A Multisite, Multidisciplinary Delphi Consensus Study Describing “Usual Care” Intervention Strategies for School-Age to Transition-Age Youth With Autism
Open accessAbstract
Understanding usual care is important to reduce health disparities and improve the dissemination of evidence-based practices for youth (ages 7-22 years) with autism spectrum disorder (ASD). A barrier to describing "usual ASD care" is the lack of a common vocabulary and inventory of the practices used by a diverse provider field. To address this barrier, we gathered input from expert providers to develop an inventory of usual care practices and assess expert familiarity and perceptions of these practices as interventions for anxiety, externalizing, and social difficulties in ASD. Purposeful sampling recruited 66 expert ASD providers representing multiple disciplines from 5 sites. Via a 2-round Delphi poll, experts reviewed, suggested revisions to and rated 49 literature-derived practices on several dimensions (familiarity, usefulness, common use, research support). A revised list of 55 practices and anonymous summary of group characteristics and ratings was then returned for further review. Results yielded 55 intervention practices, 48 of which were identified as "familiar" approaches by consensus (≥ 75% endorsement). Greater variation was observed in practices identified by consensus as most often used, useful, and research supported, depending upon the target problem. Findings provide an inventory of practices, reflective of the multidisciplinary language and approaches of expert ASD providers. This inventory may be used to better assess what constitutes usual care for youth with ASD in the United States. Moreover, findings offer insights from clinical experts regarding the range and acceptability of practices that may inform and ground treatment research, dissemination, and implementation efforts.
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Providers who deliver ASD-EBPs to individuals with ASD also commonly use preference-based practices with unestablished or undetermined evidence for use.
“Additionally, self-report and observational data demonstrate that providers who deliver ASD-EBPs to individuals with ASD also commonly use preference-based practices with unestablished or undetermined evidence for use (Brookman-Frazee et al., 2010; Pickard et al., 2018; Kerns et al., 2019).”
From Implementation-as-Usual in Community-Based Organizations Providing Specialized Services to Individuals with Autism Spectrum Disorder: A Mixed Methods Study (2021) · cites this paper as Kerns et al., 2019
The Discussion (page unavailable) reports that experts viewed some ASD evidence-based practices as commonly used and describes a practice not yet empirically examined despite widespread use. But the study used expert Delphi ratings, not observational data, and its Limitations section says it was not designed to provide a representative picture of community practice. It therefore does not establish that providers delivering EBPs also commonly use the less-supported practices. (LLM, conf=0.85)
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- Authors
- Kerns, C. M., Moskowitz, L. J., Rosen, T., Drahota, A., Wainer, A., Josephson, A. R., Soorya, L., Cohn, E., Chacko, A., & Lerner, M. D.
- Affiliations
- Drexel University (US)
- St. John's University (US)
- Stony Brook University (US)
- Michigan State University (US)
- Rush University Medical Center (US)
- Adelphi University (US)
- New York University (US)
- Corresponding author
- Kerns, Connor M.
- ORCID
- Venue
- Journal of Clinical Child & Adolescent Psychology
- Publisher
- Informa UK Limited
- Published
- 2018-01-31
- Volume
- 48
- Issue
- sup1
- Pages
- S247-S268
- ISSN
- 1537-4416 (ISSN-L)
- 1537-4424
- PMC
- PMC6067994
- OpenAlex
- W2793906341
- Cited by
- 18
- References
- 53
- Citations by year
- 2025: 2 · 2024: 1 · 2023: 3 · 2022: 4 · 2021: 3 · 2020: 3 · 2019: 2
- FWCI
- 1.19
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Clinical Child & Adolescent Psychology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (K23HD087472)
- National Institute of Mental Health (K01MH093477, R01MH110585)
- Simons Foundation (SFARI# 381283;)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Keywords
- autism spectrum disorder, usual care, intervention strategies, expert consensus, anxiety, externalizing problems, social difficulties, evidence-based practice dissemination, health disparities
- MeSH terms
- Autism Spectrum Disorder, Adolescent, Adult, Child, Delphi Technique, Female, Humans, Male, Schools, Consensus, Young Adult
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