# Barriers and Innovations Towards Accessing an Autism Diagnosis in Rural Northern Ontario: A Qualitative Study

## TL;DR

This study explores the challenges and solutions for getting autism diagnoses in rural Northern Ontario, focusing on barriers and innovations in the diagnostic process.

## Contribution

The study identifies five key themes affecting autism diagnosis access in rural areas and highlights innovative solutions like community clinics and interprofessional collaboration.

## Key findings

- Gaps in autism knowledge and complex systems delay early identification in rural areas.
- Community clinics and interprofessional collaboration help overcome access barriers for families.
- Culturally responsive care improves understanding and supports appropriate next steps for families.

## Abstract

Early identification and diagnosis of autism are essential steps in supporting children and families. In rural communities, families can experience significant challenges in accessing an autism diagnosis.

We conducted semistructured interviews with four groups of participants: managers (n = 11), diagnosticians (n = 7), clinicians (n = 14) and parents/caregivers (n = 20) across six regions in Northern Ontario to learn of barriers and facilitators in accessing an autism diagnosis. Two independent coders coded each transcript and used inductive thematic analysis to identify themes across participants and regions.

Five themes were generated from participants: (1) Gaps in autism knowledge delay early identification for children requiring an autism assessment; (2) complex systems create navigation barriers for families in knowing where to seek help; (3) families with limited access to resources face delays in the early identification process; (4) staffing challenges exacerbate barriers within the autism diagnostic process; and (5) collaboration among health disciplines while using a culturally responsive approach to care facilitates the autism assessment process.

Hopes about the future of accessing an autism diagnosis were shared by families and professionals; although some challenges are fixed (e.g., vast geography), others are amenable to interventions such as building community knowledge and streamlining service navigation.

Community‐level knowledge of autism can support early identification of children requiring a developmental assessment.Referrals for an autism assessment can be delayed when parent concerns about their child's development are not taken seriously by physicians.Community clinics (i.e., where health care professionals go into rural communities) support families who may not have access to transportation or internet capabilities (e.g., Wi‐Fi access) for virtual options.Interprofessional collaboration and communication among health care professionals of varying disciplines facilitate the autism diagnostic process.Culturally responsive care supports families in understanding their values and beliefs while also facilitating appropriate next steps for the child.

Community‐level knowledge of autism can support early identification of children requiring a developmental assessment.

Referrals for an autism assessment can be delayed when parent concerns about their child's development are not taken seriously by physicians.

Community clinics (i.e., where health care professionals go into rural communities) support families who may not have access to transportation or internet capabilities (e.g., Wi‐Fi access) for virtual options.

Interprofessional collaboration and communication among health care professionals of varying disciplines facilitate the autism diagnostic process.

Culturally responsive care supports families in understanding their values and beliefs while also facilitating appropriate next steps for the child.