Service Delivery

Documenting and Understanding Parent's Intervention Choices for Their Child with Autism Spectrum Disorder.

Shepherd et al. (2018) · Journal of autism and developmental disorders 2018
★ The Verdict

Parents mostly skip interventions because of cost and access hurdles, not because they reject them—fix funding and use pediatricians as messengers.

✓ Read this if BCBAs writing treatment plans for families who travel long distances or pay out of pocket.
✗ Skip if Clinicians in fully funded systems where every client already has free transport and coverage.

01Research in Context

01

What this study did

Shepherd et al. (2018) asked 570 New Zealand parents how they pick autism services.

The team used an online survey. They wanted to know why some families use many treatments while others use none.

02

What they found

Money and doctor advice steer choices more than parent age or child traits.

Families who skip services usually face cost or travel hurdles, not disbelief in science.

03

How this fits with other research

Wilson et al. (2021) talked to Australian parents and heard the same story: access beats ideology.

Pickard et al. (2019) then showed co-design and Medicaid funding can cut those same barriers.

Zhu et al. (2026) added a twist: in China, government cash plus caregiver training lifted uptake—same levers, new country.

Together the four studies form a chain: survey finds cost wall, next trials show how to knock it down.

04

Why it matters

You can stop guessing that resistant parents “don’t believe in ABA.” Ask about cost, travel, and work hours first. Bring pediatricians into the chat; their word sways families. When you write treatment plans, pair clinical goals with funding leads and ride-share codes.

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02At a glance

Intervention
not applicable
Design
survey
Sample size
570
Population
autism spectrum disorder
Finding
not reported

03Original abstract

Understanding why parents choose some interventions but not others for their child with autism is important for a number of reasons. Estimating the proportion of evidence-based interventions engaged, identifying the agencies influencing parental decisions, and elucidating the barriers or reasons leading to intervention rejection or discontinuation can result in better service provision. New Zealand parents (n = 570) of a child with autism reported what interventions were being engaged, and why some interventions were engaged but not others. Funding was a major determinant of intervention engagement, while medical professionals exerted the most influence. Sources of support were not related to intervention engagement, but parental perceptions of their child's symptom severity were. Finally, non-engagement does not necessarily reflect parental opposition to an intervention, but rather the existence of barriers.

Journal of autism and developmental disorders, 2018 · doi:10.1007/s10803-017-3395-7