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A Mixed-methods Examination of Culturally Responsive Adaptation to an Evidence-based Parent-mediated Intervention Implemented for Autistic Children

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Abstract

Parent-mediated interventions (PMIs) are considered an evidence-based practice for fostering social communication skills in young autistic children and for promoting parent responsivity and empowerment, yet barriers to caregiver engagement are evident when PMIs are implemented within historically underserved community settings. Issues of caregiver engagement can reflect a lack of fit between PMIs and the needs of diverse families. We used a mixed methods approach to examine barriers to participating in an evidence-based PMI, Project ImPACT (Ingersoll & Dvortcsak, 2019), within an outpatient setting, as well as strategies that clinicians reported using to deliver and adapt Project ImPACT for minoritized families. Participants included 134 caregivers of a child 13 to 48 months with autism or other social communication differences and six clinicians delivering Project ImPACT. Findings suggest that caregivers experience barriers to participating in Project ImPACT and that these barriers are associated with caregivers’ ability to complete the program. Although quantitative findings indicate that adaptation to Project ImPACT did not differ by caregiver and child background, qualitative findings highlighted that clinicians attempt to deliver Project ImPACT to respond to the needs of families from minoritized backgrounds by actively considering the family’s culture, psychosocial experiences, goals, and specific barriers. Further, both qualitative and quantitative findings suggest that culturally responsive care and adaptations may support caregiver engagement, including rapport, trust, buy-in, and attendance. Approaches to center cultural alongside contextual/psychosocial considerations within family-centered care in the implementation of PMIs are also highlighted.

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References

  • Aggarwal, N. K., Pieh, M. C., Dixon, L., Guarnaccia, P., Alegria, M., & Lewis-Fernandez, R. (2016). Clinician descriptions of communication strategies to improve treatment engagement by racial/ethnic minorities in mental health services: A systematic review. Patient Education and Counseling, 99(2), 198–209.

    Article  PubMed  Google Scholar 

  • American Speech-Language-Hearing Association (2022). Demographic profile of ASHA members providing bilingual services, year-end 2021https://www.asha.org/siteassets/surveys/demographic-profile-bilingual-spanish-service-members.pdf.

  • American Psychological Association (2022). Demographics of U.S. psychology workforce [interactive data tool]. Retrieved from https://www.apa.org/workforce/data-tools/demographics.

  • Bartoli, E., & Pyati, A. (2009). Addressing clients’ racism and racial prejudice in individual psychotherapy: Therapeutic considerations. Psychotherapy: Theory Research Practice Training, 46(2), 145–157.

    Article  Google Scholar 

  • Becker, S. P., Burns, G. L., Leopold, D. R., Olson, R. K., & Willcutt, E. G. (2018). Differential impact of trait sluggish cognitive tempo and ADHD inattention in early childhood on adolescent functioning. Journal of Child Psychology and Psychiatry, 59(10), 1094–1104.

    Article  PubMed  Google Scholar 

  • Beebe, J. (1995). Basic concepts and techniques of rapid appraisal. Human Organization, 54(1), 42–51.

  • Ben, J., Cormack, D., Harris, R., & Paradies, Y. (2017). Racism and health service utilisation: A systematic review and meta-analysis. PloS One, 12(12), e0189900.

  • Bernal, G., Bonilla, J., & Bellido, C. (1995). Ecological validity and cultural sensitivity for outcome research: Issues for the cultural adaptation and development of psychosocial treatments with hispanics. Journal of Abnormal Child Psychology, 23(1), 67–82.

    Article  CAS  PubMed  Google Scholar 

  • Boggs, S. R., Eyberg, S. M., Edwards, D. L., Rayfield, A., Jacobs, J., Bagner, D., & Hood, K. K. (2005). Outcomes of parent-child interaction therapy: A comparison of treatment completers and study dropouts one to three years later. Child and Family Behavior Therapy, 26(4), 1–22.

    Article  Google Scholar 

  • Brian, J., Drmic, I., Roncadin, C., Dowds, E., Shaver, C., Smith, I. M., Zwaigenbaum, L., Sacrey, L. R., & Bryson, S. E. (2022). Effectiveness of a parent-mediated intervention for toddlers with autism spectrum disorder: Evidence from a large community implementation. Autism, 13623613211068934.

  • Brookman-Frazee, L., & Koegel, R. L. (2004). Using parent/clinician partnerships in parent education programs for children with autism. Journal of Positive Behavior Interventions, 6, 195–213.

    Article  Google Scholar 

  • Burkett, K., Morris, E., Manning-Courtney, P., Anthony, J., & Shambley-Ebron, D. (2015). African American families on autism diagnosis and treatment: The influence of culture. Journal of Autism and Developmental Disorders, 45(10), 3244–3254.

    Article  PubMed  Google Scholar 

  • Carr, T., & Lord, C. (2016). A pilot study promoting participation of families with limited resources in early autism intervention. Research in Autism Spectrum Disorders, 25, 87–96.

    Article  Google Scholar 

  • Carruthers, S., Mleczko, N., Page, S., Ahuja, S., Ellis, C., Howlin, P., Leadbitter, K., Taylor, L., Slonims, V., & Charman, T. (2022). Using implementation science frameworks to explore barriers and facilitators for parents’ use of therapeutic strategies following a parent-mediated autism intervention. Autism, 13623613221125630.

  • Casagrande, K. A., & Ingersoll, B. R. (2017). Service delivery outcomes in ASD: Role of parent education, empowerment, and professional partnerships. Journal of Child and Family Studies, 26(9), 2386–2395.

    Article  Google Scholar 

  • Castro, S., Pinto, A., & Simeonsson, R. J. (2014). Content analysis of Portuguese individualized education programmes for young children with autism using the ICF-CY framework. European Early Childhood Education Research Journal, 22(1), 91–104.

    Article  Google Scholar 

  • U.S. Census Bureau (2020). 2020 Census illuminates racial and ethnic composition of the country. Retrieved from https://www.census.gov/library/stories/2021/08/improved-race-ethnicity-measuresreveal-united-states-population-much-more-multiracial.html.

  • Chacko, A., Jensen, S. A., Lowry, L. S., Cornwell, M., Chimklis, A., Chan, E., Lee, D., & Pulgarin, B. (2016). Engagement in behavioral parent training: Review of the literature and implications for practice. Clinical Child and Family Psychology Review, 19(3), 204–215.

    Article  PubMed  Google Scholar 

  • Clauss-Ehlers, C. S., Chiriboga, D. A., Hunter, S. J., Roysircar, G., & Tummala-Narra, P. (2019). APA Multicultural Guidelines executive summary: Ecological approach to context, identity, and intersectionality. American Psychologist, 74(2), 232.

    Article  PubMed  Google Scholar 

  • Čolić, M., & Milačić-Vidojević, I. (2021). Perceived stigma among Serbian parents of children with autism spectrum disorder and children with physical disabilities: Validation of a new instrument. Journal of Autism and Developmental Disorders, 51(2), 501–513.

    Article  PubMed  Google Scholar 

  • Dababnah, S., Shaia, W. E., Kim, I., & Magaña, S. (2021). Parents taking action: Adapting a peer-to-peer program for parents raising black children with autism. Inclusion, 9(3), 205–224.

    Article  Google Scholar 

  • Dempsey, I., & Keen, D. (2008). A review of processes and outcomes in family-centered services for children with a disability. Topics in Early Childhood Special Education, 28(1), 42–52.

    Article  Google Scholar 

  • Dickson, K. S., Zeedyk, S. M., Martinez, J., & Haine-Schlagel, R. (2017). Examining ethnic disparities in provider and parent in-session participation engagement. Journal of Children’s Services, 12(1), 47–58.

  • DuBay, M., Watson, L. R., Baranek, G. T., Lee, H., Rojevic, C., Brinson, W., Smith, D., & Sideris, J. (2021). Rigorous translation and cultural adaptation of an autism screening tool: First Years Inventory as a case study. Journal of Autism and Developmental Disorders, 51(11), 3917–3928.

    Article  PubMed  PubMed Central  Google Scholar 

  • Dunst, C. J., Trivette, C. M., Davis, M., & Cornwell, J. (1988). Enabling and empowering families of children with health impairments. Children’s Health Care, 17(2), 71–81.

    Article  Google Scholar 

  • Elbert, N. J., van Os-Medendorp, H., van Renselaar, W., Ekeland, A. G., Hakkaart-van Roijen, L., Raat, H., & Pasmans, S. G. (2014). Effectiveness and cost-effectiveness of ehealth interventions in somatic diseases: A systematic review of systematic reviews and meta-analyses. Journal of Medical Internet Research, 16(4), e2790.

  • Fernandez, M. A., & Eyberg, S. M. (2009). Predicting treatment and follow-up attrition in parent–child interaction therapy. Journal of Abnormal Child Psychology, 37(3), 431–441.

    Article  PubMed  Google Scholar 

  • Foronda, C., Baptiste, D. L., Reinholdt, M. M., & Ousman, K. (2016). Cultural humility: A concept analysis. Journal of Transcultural Nursing, 27(3), 210–217.

    Article  PubMed  Google Scholar 

  • Georgiadis, C., Bose, D., Wolenski, R., Javadi, N., Coxe, S., Pettit, J. W., & Comer, J. S. (2022). How flexible are treatments for youth internalizing disorders? Examining modification guidelines included across supported treatments. Journal of Clinical Child and Adolescent Psychology, 51(5), 593–609.

    Article  PubMed  Google Scholar 

  • Golnik, A., Maccabee-Ryaboy, N., Scal, P., Wey, A., & Gaillard, P. (2012). Shared decision making: Improving care for children with autism. Intellectual and Developmental Disabilities, 50(4), 322–331.

    Article  PubMed  Google Scholar 

  • Greenhalgh, T., Stramer, K., Bratan, T., Byrne, E., Russell, J., & Potts, H. W. (2010). Adoption and non-adoption of a shared electronic summary record in England: a mixed-method case study. BMJ, 340.

  • Guerrero, A. D., Chen, J., Inkelas, M., Rodriguez, H. P., & Ortega, A. N. (2010). Racial and ethnic disparities in pediatric experiences of family-centered care. Medical Care, 48(4), 388.

    Article  PubMed  PubMed Central  Google Scholar 

  • Haine-Schlagel, R., & Walsh, N. E. (2015). A review of parent participation engagement in child and family mental health treatment. Clinical Child and Family Psychology Review, 18(2), 133–150.

    Article  PubMed  PubMed Central  Google Scholar 

  • Haine-Schlagel, R., Mechammil, M., & Brookman-Frazee, L. (2017). Stakeholder perspectives on a toolkit to enhance caregiver participation in community-based child mental health services. Psychological Services, 14(3), 373.

    Article  PubMed  PubMed Central  Google Scholar 

  • Haine-Schlagel, R., Rieth, S., Dickson, K. S., Brookman‐Frazee, L., & Stahmer, A. (2020). Adapting parent engagement strategies for an evidence‐based parent‐mediated intervention for young children at risk for autism spectrum disorder. Journal of Community Psychology, 48(4), 1215–1237.

    Article  PubMed  Google Scholar 

  • Hammer, C. S., Burchinal, M., Hong, S. S., LaForett, D. R., Páez, M., Buysse, V., Espinosa, L., Castro, D., & López, L. M. (2020). Change in language and literacy knowledge for spanish-english dual language learners at school-entry: Analyses from three studies. Early Childhood Research Quarterly, 51, 81–92.

    Article  Google Scholar 

  • Ingersoll, B., & Dvortcsak, A. (2019). Teaching social communication to children with autism and other developmental delays (2-book set): The Project ImPACT guide to coaching parents and the Project ImPACT manual for parents. Guilford Publications.

  • Jegatheesan, B., Miller, P. J., & Fowler, S. A. (2010). Autism from a religious perspective: A study of parental beliefs in south Asian muslim immigrant families. Focus on Autism and Other Developmental Disabilities, 25(2), 98–109.

    Article  Google Scholar 

  • Kaiser, K., Villalobos, M. E., Locke, J., Iruka, I. U., Proctor, C., & Boyd, B. (2022). A culturally grounded autism parent training program with Black parents. Autism, 26(3), 716–726.

  • Kasari, C., Lawton, K., Shih, W., Barker, T. V., Landa, R., Lord, C., Orlich, F., King, B., Wetherby, A., & Senturk, D. (2014). Caregiver-mediated intervention for low-resourced preschoolers with autism: An R CT. Pediatrics, 134(1), e72–e79.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kazdin, A. E., Holland, L., & Crowley, M. (1997). Family experience of barriers to treatment and premature termination from child therapy. Journal of Consulting and Clinical Psychology, 65(3), 453.

    Article  CAS  PubMed  Google Scholar 

  • Kim, R. E., Lau, A. S., & Chorpita, B. F. (2016). The impact of latino caregiver acculturation on treatment engagement in children’s community mental health services. Journal of Child and Family Studies, 25(3), 891–901.

    Article  Google Scholar 

  • Kim, I., Dababnah, S., & Lee, J. (2020). The influence of race and ethnicity on the relationship between family resilience and parenting stress in caregivers of children with autism. Journal of Autism and Developmental Disorders, 50(2), 650–658.

    Article  PubMed  Google Scholar 

  • King, S., King, G., & Rosenbaum, P. (2004). Evaluating health service delivery to children with chronic conditions and their families: Development of a refined measure of processes of care (MPOC-20). Children’s Health Care, 33(1), 35–57.

    Article  Google Scholar 

  • Kirk, M. A., Moore, J. E., Stirman, W., S., & Birken, S. A. (2020). Towards a comprehensive model for understanding adaptations’ impact: The model for adaptation design and impact (MADI). Implementation Science, 15(1), 1–15.

    Article  Google Scholar 

  • Lindsey, M. A., Brandt, N. E., Becker, K. D., Lee, B. R., Barth, R. P., Daleiden, E. L., & Chorpita, B. F. (2014). Identifying the common elements of treatment engagement interventions in children’s mental health services. Clinical Child and Family Psychology Review, 17(3), 283–298.

    Article  PubMed  Google Scholar 

  • Lopez, K., Magaña, S., Morales, M., & Iland, E. (2019). Parents taking action: Reducing disparities through a culturally informed intervention for Latinx parents of children with autism. Journal of Ethnic and Cultural Diversity in Social Work, 28(1), 31–49.

    Article  Google Scholar 

  • Lord, C., & Bishop, S. L. (2021). Let’s be clear that autism spectrum disorder symptoms are not always related to autism spectrum disorder. American Journal of Psychiatry, 178(8), 680–682.

    Article  PubMed  Google Scholar 

  • Lu, W., Todhunter-Reid, A., Mitsdarffer, M. L., Muñoz-Laboy, M., Yoon, A. S., & Xu, L. (2021). Barriers and facilitators for mental health service use among racial/ethnic minority adolescents: A systematic review of literature. Frontiers in Public Health, 9, 641605.

    Article  PubMed  PubMed Central  Google Scholar 

  • Malott, K. M., & Schaefle, S. (2015). Addressing clients’ experiences of racism: A model for clinical practice. Journal of Counseling and Development, 93(3), 361–369.

    Article  Google Scholar 

  • Martinez-Torres, K., Boorom, O., Peredo, T. N., Camarata, S., & Lense, M. D. (2021). Using the ecological validity model to adapt parent-involved interventions for children with Autism Spectrum Disorder in the Latinx community: A conceptual review. Research in Developmental Disabilities, 116, 104012.

    Article  PubMed  PubMed Central  Google Scholar 

  • Miller, C. J., Wiltsey-Stirman, S., & Baumann, A. A. (2020). Iterative decision-making for evaluation of adaptations (IDEA): A decision tree for balancing adaptation, fidelity, and intervention impact. Journal of Community Psychology, 48(4), 1163–1177.

  • Nevill, R. E., Lecavalier, L., & Stratis, E. A. (2018). Meta-analysis of parent-mediated interventions for young children with autism spectrum disorder. Autism, 22(2), 84–98.

    Article  PubMed  Google Scholar 

  • Oono, I. P., Honey, E. J., & McConachie, H. (2013). Parent-mediated early intervention for young children with autism spectrum disorders (ASD). Evidence‐Based Child Health: A Cochrane Review Journal, 8(6), 2380–2479.

    Article  Google Scholar 

  • Palinkas, L. A., Aarons, G. A., Horwitz, S., Chamberlain, P., Hurlburt, M., & Landsverk, J. (2011). Mixed method designs in implementation research. Administration and Policy in Mental Health and Mental Health Services Research, 38(1), 44–53.

    Article  PubMed  Google Scholar 

  • Pearson, J. N., & Meadan, H. (2021). FACES: An advocacy intervention for African American parents of children with autism. Intellectual and Developmental Disabilities, 59(2), 155–171.

    Article  PubMed  Google Scholar 

  • Pellecchia, M., Nuske, H. J., Straiton, D., McGhee Hassrick, E., Gulsrud, A., Iadarola, S., Vejnoska, S. F., Bullen, B., Haine-Schlagel, R., Kasari, C., Mandell, D. S., Smith, T., & Stahmer, A. C. (2018). Strategies to engage underrepresented parents in child intervention services: A review of effectiveness and co-occurring use. Journal of Child and Family Studies, 27(10), 3141–3154.

    Article  Google Scholar 

  • Pickard, K. E., & Ingersoll, B. R. (2016). Quality versus quantity: The role of socioeconomic status on parent-reported service knowledge, service use, unmet service needs, and barriers to service use. Autism, 20(1), 106–115.

    Article  PubMed  Google Scholar 

  • Pierce, N. P., O’Reilly, M. F., Sorrells, A. M., Fragale, C. L., White, P. J., Aguilar, J. M., & Cole, H. A. (2014). Ethnicity reporting practices for empirical research in three autism-related journals. Journal of Autism and Developmental Disorders, 44(7), 1507–1519.

    Article  PubMed  Google Scholar 

  • Restrepo, M. A., Morgan, G. P., & Thompson, M. S. (2013). The efficacy of a vocabulary intervention for dual-language learners with language impairment. Journal of Speech Language and Hearing Research, 56(2), 748–765.

    Article  Google Scholar 

  • Sanchez, A. L., Comer, J. S., & LaRoche, M. (2022a). Enhancing the responsiveness of family-based CBT through culturally informed case conceptualization and treatment planning. Cognitive and Behavioral Practice, 29(4), 750–770.

    Article  Google Scholar 

  • Sanchez, A. L., Jent, J., Aggarwal, N. K., Chavira, D., Coxe, S., Garcia, D., La Rocha, M., & Comer, J. S. (2022b). Person-centered cultural assessment can improve child mental health service engagement and outcomes. Journal of Clinical Child and Adolescent Psychology, 51(1), 1–22.

    Article  PubMed  Google Scholar 

  • Shaw, K. A., Williams, S., Hughes, M. M., Warren, Z., Bakian, A. V., Durkin, M. S., ... & Maenner, M. J. (2023). Statewide county-level autism spectrum disorder prevalence estimates?seven US states, 2018. Annals of Epidemiology, 79, 39–43.

  • Smith, K. A., Gehricke, J. G., Iadarola, S., Wolfe, A., & Kuhlthau, K. A. (2020). Disparities in service use among children with autism: A systematic review. Pediatrics, 145(Supplement_1), S35–S46.

    Article  PubMed  Google Scholar 

  • Stadnick, N. A., Aarons, G. A., Martinez, K., Sklar, M., Coleman, K. J., Gizzo, D. P., Lane, E., Kuelbs, C. L., & Brookman-Frazee, L. (2022). Implementation outcomes from a pilot of Access to tailored Autism Integrated Care for children with autism and mental health needs. Autism, 13623613211065801.

  • Stahmer, A. C., Vejnoska, S., Iadarola, S., Straiton, D., Segovia, F. R., Luelmo, P., Morgan, E. H., Lee, S., Javed, H., Bronstein, A., Hochheimer, B., Cho, S., Aranbarri, E., Mandell, A., Hassrick, D., Smith, E. M., T., & Kasari, C. (2019). Caregiver voices: Cross-cultural input on improving access to autism services. Journal of Racial and Ethnic Health Disparities, 6(4), 752–773.

    Article  PubMed  PubMed Central  Google Scholar 

  • Steinbrenner, J. R., McIntyre, N., Rentschler, L. F., Pearson, J. N., Luelmo, P., Jaramillo, M. E., Boyd, B. A., Wong, C., Nowell, S. W., Odom, S. L., & Hume, K. A. (2022). Patterns in reporting and participant inclusion related to race and ethnicity in autism intervention literature: Data from a large-scale systematic review of evidence-based practices. Autism, 13623613211072593.

  • Stirman, S. W., Miller, C. J., Toder, K., & Calloway, A. (2013). Development of a framework and coding system for modifications and adaptations of evidence-based interventions. Implementation Science, 8(1), 1–12.

    Article  Google Scholar 

  • Stirman, S., Baumann, A. A., & Miller, C. J. (2019). The FRAME: An expanded framework for reporting adaptations and modifications to evidence-based interventions. Implementation Science, 14(1), 1–10.

    Google Scholar 

  • Straiton, D., & Sridhar, A. (2022). Call to action for autism clinicians in response to anti-Black racism. Autism, 26(4), 988–994.

    Article  PubMed  Google Scholar 

  • Tervalon, M., & Murray-Garcia, J. (1998). Cultural humility versus cultural competence: A critical distinction in defining physician training outcomes in multicultural education. Journal of Health Care for the Poor and Underserved, 9(2), 117–125.

    Article  CAS  PubMed  Google Scholar 

  • Vanegas, S. B., Xu, Y., Magaña, S., & Heller, T. (2022). You had this clean window, but it was glued shut: Identifying the needs of parents and providers of children and youth with autism spectrum disorders in rural areas through a life course perspective. Journal of Developmental and Physical Disabilities, 1–25.

  • Vindrola-Padros, C., & Johnson, G. A. (2020). Rapid techniques in qualitative research: A critical review of the literature. Qualitative Health Research, 30(10), 1596–1604.

    Article  PubMed  Google Scholar 

  • Yoder, P. J., Stone, W. L., & Edmunds, S. R. (2021). Parent utilization of ImPACT intervention strategies is a mediator of proximal then distal social communication outcomes in younger siblings of children with ASD. Autism, 25(1), 44–57.

    Article  PubMed  Google Scholar 

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Acknowledgements

Thank you to the clinicians and families who dedicated their time to participating in this research.

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Authors and Affiliations

  1. Department of Pediatrics, Marcus Autism Center, Emory University School of Medicine, Children’s Healthcare of Atlanta, Atlanta, GA, USA

    Asha Rudrabhatla, Nicole Hendrix, Scott Gillespie, Kathryn Ulven, Andrew Jergel, Elizabeth Greenfield, Karen Guerra & Katherine Pickard

  2. Current Affiliation: Department of Psychology, George Mason University, Fairfax, VA, USA

    Asha Rudrabhatla

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  1. Asha Rudrabhatla
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Dr. Katherine Pickard is a certified trainer in Project ImPACT and has received royalties for conducting trainings that are donated back to the Marcus Autism Center Early Intervention Program.

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Rudrabhatla, A., Hendrix, N., Gillespie, S. et al. A Mixed-methods Examination of Culturally Responsive Adaptation to an Evidence-based Parent-mediated Intervention Implemented for Autistic Children. Adm Policy Ment Health 51, 406–424 (2024). https://doi.org/10.1007/s10488-024-01343-9

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