires, telemedicine can play an essential role in speeding up the autism diagnosis process. Because of the high number of evaluation requests for ASD, there are very long waiting lists. The systematic increase in telemedicine, together with traditional assessment in-person procedures will significantly decrease the needed times for a diagnostic indication. Early diagnosis is crucial to help a child with ASD, since early identification can significantly improve the child's developmental trajectory. Moreover, research has shown that young children who receive the early intervention can have higher chances of demonstrating significant gains in functioning than children diagnosed later.

In conclusion, the presented working models for preliminary diagnosis and intervention must be considered as both a partial response to the current emergency status and, at the same time, as a possible integration into traditional approaches.

**Author Contributions:** Conceptualization, methodology and writing draft, A.N. The author has read and agreed to the published version of the manuscript.

**Funding:** This research received no funds.

**Acknowledgments:** I would like to thank the parents and children I meet every day in my work.

**Conflicts of Interest:** No conflict of interest is reported.
