Care Coordination:Testing Associations between Social Networks and the Perceived Transition Success for Low Resource Children with ASD

Background: Parents and providers face challenges preparing children with ASD for school transitions (Boyd, McDowall, & Cooper, 2002; Tehee, Honan, & Hevey, 2009). Social relationships among a child’s key supporters could provide important resources to improve transition success. Social network analysis offers powerful ways to examine dimensions ofthese relationships such as sharing and problem-solving (Fischer 1982; Rodrique et al 1990; Laumann and Pappi 1976; Breiger 1981). Network approaches have been applied in studies of health or health behavior (Bearman & Moody 2004; Bearman, Moody & Stovel 2004; Christakis & Fowler 2007, 2008; Coleman, Elihu & Menzel 1966) as well as health information-seeking (Colon-Ramos et al 2009) and communication and decision-making among health care personnel (Creswick, Westbrook & Braithwaite 2009; Fattore et al 2009; Scott et al 2005). Our study tests associations between structural dimensions of social relationships and transition success for children with ASD, thereby informing systematic attempts to improve school transitions for these children.

Objectives: Use ego-centric social network techniques to test the association between the perception of transition success and different types of social relationships, including instrumental relationships such as problem-solving networks and affective relationships such as trust networks. We test the hypothesis that problem solving networks and trust networks among home/school/community care providers are associated with perceptions of transition success.

Methods: 47 participants completed social network interviews, conducted 6 weeks before the end of the child’s school year at the old school, including 8 parents and 39 providers. We interviewed key participants using the SoDI: The Social Dynamics of Intervention Measure (McGhee Hassrick et al 2018; McGhee Hassrick and Carley 2015), where each participant reported frequency of problem solving and degree of trust for each person on the team roster. Using ORA network analysis software (Carley et al 2004), we computed egocentric problem solving and trust measures for each participant, including in-degree (# of team members who seek out the participant), out-degree (# of team members that the participant seeks out) and eigenvector centrality (degree of connectivity that the participant had with well-connected team members). Participants also rated perceived transition success on a 5-point Likert scale, where 1 = not successful and 5 =very successful. We used OLS regression to test associations between our outcome measure of perceived transition success and our egocentric network predictor variables.

Results: Perceived transition success was positively and modestly associated with out-degree centrality in trust networks, positively and significantly associated with eigenvalue centrality in trust networks and negatively associated with in-degree centrality in trust networks. It was also positively associated with indegree, outdegree and eigenvector centrality in problem solving networks, but these associations were not significant.

Conclusions: Trust was an important predictor for transition success. When participants trusted team members who themselves where highly trusted, their perception of the child’s transition success was significantly higher. This finding suggests that building trust for key leaders on a child’s team might increase the perception of transition success.