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Abstract: This study compared service use for families of children with autism spectrum disorder (ASD) who live in rural vs. non-rural areas. Participants were 415 caregivers of children with ASD, of whom 101 (23.7%) lived in rural areas of a southeastern state. Participants completed an online survey regarding access and quality of different services. For rural families, the most common services that were recommended but not implemented included behavior support services and parent support groups. Rural families also had to travel longer distances and for more time to access these services. For behavior support services, rural (vs. non-rural) families had lower perceptions of effectiveness. In addition, a map showing locations of all of the state's Board Certified Behavior Analysts (BCBA) and Speech Language Pathologists (SLP) revealed that, compared to SLPs, BCBAs were present in a lower percentage of rural counties. Implications for practice and future research are discussed.
Across the United States, the number of children diagnosed with autism spectrum disorder (ASD) has risen drastically. Currently, one in 68 children have been identified with ASD (CDC, 2014). Due to the increasing prevalence of ASD, families and service providers require reliable information regarding relevant services. We know that children with ASD utilize a combination of services, averaging three or more (CDC, 2012; Ruble & McGrew, 2007; Thomas, Morrissey, & McLaurin, 2007). Even though children with ASD require many services, families often encounter difficulty accessing and implementing recommended services. Warren, Vehorn, Dohrmann, Newsom, and Taylor (2013) found that only a minority of families reported successful implementation of different services such as applied behavior analysis (ABA) services, sleep evaluations, and genetic testing.
Although many parents of children with ASD find it difficult to access quality services, greater challenges may be experienced by families in rural areas. In general, rural parents reported decreased access to services, and the services themselves were considered to be less effective (Chen, Liu, Su, Huang, & Lin, 2007; Mandell, Novak, & Zubritsky, 2005). Other studies found that rural families have less access to specialized personnel and services, such as mental health services (Hendryx, 2008; Knapcyzk, Chapman, Rodes, & Chung, 2001; Murphy & Ruble, 2012). In addition, some services may seem more difficult to access than others. In fact, parents of children with ASD...