Providing Accessible Diagnostic Evaluations and Psychoeducation for Autism Spectrum Disorder in Rural Southwest Virginia

Early detection and intervention are crucial for optimal outcomes in autism spectrum disorder (ASD), but access to services is often lacking in rural communities. In fact, the average age of ASD diagnosis in rural communities is later than elsewhere, increasing the risk of missed early intervention and subsequently poorer outcomes. Caregivers in Southwest Virginia report that major barriers to ASD services include few providers with expertise in ASD, unaffordability of services, and geographic isolation; limited parent training or education about ASD emerges as a particular paucity in this region. To address these barriers, the current pilot study assessed the feasibility of delivering ASD assessment through a mobile clinic (n = 15). During COVID-19, the study shifted to pilot an ASD teleassessment protocol (n = 15). Participants included 30 children between 1.7 and 14.9 years of age and one or both caregivers. Following a diagnostic feedback session, caregivers of children who received an ASD diagnosis (n = 28) were randomized to either attend psychoeducation sessions or receive comparable materials about ASD, with the goal of improving caregiver ASD knowledge and empowerment to seek and provide care for their child. Although flexibility in scheduling was necessary to accommodate families’ schedules, both delivery formats exhibited high feasibility and strong caregiver satisfaction. The primary reason for rescheduling mobile assessments was weather-related, whereas teleassessments were rescheduled due to family emergencies and work-related conflicts. Caregiver empowerment in the domains of family and the community improved after receiving assessment and psychoeducation services, as did total ASD knowledge (η2 = .114–.235, p < .05).