Strengths and limitations
intellectual disabilities, confusion
A strength of this study was its use and advancement of the implementation science framework FRAME. Although many studies capture provider perspectives on adaptation of interventions, this paper highlights the consumer voice. Additionally, rapid analysis was used for faster turnaround of results, which allowed for further investigation of adaptations. This study was also strengthened by its focus on traditionally underserved families.A limitation of this study was that most parents were interviewed a few years after their participation in FN. As a result, multiple parents had forgotten details about their experience and in some cases, their navigator. Given that navigation is novel in many settings and navigators offer help across multiple areas of need, parental confusion is not surprising. Another limitation of this study was that parents of children who were not diagnosed with ASD in the larger study but still received FN were beyond the scope of this study and thus excluded. Future studies could examine how families who participated in an intervention focused on ASD but whose children received other diagnoses benefitted or experienced potential harm (e.g., unnecessary stigma or stress) from the intervention. This could also help us better understand how FN could be used for children with other developmental and intellectual disabilities.A final limitation of this study was that inclusion of other stakeholder groups, such as supervision teams, healthcare providers, and clinic staff, was not feasible. Interviews with members of these other groups would likely identify new recommendations as well insight into recommendations made by parents and navigators. It is also likely that these groups might identify modifications associated with cost reduction, a key area that was not raised in this study.