Title : Frequent interaction of primary care providers with autistic people as a predictor of primary care quality
Abstract:
Autistic individuals experience poorer healthcare quality than non-autistic adults despite having an increased susceptibility to chronic health conditions. Previous research suggests that providers familiarity with autism may improve healthcare interactions, yet it remains unclear whether greater exposure to autistic individuals translates into greater knowledge of best practices in primary care.
This study examined whether the frequency of primary care providers' interactions with autistic people predicts knowledge of evidence-based practices for caring for autistic patients. Sixty-four primary care providers from five healthcare practice sites in the greater Boston area completed a survey assessing their experience with autistic patients and knowledge of best practices. Knowledge was evaluated using four statements adapted from the Western Region ASERT Autism Spectrum Disorder Survey addressing communication strategies, use of restraint, beliefs regarding autism as a condition to be cured, and management of crisis situations. Participants responded on a 5-point Likert scale ranging from strongly disagree to strongly agree. Frequency of interaction with autistic people was measured on a 5-point scale from never to daily. Simple linear regression analyses were conducted to determine whether interaction frequency predicted responses to each best-practice item.
Frequency of interaction with autistic people was not a significant predictor of knowledge of best practices for any of the four survey items. However, responses to three best-practice questions were significantly skewed toward the correct answer, suggesting broad agreement with several evidence-based recommendations. Additionally, responses to the statements "Autism can and/or should be cured" and "Using a hands-on approach (grabbing or restraining) a person with autism during a crisis situation may create fear, anxiety, and resistance" were significantly negatively correlated (r = −0.297, p < .05).
These findings indicate that greater interaction with autistic individuals alone does not predict primary care providers' knowledge of best practices, suggesting that familiarity through clinical exposure may be insufficient to improve autism-related knowledge. The absence of significant relationships may reflect persistent uncertainty regarding the care of autistic patients regardless of providers' prior experience. Although providers generally demonstrated accurate responses on several best-practice items, the findings highlight the need for standardized autism-specific education in primary care to improve provider preparedness and ultimately reduce disparities in healthcare quality experienced by autistic individuals.
