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

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.

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Abbreviations

ASD:

Autism spectrum disorder

ADHD:

Attention deficit hyperactivity disorder

PCP:

Primary care provider

QI:

Quality improvement

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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.

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Authors

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.

Corresponding author

Correspondence to Jeanne Van Cleave.

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The authors have no conflicts of interest to disclose.

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Cite this article

Van Cleave, J., Holifield, C., Neumeyer, A.M. et al. Expanding the Capacity of Primary Care to Treat Co-morbidities in Children with Autism Spectrum Disorder. J Autism Dev Disord 48, 4222–4230 (2018). https://doi.org/10.1007/s10803-018-3630-x

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Keywords

  • Autism spectrum disorders
  • Primary care
  • Healthcare delivery
  • Subspecialty care
  • Quality improvement