“We’re underserved, but we do the best we can”: Accessing Behavioral Health Services for Autistic Children in Rural Appalachia

Autistic children and their families, especially those with co-occurring externalizing behavior, benefit from specialized behavioral healthcare services such as behavioral parent training (BPT). While past research has examined common barriers to families accessing care in a broad sense, relatively little is known about the unique experiences of families in the Appalachian region.

The present study employed qualitative methods to explore the experiences of seven parents and three community providers interested in telehealth-delivered BPT for their autistic children/clients. Interviews inquired about participants’ experiences with autism and accessing care in rural Appalachia.

We found caregiver and provider perspectives aligned and centered around the multifaceted unmet needs of these families; barriers to accessing services in this region; factors that enable greater access, including telehealth; and the unique role that Appalachian culture plays in the provision of services. Preliminary recommendations for addressing the needs of autistic children and their families in rural Appalachia and directions for future research are discussed.