Shared Decision Making and Treatment Decisions for Young Children With Autism Spectrum Disorder.
OBJECTIVE
To describe influences on shared decision making between primary care pediatricians and parents of young children with autism spectrum disorder (ASD).


METHODS
We conducted a qualitative study using key informant interviews with 20 pediatricians of varying experience from 10 primary care practices and 20 English-speaking parents of young children (aged 2-5 years) with a parent-reported diagnosis of ASD. Subjects were recruited through purposive sampling. Interviews were audiotaped, transcribed verbatim, and analyzed using an integrated approach to data analysis. Differences in coding were resolved by consensus. We achieved thematic saturation and ceased recruitment after 20 interviews were completed within each group.


RESULTS
Three primary themes emerged: 1) pediatricians and parents reported knowledge gaps by pediatricians about ASD treatments and community resources as well as ambiguity regarding the pediatrician's role in ASD care; 2) there was little communication between parents and pediatricians about treatment choices; 3) use of complementary and alternative medical treatments created conflict between pediatricians and parents, and as a result, parents may independently pursue treatments, without the benefit of discussing safety and efficacy with pediatricians. Despite these barriers, parents desired increased support and guidance from their pediatricians, including for complementary and alternative medicine.


CONCLUSIONS
Much work is needed to effectively foster shared decision making in the context of ASD treatment decisions in primary care, including pediatrician training in ASD to enhance knowledge about evidence-based and novel treatments, clinical practice guidelines, and community resources.
['Levy|Susan E|SE|', 'Frasso|Rosemary|R|', 'Colantonio|Stephanie|S|', 'Reed|Hayley|H|', 'Stein|Gail|G|', 'Barg|Frances K|FK|', 'Mandell|David S|DS|', 'Fiks|Alexander G|AG|']
D000328:Adult D000067877:Autism Spectrum Disorder D002648:Child D002675:Child, Preschool D003657:Decision Making D005260:Female D006801:Humans D007223:Infant D008297:Male D008875:Middle Aged D010290:Parents D000072143:Pediatricians D036301:Qualitative Research
shared decision making treatment decisions autism autism spectrum disorder