For children, flourishing typically encompasses positive emotional, psychological, and social well-being, alongside curiosity, resilience, and self-regulation. When children are flourishing, they are not simply surviving, they are actively thriving, engaging with the world, and developing their full potential. For children with developmental disabilities, such as autism spectrum disorder (ASD), flourishing is characterized by the ability to form meaningful relationships, manage emotions and behaviors effectively, and engage in learning and curiosity. And, according to the National Survey of Children’s Health (NSCH), children with special healthcare needs, including ASD, flourish at about half the rate of those without such needs. 

Identifying what promotes well-being in children with autism is crucial for designing effective interventions and support systems that promote overall growth and development. And although research on children with autism has advanced, there is still limited understanding of what helps or hinders their flourishing. While previous studies have examined ways in which parental perceptions, functional challenges, and educational factors might affect autistic flourishing, little has been done to learn which healthcare system factors truly enable autistic children to thrive. A recent journal article, Linking System of Care Services to Flourishing in School-Aged Children with Autism, explains how two researchers aimed to address this research gap.

From the outset, Wanqing Zhang, MD, PhD, an associate professor and research methodologist in the Department of Health Sciences at the UNC School of Medicine, and Stephanie Reszka, PhD, a research scientist at the UNC Frank Porter Graham Child Development Institute, expected that children with autism who receive high-quality, coordinated healthcare would be more likely to meet the flourishing criteria defined by the Center for Child and Adolescent Health than those who do not receive such care.

Zhang and Reszka used publicly available data from the US 2021–2022 NSCH, which surveys U.S. households with children under 18 years of age, to examine how access to quality health systems relates to flourishing in children with autism.  Their research specifically focused on 2,253 children aged 6–17 diagnosed with autism who had complete data on the flourishing measure. 

Zhang’s and Reszka’s analysis found that children with autism who receive coordinated care are significantly more likely to flourish than those without needed care. And certain elements of care more heavily affected these flourishing outcomes. For example, effective collaboration between families and healthcare providers made a positive impact. This coordinated care leads to more personalized care that can be tailored to support a child’s unique needs. 

For families of children with autism, 9.2% of children whose parents felt like partners in their care were reported to be flourishing, compared to only 3.6% of children whose parents did not feel like partners in their care.

The researchers also found that providing services focused on transitioning to adult healthcare for adolescents with autism is important. Adolescents with autism who receive this kind of care are twice as likely to flourish than those who do not receive similar care.

More than one-fifth of adolescent children with autism (22.3%) who received services to prepare for transition were reported to be flourishing, compared to 13.4% of adolescent children who did not receive such services.

Noting some limitations in this study, Zhang and Reszka suggest that future research in this area should use larger samples, develop comprehensive measures of flourishing, and consider cultural context. 

Overall, the analysis points to the importance of providing a well-coordinated system of healthcare on flourishing among children and adolescents with autism. Early and timely intervention and continuous care—incorporating effective healthcare collaboration with input from families and transition programs tailored for adolescents with autism—are paramount for positive outcomes.