Chapter Six - A Public Health Approach to Family Supports: Empowering Families of Children with Autism Through the ECHO Model

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Children with autism spectrum disorder (ASD) often receive many direct services designed to improve their clinical outcomes. Indeed, direct service provision is critical to helping those with ASD reach their fullest potential. However, this approach often ignores the contextual factors that are likely to impact the effectiveness of those interventions. Given that a majority of the US health care system is not designed to support families, we argue (1) for taking a public health approach to supporting families and (2) that this will ultimately improve child outcomes. We use the Bioecological Theory of Human Development (Bronfenbrenner & Morris, 1998) as a model of how families, who are often responsible for coordinating care, providing in-home and long-term supports, and coordinating the services a child receives, should receive additional support. We use family well-being to frame the public health problem and review several family support programs. In particular, we use an innovative program, ECHO for Families, as an example of how families can be empowered to support their children, and how this improves family well-being. Additionally, we describe the importance of scaling up family support programs and how the ECHO for Families has been able to meet the unique needs of a vast frontier state with limited resources. Finally, we argue that conceptualizing family supports as a matter of public health may lead to novel funding mechanisms that could improve well-being of the whole family, as well as improve outcomes for children with ASD.