Golden insights : autism evaluation practices in school, clinical, and rural settings.

Evidence-based assessment practices, including the use of psychometrically supported instruments, are crucial to accurate and timely diagnoses of autism. Despite the importance of adhering to evidence-based practices, there is currently limited research regarding the potential differences related to autism assessment practices across service settings. This two-part dissertation examined key factors that may differ across settings (i.e., school, clinical, and rural) in which autism evaluations are conducted. Part 1 used a quantitative approach (i.e., Mann-Whitney U test, latent profile analysis [LPA], chi-square analysis) to explore factors, such as instrument and procedure use, clinician characteristics, and barriers to the utilization of evidence-based practices. Results revealed significant differences in school and non-school (i.e., clinical) providers’ assessment practices and perceived barriers to using gold-standard autism instruments (i.e., Autism Diagnostic Observation Schedule, Second Edition [ADOS-2]; Lord et al., 2012a; Autism Diagnostic Interview-Revised [ADI-R]; Rutter et al., 2003a). Additionally, the LPA found that a five-profile solution was the best fit. Profiles differentiated according to practitioners’ ADOS-2 and ADI-R frequency use, training composite scores, and years of experience, as well as profile membership, were significantly associated with practitioners’ workplace setting. Part 2 utilized a convergent parallel mixed-methods design, incorporating survey responses and interviews of rural practitioners. Descriptive statistics and inductive thematic analysis were used to examine rural practitioners’ evaluation practices; factors influencing practitioners’ use of the ADOS-2 and ADI-R; practitioners’ identified training and support needs; and the cultural context of rural communities. Survey data revealed key insights into the context of autism evaluation practices in rural settings. Five themes emerged from inductive thematic analysis that expanded upon the survey results. Taken together, the findings from these studies extend previous literature by demonstrating differences in instrument and procedure usage across service settings in the context of autism evaluations, and addressing why differences may exist (i.e., system-level factors and perceived limitations of assessment instruments). Additionally, these findings have important practice implications for psychology trainers in equipping evaluators in evidence-based practices in autism evaluations across settings.

Name thesis:degree_name

Ph.D.

Level thesis:degree_level

Doctoral

Grantor

Baylor University.

Year dc:date.issued

2026

Author dc:creator

• Mitchell, Scarlett M., 1999-

Advisor dc:contributor.advisor

• Mire, Sarah S.

• Autism spectrum disorder (ASD)
• Assessment.

Language dc:language.iso

en

Handle dc:identifier.uri

https://hdl.handle.net/2104/15033

OAI identifier oai:identifier

oai:baylor-ir.tdl.org:2104/15033