Annually, over 11.5 billion dollars are spent on services for individuals with autism spectrum disorder (ASD).
Services for young (aged 3-5) children with ASD are critical as the appropriate mix of services based on
evidence-based treatments leads to improved child outcomes. Multiple service delivery systems offer services
to children with ASD; there is no unified system of care putting the onus on parents to identify and coordinate
services for their offspring with ASD. Parents of young children with ASD struggle to access needed services
due to the differing eligibility criteria and norms of service delivery systems. Service disparities are
compounded among low-resourced families of children with ASD who face greater barriers in accessing
services for their offspring. Family service navigators (FSNs) may support low-resourced families of young
children with ASD to identify, access, and use needed services for their children with ASD. The patient
navigator model has proven effective in other populations. Also, the Train-the-Trainer model (e.g., training
parents of children with ASD to support other parents of children with ASD) has preliminary evidence of
feasibility and effectiveness among low-resourced families of children with ASD. Accordingly, using an
effectiveness-implementation hybrid design (Type 1), this project has three aims: (1) to iteratively create the
Service Navigator for Autism Project (SNAP) and a Technology-Based Treatment Support System (TSS) to
develop FSNs (i.e., low-resourced parents of children with ASD who will support low-resourced parents of
young children with ASD); (2) to test the SNAP and TSS with respect to intervention target and implementation
outcomes; and (3) to determine the impact of FSNs on intervention targets, and implementation, service and
clinical outcomes for young children with ASD from English and Spanish-speaking, low-resourced families. The
SNAP will reflect both a patient navigator model and TTT framework. To do this, an Advisory Board of
professionals, 10 low-resourced parents of children with ASD, and ASD experts will help develop the SNAP
and the TSS. A single-arm survey study will be conducted to determine the effect of the SNAP and TSS on
intervention targets (i.e., knowledge, advocacy, skills, empowerment, ability to facilitate knowledge, self-
efficacy, and capacity) and implementation outcomes (i.e., feasibility, fidelity, acceptability, usability, and
barriers to implementation). For the third aim, a developmental pilot RCT will be conducted to determine the
impact of the FSNs on intervention targets and implementation, service delivery and clinical outcomes of young
children with ASD from low-resourced families. Data generated from this study will help launch a larger, clinical
trial potentially with a effectiveness-implementation hybrid design (Type 2) to determine the effect of FSNs on
intervention targets, and implementation, service delivery and clinical outcomes leading to reduced service
disparities among young children with ASD from low-resourced families. Ultimately, this research will lead to a
cadre of FSNs who will improve access and functioning of young children with ASD from marginalized families.
