From Research Settings to Parents: The Referral Sources of Evidence-Based and Non Evidence-Based Practices

Background: Literature in the ASD field has repeatedly highlighted the need for a more effective framework of disseminating evidence-based practices into community settings. Despite a significant amount of research that has documented the types of services that are being used by parents of children with ASD, research has yet to determine who recommends parents to specific intervention practices and, more generally, how intervention-related knowledge spreads to parents. As a result, the current study seeks to clarify the process by which interventions are disseminated to parents. Research has noted that health recommendations can come from both formal (i.e. individuals who are paid for the services they provide) and informal (i.e. unpaid individuals such as family and friends) individuals. As in other health fields, parents of children with ASD make critical decisions about services and treatments for their child based off of advice that they seek out from other individuals.

Objectives: The current study sought to examine 1.) the types of services primary caregivers are accessing for their child with ASD, and 2.) the specific professionals and individuals who are the referral sources of evidence-based and non evidence-based practices.

Methods: 244 primary caregivers of a child with an ASD diagnosis between the ages of 2 and 17 (M=6.17 years) completed an online survey that assessed the following: basic demographic information, ASD symptom severity, social network size, social network makeup, social network density, autism services accessed, parenting stress level, and social support.  Service recommendations were broken down in order to analyze which specific professions and individuals were making recommendations to both evidence-based and non evidence-based practices.   

Results: Primary caregiver service is depicted in Figure 1. 94.67 % of primary caregivers were accessing at least one evidence-based practice for their child and 58.20% were accessing at least one non-evidence-based practice for their child. A Pearson’s chi-square was run in order to determine whether social network formality (i.e. formal or informal individuals) significantly predicted whether a recommendation was made to an EBP (i.e EBP or non-EBP). The chi-square was significant [X²(6)=253.96, p<0.001], indicating that formal social network ties were significantly more likely to make recommendations to an EBP. Moreover, an odds ratio indicated that formal recommendations were 10.17 times more likely to make a recommendation to an EBP. Specific recommendations within each profession are provided in Figure 2. 

Conclusions: Research within the ASD field has already documented the importance of individual recommendations in the choices that parents make about service use for their child with ASD. The present study clarifies the nature of these recommendations. Given the significant research to practice gap within the ASD field, the current study provides important implications for the ways in which we disseminate EBPs to parents.