This page is written for referring pediatricians, therapists, school teams, early intervention coordinators, and ABA providers who receive our reports, and for families who want to know exactly how the evaluation is conducted. It names every instrument we use and the published evidence behind the method.
Neither study was conducted at Foyer. They are independent published evidence for the method Foyer follows: a board-certified pediatrician conducting structured, scored observation over telehealth with validated instruments. Foyer follows that same method, with the same instrument families, across all three tracks. The process and the instruments are set out in full below.
A structured caregiver interview covering developmental, medical, and behavioral history, presenting concerns, and the questions the family hopes the evaluation will answer. The interview is organized around the DSM-5 diagnostic criteria for autism spectrum disorder, the standard every diagnosis in the United States is made against. Validated caregiver-report screening is completed before this visit — the M-CHAT-R/F for toddlers, or the age-appropriate AQ-10 for older children — so Dr. Levine arrives with context already in hand.
Outside records are reviewed at this stage: prior evaluations, Early Intervention and school documentation, and therapy notes, when the family provides them.
A play-based observation administered over video in the child's own home and scored live on the age- and language-matched instrument listed below. The caregiver administers the activities under the clinician's direction, which is how these telehealth protocols were designed and validated.
Which instrument is used is not a preference. It is determined by the child's age and expressive language level, recorded at intake.
Results are reviewed with the caregiver in plain language, with the diagnostic conclusion, severity specifiers where applicable, and recommendations for therapy, school, and next steps.
The family receives:
| Child profile | Instrument | Administration |
|---|---|---|
| Under 3 years | TELE-ASD-PEDSVanderbilt TRIAD / VUMC | Seven scored behaviors across a set of caregiver-administered, play-based activities designed and validated specifically for remote delivery. |
| 3 to 5 years, or older with limited or emerging speech | CARS-2 Standard Version (ST)Childhood Autism Rating Scale, 2nd edition | Fifteen rated items, administered through a telehealth-adapted observation protocol and scored against published CARS-2 severity bands. |
| 6 to 17 years with fluent speech | CARS-2 High-Functioning Version (HF)Childhood Autism Rating Scale, 2nd edition | Fifteen rated items calibrated for verbally fluent presentations, administered through a telehealth-adapted protocol. |
Alongside the observation instrument, every evaluation includes a DSM-5 diagnostic criteria interview, documented criterion by criterion in the chart and the final report; autism-specific caregiver screening before the first visit (M-CHAT-R/F for toddlers, AQ-10 for older children), with the Vanderbilt or the SDQ added where co-occurring attention, anxiety, mood, or behavior concerns are suspected; review of outside records when provided; and medical and developmental rule-outs, including hearing and vision history, conducted by a physician.
Not every evaluation produces a clean answer, and a practice that never reports one is not evaluating carefully. When a case does not resolve on the evidence available, Foyer documents an inconclusive finding with an in-person referral rather than forcing a conclusion.
The same applies where a child's presentation calls for assessment this format cannot provide. That result is written up as carefully as a diagnosis, with the reasoning stated, so the next clinician starts from something useful rather than from nothing.
Clinicians and programs can reach us directly. A one-page clinical overview of this process is available for your files.