Access to Care After Autism Diagnosis During the COVID-19 Pandemic: A Quality Improvement Project.

This study looked at how COVID-19 affected access to autism services for 62 children diagnosed in early 2020. Only 1 in 5 families got all the services they needed, while half got some services. Many families lost contact with their doctors and had changes to their school support. When researchers called families and provided help, some were able to access new services or reconnect with their care team.

This quality improvement study examined barriers to autism services during COVID-19 by following 62 children diagnosed with ASD between March-June 2020 at an urban safety net hospital. Initial findings showed only 19% accessed all recommended services, while 52% accessed some services and 15% accessed none. Nearly half (48%) experienced changes to their educational programs, and 26% lacked follow-up with their developmental pediatrician. A brief intervention approach helped 13 patients access new services and reconnected 9 patients who were lost to follow-up.

The study highlights significant service disruptions during the pandemic and challenges with telemedicine transitions in maintaining patient contact.

Healthcare systems should develop proactive outreach strategies for newly diagnosed autism patients during service disruptions. Telemedicine transitions require enhanced patient contact protocols. Quality improvement approaches with brief interventions may help reconnect families with services during crisis periods.

Single-site study at urban safety net hospital limits generalizability. Quality improvement design without control group. Small sample size and unclear methodology for service access determination. Follow-up period was brief and service access definitions not clearly specified.

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. 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. 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. 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.