In Search of Culturally Appropriate Autism Interventions for Latino Families

Background: Latinos represent the fastest growing minority population in the United States, and the proportion of Latino children with autism spectrum disorder (ASD) in early intervention programs (i.e., for children birth to 5 years of age) shows concomitant increases. Despite these changing demographics, the vast majority of evidence-based ASD interventions have been designed for and tested with mostly White, mid-upper class, monolingual English-speaking populations. Unfortunately, research suggests that interventions that are incongruent with a target population’s culture may be less effective. Specifically, participation rates and response to treatment may be reduced. To either adapt current evidence-based interventions or design new interventions for Latino populations, we must have input from members of the Latino community, including knowledge of families’ perceptions of intervention models and components of evidence-based practices.

Objectives: The first aim of this mixed methods study was to determine if there were quantitative differences in the ways that Latino Spanish-speaking (LSS) families and non-Latino White English-speaking (NLW) families rate the family-centeredness and helpfulness of their interventions. We hypothesized that because many evidence-based interventions were not designed or tested with LSS families, that these families would perceive lower levels of family-centeredness or helpfulness. The second, qualitative, aim of the study was to identify intervention models, strategies, and targets that are perceived as more culturally appropriate, feasible, and acceptable for LSS families, and to understand the variability that likely exists among these families.

Methods: NLW (n=27) and LSS (n=25) parents of young children with ASD completed the Family Outcomes Survey and Measure of Processes of Care as measures of helpfulness and family-centeredness of intervention, respectively. Additionally, LSS parents and other caregivers of young children with ASD shared perspectives of their child's interventions through focus groups. Topics of discussion included caregivers' level of involvement in therapy, perceptions of caregiver-mediated intervention models, as well as the feasibility, acceptability, and appropriateness of a number of several prominent evidence-based ASD strategies (prompting, video modeling, naturalistic interventions, and discrete trials) in the context of their own family.

Results: Contrary to expectations, preliminary survey results indicate that NLW parents report that intervention is less helpful in teaching parents to help their child develop and learn compared to LSS parents (t = 2.11; p <.05). However, LSS parents reported having fewer friends or family to rely on for support (t = 2.48; p < .05). Focus group participants reported a wide range of levels of involvement in therapy and perceptions of the benefits or drawbacks for specific intervention strategies. Preliminary thematic analyses revealed that parents almost unanimously wanted training and education on how to carry out interventions in the home environment even when children receive intervention in the school setting. Other themes will be discussed.

Conclusions: Findings suggest a need to provide specific, ongoing caregiver training and support to families of children with ASD, even for parents of preschool and school-age children. Specific strategies to culturally adapt interventions will be discussed. Future research should examine the benefits of caregiver training and support interventions at the preschool and school-age levels.