(PS2-48) Barriers in Access to Autism Diagnostic Evaluations from ASD Provider Perspectives

Background: Long wait times for autism diagnostic services are a challenge for everyone, but they disproportionately affect marginalized communities who face additional barriers to timely evaluation, early intervention, and essential support. While many autism specialty clinics implement strategies to reduce these barriers to care, they vary significantly across sites and few analyze and disseminate the impact of these efforts.  

Objectives 

1. Examine populations targeted and strategies used by autism specialty clinics to enhance diagnostic equity. 


2. Qualitatively explore perceived helpfulness and barriers associated with the strategies. 

Methods: Surveys were distributed to ASD providers across the United States via REDCap. Inductive content analysis using a grounded theory approach was used. Qualitative coding and analyses were completed by two coders and responses were triangulated with quantitative findings. 

Results: Many clinics (n=76) reported implementing at least one strategy to reduce diagnostic barriers. Clinics reported seeing families with Medicaid (69.7%), targeting low-income populations (36.8%), targeting racial and ethnic minority populations (31.6%), targeting low education populations (27.6%), and targeting LGBTQ+ individuals (10.5%). Only 27.6% of clinics reported keeping or analyzing patient demographic data to examine equity issues. Themes about reducing or removing the requirement for intake paperwork and offering interpretation services or clinical services in another language emerged as strategies used to address barriers. Providers considered wait times, assessments being too short or too lengthy, and difficulty navigating recommendations as getting in the way of a family’s having a positive experience.   

Conclusion: While many autism clinics implement strategies to improve diagnostic equity, few analyze demographic data to assess impact. Common efforts include serving Medicaid recipients and marginalized populations, with key barriers being wait times and complex post-diagnosis navigation. Findings highlight the need for systematic data tracking and targeted interventions to enhance equitable access.