a b s t r a c t
Family-centered care (FCC) has been linked with improved parent and child outcomes, yet its implementation can be challenging due to family, professional, organizational and systemic factors and policies. This study aims to increase knowledge and understanding of how families with children with
autism spectrum disorder (ASD) experience FCC in Alberta, Canada. 152 parents with a child with ASD
completed the Measure of Processes of Care, separately for each utilized service sector, and 146 professionals working with persons with ASD completed the Measure of Processes of Care e Service Providers. Additionally, in-depth interviews were conducted with a sub-sample of 19 parents, purposefully
sampled for diversity in child and family characteristics. Data were collected in 2011. Descriptive and
inferential statistics were used to analyze quantitative data. Interview transcripts were analyzed using
grounded theory constant comparison methods, yielding a data generated theoretical model depicting
families’ experiences with FCC over time and across service sectors. There were no statistically significant
differences in FCC scores across service sectors, but statistically significant differences in FCC scores
between parents’ and professionals’ were found. Qualitative data revealed positive experiences and
perceptions of receiving FCC from professionals “on the ground” across sectors, but negative experiences
and perceptions of FCC at the systems level (i.e., administration, funders). These broad experiences
emerged as a core theme “System of Exclusion”, which integrated the key themes: (1) “The Fight”, (2)
“Roles and Restrictions of Care”, and (3) “Therapeutic Rapport”. Professionals and service providers can
use findings to ensure that services reflect current conceptualizations of FCC, and decision and policy
makers can use findings to recognize systemic barriers to implementing FCC and inform policy change.