Barriers to High-quality Therapy Services for Children with Autism Spectrum Disorder: An Analysis of Street-level Policy Practice of Therapy Service Organisations in China

Abstract

Social workers with children with autism spectrum disorder (ASD) should assist them to have timely access to high-quality therapy services. This research addresses the gap between policy intention to improve the quality of therapy services and families’ unmet needs by examining the policy implementation practices of therapy service organisations. A longitudinal study was conducted in Beijing from 2013 to 2022. Qualitative data were obtained from policy documents and interviews with the managers of therapy service organisations (n = 17), therapists (n = 19) and families of children with ASD (n = 35). It found that the government policies created service challenges for the organisations. Managers adopted a short-term focus on organisational survival due to inadequate resources to implement the policy, intensified competition for therapists and service users and pressure from performance measurement. They focused on improving the sites, facilities, publicity and documentation of the organisations rather than the effectiveness of therapy services. Consequently, families still felt they were unable to access good quality therapy. The implications reinforce the significance for social workers to work with the government to actively supporting the training of therapists, establishing meaningful service quality measurement and promoting practical guidance about service quality standards to families of children with ASD.