Bridging the Gap in Primary Care for ASD: A Parallel Cross-Perspective Analysis of Physician Self-Efficacy and Parental Perceptions

Background: Autism spectrum disorder carries a psychiatric-comorbidity burden that, depending on the sample, reaches 70–83%—placing the condition at the center of routine child mental-health service delivery. Primary care physicians act as gatekeepers, care coordinators, and frequently the de facto first mental-health contact, yet the mental-health competencies they bring to consultations with autistic children have rarely been characterized in parallel with the perspective of parents. This study evaluated physician self-efficacy in such consultations and compared physicians’ and parents’ reports of physician situational anxiety and of the implementation of routine clinical strategies. Methods: Two parallel, web-based surveys were distributed between October 2023 and February 2024 to PCPs (N = 166) and parents of children with ASD (N = 177) in Poland. Data evaluated demographics, situational anxiety, self-efficacy, and the frequency of utilizing specific autism-tailored clinical accommodations. Results: Among physicians, higher self-efficacy was associated with lower situational anxiety (ρ = −0.24, p = 0.002) and with more frequent use of clinical strategies (ρ = 0.41, p < 0.001). Physicians reported higher situational anxiety than parents attributed to them (U = 8545.0, Z = −7.49, p < 0.001). Physicians’ reports of routine strategy delivery exceeded parents’ reports of receiving them in the three directly comparable domains of clinical strategy use, with a fourth, non-equivalent comparison also differing (physician confidence in adapting the clinical environment versus parental report of the frequency of sensory adjustments); the largest relative difference concerned family-centred needs (OR = 3.94, 95% CI 2.06–7.54), followed by the discussion of social difficulties (OR = 3.18), the tracking of ongoing external therapies (OR = 2.70), and sensory accommodations in the medical setting (OR = 2.44). Parental reports also highlighted significant organizational barriers, particularly in priority scheduling. Conclusions: Physicians reported greater situational anxiety than parents perceived in them, and physicians’ reports of routine strategy delivery consistently exceeded parents’ reports of receiving them. Because the physician and parent samples were independent, these findings indicate different distributions of the two groups’ reports rather than within-consultation disagreement. Optimizing primary care for the autistic community may require systemic reforms, standardized communicative checklists, and institutionalized accommodations—directions suggested by the observed pattern that were not tested in the present cross-sectional, self-report design and require future evaluation.