Assessing Community Needs for Autism Spectrum Disorder: A Review of Rural/Frontier Needs Through Community Outreach With Developmental Pediatrics.

Early intervention is known to improve long-term outcomes for individuals with autism spectrum disorder (ASD). Access barriers to care limit timely engagement with supportive services. This report characterized the community needs and supportive services for children and families with suspected or diagnosed ASD. Families and providers participating in outreach clinics identified available services and their attitudes about support for ASD diagnosis. Chart reviews provided referral history, insurance, and current services. Children were nearly 6 years old, 95% of families relied on public health insurance, whereas 50% reported traveling 11 miles or greater for supportive services. Most providers (83%) were medically trained in primary care and placed 1-5 referrals per month to a tertiary referral hospital. Providers reported travel difficulty as the primary reason for referring patients for evaluation. Multiple barriers for supportive services were identified, highlighting the importance to increase the capacity and availability of local ASD supportive services.

Mothers' Perspectives on Follow-up for Postpartum Depression Screening in Primary Care.

OBJECTIVE: To qualitatively assess mothers' perspectives on barriers to and facilitators of follow-up of at-risk postpartum depression (PPD) screening test results. METHODS: We conducted semistructured qualitative telephone interviews with 17 women who scored in the moderate or high-risk range on the Edinburgh Postpartum Depression Scale. Interviews explored personal experience with depressive symptoms, barriers and facilitators to receiving mental health care postpartum, and suggestions for primary care follow-up of at-risk screens. The team created a coding structure that was updated during review of transcripts. Findings were triangulated and external validity assessed via discussions with a mother who experienced PPD, a perinatal social worker, and a perinatal psychologist. RESULTS: Personal health/attitude, family/friends, community, and health care system factors influenced mothers' follow-up of at-risk PPD screening test results. Health and personal attitude factors included anxiety, physical and emotional exhaustion, self-care and recognition of symptoms, and living up to personal and family expectations. Family/friend factors included material and emotional support and competing priorities. Community factors included child care affordability and availability, access to transportation, geographic access to resources, social networks, and community mental health stigma. Health care factors included pediatrician taking the mother's symptoms seriously, adequate time with the pediatrician, mother and pediatrician focus on the child's health, and access to mental health referrals. CONCLUSION: Addressing barriers to follow-up after PPD screening may enable better service access for at-risk families.

Parent Perceptions of Community Autism Spectrum Disorder Stigma: Measure Validation and Associations in a Multi-site Sample.

In this study we developed a brief, English/Spanish bilingual parent-reported scale of perceived community autism spectrum disorder (ASD) stigma and tested it in a multi-site sample of Latino and non-Latino white parents of children with ASD. Confirmatory factor analysis of the scale supported a single factor solution with 8 items showing good internal consistency. Regression modeling suggested that stigma score was associated with unmet ASD care needs but not therapy hours or therapy types. Child public insurance, parent nativity, number of children with ASD in the household, parent-reported ASD severity, and family structure, were associated with higher stigma score. The scale and the scale's associations with service use may be useful to those attempting to measure or reduce ASD stigma.