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

J Autism Dev Disord. 2018 Dec;48(12):4222-4230. doi: 10.1007/s10803-018-3630-x.


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; Healthcare delivery; Primary care; Quality improvement; Subspecialty care.

MeSH terms

  • Attention Deficit Disorder with Hyperactivity / complications
  • Attention Deficit Disorder with Hyperactivity / therapy*
  • Autism Spectrum Disorder / complications
  • Autism Spectrum Disorder / therapy*
  • Child
  • Delivery of Health Care
  • Female
  • Health Personnel
  • Humans
  • Male
  • Parents
  • Primary Health Care*
  • Qualitative Research
  • Quality Improvement
  • Specialization