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Journal of Autism and Developmental Disorders

, Volume 48, Issue 12, pp 4222–4230 | Cite as

Expanding the Capacity of Primary Care to Treat Co-morbidities in Children with Autism Spectrum Disorder

  • Jeanne Van CleaveEmail author
  • Chloe Holifield
  • Ann M. Neumeyer
  • James M. Perrin
  • Erin Powers
  • Linda Van
  • Karen A. Kuhlthau
Original Paper

Abstract

We examined barriers and facilitators to expanding primary care’s capacity to manage conditions associated with autism spectrum disorder (ASD). We conducted semi-structured interviews with specialists, primary care providers (PCPs), primary care staff, and parents of children with ASD, discussing health/behavior problems encountered, co-management, and patient/family experience. Participants endorsed primary care as the right place for ASD-associated conditions. Specialists advising PCPs, in lieu of referrals, efficiently uses their expertise. PCPs’ ability to manage ASD-associated conditions hinged on how behavioral aspects of ASD affected care delivery. Practices lacked ASD-specific policies but made individual-level accommodations and broader improvements benefitting children with ASD. Enhancing access to specialty expertise, particularly around ASD-associated behaviors, and building on current quality improvements appear important to expanding primary care.

Keywords

Autism spectrum disorders Primary care Healthcare delivery Subspecialty care Quality improvement 

Abbreviations

ASD

Autism spectrum disorder

ADHD

Attention deficit hyperactivity disorder

PCP

Primary care provider

QI

Quality improvement

Notes

Author Contributions

JV conceived of the study, participated in its design, data collection, data analysis and interpretation and drafted the manuscript; CH participated in the coordination of data collection, and analysis and interpretation of the data; AMN participated in the design and informed the data collection and interpretation of the study; JMP conceived of the study, and participated in the design, data analysis and writing the manuscript; EP participated in the data analysis and interpretation of the study; LV participated in the data analysis and interpretation of the study; KAK participated in the design, data collection, interpretation and writing of the manuscript. All authors read and approved the final manuscript.

Funding

This study was funded through the Autism Intervention Research Network on Physical Health (AIR-P), which is supported by Health Resources and Services Administration (HRSA) cooperative agreement UA3 MC 11054.

Compliance with Ethical Standards

Conflict of interest

The authors have no conflicts of interest to disclose.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS)University of ColoradoAuroraUSA
  2. 2.Department of PediatricsDavid Geffen School of Medicine at UCLALos AngelesUSA
  3. 3.Lurie Center for AutismMassGeneral Hospital for ChildrenLexingtonUSA
  4. 4.Department of NeurologyHarvard Medical SchoolBostonUSA
  5. 5.Department of PediatricsHarvard Medical SchoolBostonUSA
  6. 6.Division of General Academic PediatricsMassGeneral Hospital for ChildrenBostonUSA
  7. 7.University of California, Irvine School of MedicineIrvineUSA
  8. 8.Touro College of Osteopathic MedicineNew YorkUSA
  9. 9.Adult and Child Consortium for Health Outcomes Research and Delivery ScienceUniversity of Colorado and Children’s Hospital ColoradoAuroraUSA

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