Randomized Control Trial: Impact of the Parents Taking Action Program on Latino Children with ASD and Their Parents
ASD prevalence among Latino children has increased dramatically over the past decade and research has documented substantial disparities in treatments and services among Latino children with ASD compared to White children. To reduce disparities for Latino children with ASD, Parents Taking Action (PTA), a culturally informed psychoeducation program, was developed. PTA is based on an ecological validity model, which addresses specific dimensions of culture in the development of interventions. PTA is a 14-week program delivered by promotoras de salud (community health workers). Promotoras are bilingual Latina mothers of children with ASD and have been identified as active members in their community. PTA content informs parents about ASD and their child’s rights, and teaches parents evidenced-based (EB) strategies grounded in applied behavior analysis to use with their children.
To test the efficacy of PTA with respect to parent outcomes (utilizing EB strategies), and child outcomes (reduction of symptoms, increase in service use).
Participants included 89 Latina mothers and 93 children in Illinois and California. Children were all diagnosed with ASD. Following a baseline assessment, dyads were randomly assigned to a treatment now or treatment later group. Those in treatment now (mothers mean age 37.9, SD=5.3; children mean age 5.5, SD=1.8) immediately received PTA along with two follow-up assessments (after completing the program and 4 months later). The treatment later group (mothers mean age 36.2, SD=6.6; children mean age 5.2, SD=1.8) was offered the PTA program after completing two follow-up assessments (4 and 8 months post-baseline). Assessments included the Childhood Autism Rating Scale, Social and Communication Questionnaire (SCQ), Family Outcome Survey (FOS), service use questions, and measures specific to the study regarding efficacy in using EB strategies and frequency of using the EB strategies. The data included in the present study are from the baseline and time 2 assessments.
The linear mixed effects model for the child outcome showed that the treatment group had reduced SCQ scores at time 2 (lower score = less impairment). For parent outcomes, the linear mixed effects model showed a significant interaction between time and treatment group on efficacy in using the EB strategies and frequency in the use of strategies, showing an increase in these outcomes for the treatment group. We did not find a treatment effect for the FOS. Service use increased for the treatment group in California but not in Illinois.
The results show that PTA is a culturally informed program for Latino families that enhances parents’ abilities to apply evidenced based strategies with their children, which can lead to enhanced social communication skills among children. Future analysis should examine the impact of all outcomes over time, and could examine the efficacy of the program for other underserved communities.