Service Delivery

The medical home for children with autism spectrum disorders: parent and pediatrician perspectives.

Carbone et al. (2010) · Journal of autism and developmental disorders 2010
★ The Verdict

Medical homes for kids with autism flop because of delayed detection, split care, and weak provider training, but newer studies prove the model works once you add real coordination.

✓ Read this if BCBAs who help families steer pediatric, mental-health, or transition services.
✗ Skip if Clinicians only doing center-based 1:1 therapy with no care-coordination role.

01Research in Context

01

What this study did

Kaufman et al. (2010) talked to parents and pediatricians about medical homes for kids with autism.

They asked what goes wrong and why care feels broken.

The study used open-ended questions so families and doctors could speak freely.

02

What they found

Both groups say the medical home model is falling short.

Parents feel warnings about development are brushed off and care is scattered.

Doctors admit they lack autism training and get no time or tools to help.

03

How this fits with other research

Later numbers show the idea can work. Schaaf et al. (2015) found kids in a true medical home had one-third fewer unmet specialty needs.

Takahashi et al. (2023) saw an 86% drop in unmet mental-health needs for autistic teens who got care coordination.

A Boyd et al. (2024) complicates the story: having a usual doctor helps spot autism early, but too much office paperwork can slow it down.

The gap is no longer if the model helps, but how to build it right.

04

Why it matters

You can stop blaming the model and start fixing the parts that fail. Ask your families if they have one trusted doctor who tracks everything. If not, help them pick one. Share short autism fact sheets with that office so visits turn into action, not just referrals.

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→ Action — try this Monday

Call the child’s primary office, ask who handles care coordination, and email that person your top three therapy goals plus one tip that calms the child during visits.

02At a glance

Intervention
not applicable
Design
qualitative
Population
autism spectrum disorder
Finding
not reported

03Original abstract

This qualitative study examines differences between perceptions of parents and pediatricians regarding the needs of children with autism spectrum disorders (ASDs) and their families within the medical home. Two separate focus groups of parents of children with ASDs and pediatricians were conducted. Parents and pediatricians identify unmet needs within medical homes of children with ASDs. Parents perceived that physicians did not act early upon their concerns about development, and that care is less comprehensive, coordinated and family-centered than desired. Pediatricians desire to improve services but cite lack of time, training and resources as barriers. Medical homes for children with ASDs would benefit from better pediatrician ASD education and medical systems that support extended visits, care coordination and interdisciplinary collaboration.

Journal of autism and developmental disorders, 2010 · doi:10.1007/s10803-009-0874-5