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Access to Care After Autism Diagnosis During the COVID-19 Pandemic: A Quality Improvement Project
Jessica Landau-Taylor1, Christine McGivney2, Audrey Christiansen2
1Boston University School of Medicine, Boston, MA; and.
Insights
Children with autism spectrum disorder (ASD) faced significant barriers to accessing essential community services during the COVID-19 pandemic. Brief interventions helped some families reconnect with care and access new services.
Area of Science:
- Pediatric healthcare
- Autism Spectrum Disorder (ASD) research
- Public health during pandemics
Background:
- The COVID-19 pandemic created unprecedented challenges in healthcare delivery.
- Children with Autism Spectrum Disorder (ASD) often require consistent, specialized services.
- Access to care for vulnerable populations, including those with ASD, was severely impacted during the pandemic.
Purpose of the Study:
- To identify barriers to accessing services for children with ASD during the COVID-19 pandemic.
- To evaluate the effectiveness of brief interventions in improving service access.
- To understand the impact of the pandemic on individualized educational programs and applied behavior analysis.
Main Methods:
- Retrospective chart review of 62 children diagnosed with ASD.
- Patient outreach via phone calls to assess service access.
- Implementation of a modified Plan-Do-Study-Act approach with brief interventions.
- Follow-up chart review to determine service utilization post-intervention.
Main Results:
- Only 19% of children could access all recommended services at initial evaluation.
- Significant disruptions were noted in individualized educational programs and early intervention services (48%).
- Brief interventions facilitated access to new services for 13 patients and re-engagement for 9 lost to follow-up.
Conclusions:
- Children with ASD diagnosed in spring 2020 experienced substantial difficulties accessing community services.
- Telemedicine transition and communication challenges hindered follow-up care.
- Further research is crucial to address service accessibility and equity for ASD patients.
Objective:
The aim of this study was to identify barriers and improve access to services for children diagnosed with autism spectrum disorder (ASD) during the COVID-19 pandemic.
Methods:
Sixty-two patients diagnosed with ASD between March 23 and June 30, 2020, at a large urban safety net hospital were identified by chart review. Patients were called from January to March 2021 and queried regarding access to services. Brief interventions were provided as part of a modified Plan-Do-Study-Act approach. A second chart review was conducted between April and May 2021 to determine whether families accessed any additional services.
Results:
At the time of initial evaluation, 12 patients (19%) had been able to access all recommended services, 32 (52%) had been able to access some recommended services, and 9 (15%) were not able to access any services. Service levels for 9 families (15%) were undetermined. Sixteen patients (26%) lacked any follow-up with their developmental behavioral pediatrician since their initial evaluation. Thirty patients (48%) reported changes to their individualized educational program or early intervention services, and 17 patients (27%) were receiving in-home applied behavior analysis. After the brief intervention, 13 patients had accessed new services, and 9 patients previously lost to follow-up had completed an appointment.
Conclusion:
Patients diagnosed with ASD in the spring of 2020 had significant difficulty accessing community services. The transition to telemedicine exacerbated this hospital's difficulty contacting patients for follow-up. Additional research is needed to fully characterize the disruptions to services experienced by patients diagnosed with ASD during the pandemic and to increase accessibility and equity of care.
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