Usual care for youth with autism spectrum disorder: Community-based providers' reported familiarity with treatment practices.
Medical and mental-health providers still feel lost around ABA, so brief, low-dose training can close the gap.
01Research in Context
What this study did
Lerner et al. (2022) asked 701 U.S. community providers how well they knew common autism treatments.
The team sent an online survey to medical, mental-health, and education professionals who work with youth aged 11-25.
They grouped answers into three familiarity clusters to see which disciplines knew which practices.
What they found
Medical doctors and mental-health clinicians rated their ABA know-how lowest.
Education and behavioral staff felt most familiar with behavior plans and antecedent tricks.
Providers who served richer families or had more years on the job knew more strategies.
How this fits with other research
Drahota et al. (2023) used the same 701 people one year later. Instead of "Do you know it?" they asked "Do you use it?" and found antecedent tools were the most-used move.
van Timmeren et al. (2016) saw almost half of preschoolers with autism got zero behavior therapy back in 2003-04. Lerner’s 2022 data show the knowledge gap still lives—now inside the provider, not just the system.
Hustyi et al. (2025) found BCBAs themselves can’t agree on how many hours to recommend. Together these papers paint one picture: even when experts are available, decisions stay messy.
Why it matters
If you supervise across disciplines, target medical and mental-health staff first for quick lunch-and-learns. Share one-page cheat sheets on antecedent strategies—they already want to use them but lack the how-to.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Email one antecedent-strategy handout to your local pediatric clinic and offer a 15-minute virtual walk-through.
02At a glance
03Original abstract
To examine patterns and predictors of familiarity with transdisciplinary psychosocial (e.g., non-pharmacologic) practices for practitioners treating youths with autism spectrum disorder (ASD) in the United States. Practitioners (n = 701) from behavioral, education, medical, and mental health backgrounds who worked with youth (ages 7–22) with ASD completed the Usual Care for Autism Survey, which assessed provider demographics and self-reported familiarity with transdisciplinary treatment practices for the most common referral problems of ASD. We examined relations between provider-, setting-, and client-level characteristics with familiarity of key groups of the treatment practices (practice sets). Practice sets were identified using exploratory factor analysis (EFA), and demographic predictors of practice subsets were examined using generalized estimating equations (GEE). The EFA yielded a three-factor solution: (1) environmental modifications/antecedent strategies; (2) behavior analytic strategies; and (3) cognitive strategies, with overall familiarity ranked in this order. Medical providers indicated the least familiarity across disciplines. More experience with ASD and treating those with intellectual disabilities predicted greater familiarity with only environmental modifications/antecedent strategies and behavior analytic, but not cognitive strategies. Experience treating low SES clients predicted familiarity with environmental modification and behavior analytic strategies while experience treating high SES clients predicted familiarity with behavior analytic and cognitive strategies. This is the first study to identify transdisciplinary, interpretable sets of practices for treating youth with ASD based on community providers’ reported familiarity. Results highlight factors associated with familiarity with practice sets, which is essential for mapping practice availability, and optimizing training and dissemination efforts for youth with ASD.
Frontiers in Psychiatry, 2022 · doi:10.3389/fpsyt.2022.923025