Assessing Rural Care Ecosystems for Individuals With Neurodiversity: A Systematic Literature Review

This systematic literature review synthesized the results of 95 papers on neurodiversity (autism spectrum disorder, dyslexia, attention deficit hyperactivity disorder, intellectual disability) in rural areas between 2003 and 2023 to chart the status quo in current practices and understand the barriers and challenges. We find that most studies focused on understanding neurodiverse populations and their care ecosystems, and few implemented interventions to improve ecosystems. Additionally, there is a significant disparity between rural and urban areas regarding service, prevalence, and family characteristics. The results highlighted an array of mutually reinforcing challenges faced by neurodiverse populations and their families in accessing services in rural areas. Providers, teachers, and researchers struggle to support neurodiverse groups due to a lack of support, funding, resources, staff, and collaboration. We conclude by proposing specific paths forward that can improve care ecosystems for rural neurodiverse populations and support those who strive to address their lifelong needs.