Parent-Mediated Intervention for Hispanic Families of Young Children with Autism

Background: The US Hispanic population has grown rapidly over the past decade (Humes, Jones, & Ramirez, 2012) and has experienced one of the largest increases in ASD prevalence when compared to other populations (MMWR, 2014). A support system needs to be in place for this population, one that includes accessible, high-quality intervention. Unfortunately, US Hispanic families have poor access to ASD services (Harstad, Huntington, Bacic, & Barbaresi, 2013), diminished treatment quality (Magaña, Parish, Rose, Timberlake, & Swaine, 2012), and poorer outcomes when compared to White, non-Hispanic families (Fountain, Winter, & Bearman, 2012). Based on their negative experiences, Hispanic families report losing trust in the healthcare system (Zuckerman et al., 2014). These findings emphasize the importance of establishing supportive early interventions for Hispanic families of children with ASD. To date, however, no studies have examined early parent-mediated interventions for Hispanic families of children with ASD. To address this need, this study investigated a parent-mediated intervention called “Adapted Responsive Teaching” (ART; Wakeford et al., under revision) in primarily Spanish-speaking families.

Objectives: The purpose of the study was twofold: (1) to examine how ART impacts the social-communication skills of children with ASD from Hispanic families; and (2) to explore the acceptability & feasibility of ART among these families.

Methods:  This study used a multiple baseline across participants and behaviors design. Three Hispanic children diagnosed with ASD participated in an initial assessment (age range in years;months was 2;9 – 4;4). Baseline data were collected on selected social-communication behaviors for each child. During the ART intervention, parents were taught responsiveness strategies, which were intended to improve the social-communication skills of their children. Measures of parent responsiveness and parent fidelity of implementation were also taken. At the conclusion of the intervention, caregivers participated in qualitative interviews about their perspectives of the ART intervention. 

Results:  Treatment effects were demonstrated in four out of seven opportunities, providing moderate evidence for the ART intervention’s effectiveness at improving social-communication skills in Hispanic children with ASD. Two out of three children demonstrated improvements in social-interaction and requesting. For the two children who showed treatment effects, their parents also showed high levels of parent responsiveness and fidelity to intervention; the third parent demonstrated inconsistent responsiveness and fidelity to intervention. According to the interviews, parents perceived that the ART intervention was feasible and acceptable for their families overall, and felt that it would also be applicable to other Hispanic families of children with ASD. Families reported that they would continue implementing ART strategies after the program ended, but also provided suggestions for modifications.

Conclusions: ART appears to be a promising intervention option for US Hispanic, primarily-Spanish speaking families, particularly for families and children who share similar characteristics as the participants in this study. Explanations for the differences in parent and child outcomes are explored, providing guidance to professionals and families who are making decisions about early interventions, as well as to early intervention researchers conducting future studies with this population.