Amy Kelly

Increasingly, practicing behavior analysts play an integral role as interdisciplinary team members to develop instructional programs for students with autism spectrum disorder. However, there is a lack of research on collaborative training and practice as it relates to professionals in the field of ABA. In this study, 302 behavioral professionals, 95% of whom worked with individuals with ASD, were surveyed regarding what training they received in collaboration, the type and extent of collaborative interactions with other professionals, variables they perceive to inhibit and facilitate collaboration, and the extent to which they view collaboration as a valuable component of their practice. Results indicate that while applied behavior analysts frequently collaborate with a variety of professionals and view collaboration as important, on average they received little or no formal training in collaboration, were more likely to provide than to adopt programming recommendations from professionals except for those with similar training, and reported lower ratings with respect to the experience and value of collaboration in their practice. Collectively, results highlight a need to increase collaborative training of practicing behavior analysts, particularly in relation to providing recommendations to and adopting recommendations from non-behavioral professionals, and to conduct research on modes of collaboration that lead to best outcomes.

The COVID-19 pandemic has posed unique challenges for families and caregivers, as well as for autism-focused clinicians, who are faced with providing a thorough and accurate evaluation of children's specific needs and diagnoses in the absence of in-person assessment tools. The shift to telehealth assessments has challenged clinicians to reconsider approaches and assumptions that underlie the diagnostic assessment process, and to adopt new ways of individualizing standard assessments according to family and child needs. Mandates for physical distancing have uncovered deficiencies in diagnostic practices for suspected autism and have illuminated biases that have posed obstacles preventing children and families from receiving the services that they truly need. This Commentary outlines several considerations for improving diagnostic practices as we move forward from the current pandemic and continue to strive to build an adaptable, sustainable, equitable, and family-centered system of care. LAY SUMMARY: Physical distancing and the abrupt end to in-person services for many children on the autism spectrum has forced clinicians to examine the existing challenges with autism spectrum disorder (ASD) diagnostic assessment and consider things they want to keep and things that should be changed in the years ahead. New approaches such as telehealth both alleviated and exacerbated existing disparities, and brought into stark focus the importance of equitable and timely access to family-centered care. This commentary suggests ways of improving clinical practices related to ASD assessment to continue along this path.

The Autism Treatment Network and Autism Intervention Research Network on Physical Health were established in 2008 with goals of improving understanding of the medical aspects of autism spectrum disorders. Over the past decade, the combined network has conducted >2 dozen clinical studies, established clinical pathways for best practice, developed tool kits for professionals and families to support better care, and disseminated these works through numerous presentations at scientific meetings and publications in medical journals. As the joint network enters its second decade continuing this work, it is undergoing a transformation to increase these activities and accelerate their incorporation into clinical care at the primary care and specialty care levels. In this article, we describe the past accomplishments and present activities. We also outline planned undertakings such as the establishment of the Autism Learning Health Network, the increasing role of family members as co-producers of the work of the network, the growth of clinical trials activities with funding from foundations and industry, and expansion of work with primary care practices and autism specialty centers. We also discuss the challenges of supporting network activities and potential solutions to sustain the network.