In USa the prevalence of children and Youth with Special health Care needs (CYSHCN) aged birth to 21 years is 15.1%  and the prevalence of Autism is 1 in 64 births . In my home state of Maryland there is wide disparity  in access to  to quality specialized medical care for children with Autism  in addition to shortage  of manpower to serve this population as well as a side disparity in access to specialized services secondary to transportationa nd financial issues.telemedicine is currently thought of as a resource that may improve access to speciality medical and mental health services and specialist care by linking remiote areas ofof teh state to tertiary health care centers. In our study Telemedicine wa sused as teh modality to improve access to speciality care for CYSHCN, standardize evaluations and to remove the  disparity  due to poverty and transportation uses