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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Autism spectrum disorder
Attention deficit hyperactivity disorder
Primary care provider
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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.
Conflict of interest
The authors have no conflicts of interest to disclose.
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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
- Autism spectrum disorders
- Primary care
- Healthcare delivery
- Subspecialty care
- Quality improvement