Abstract
As applied behavior analysis (ABA) is widely prescribed as an intervention for autistic children, ABA practitioners must have a thorough understanding of the impact of language and culture on the individuals and families they serve. The twin purposes of this article are to discuss cultural humility in ASD service delivery, and to provide an overview of practice parameters for the expansion of equity and inclusion. These efforts are guided by the National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care. Readers will be provided with recommendations for incorporating culturally and linguistically appropriate services into training, practice, and supervision in ABA settings.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Notes
Here we are referring to ABA services for ABA therapy.
References
Akpapuna, Choi, E., Johnson, D. A., & Lopez, J. A. (2020). Encouraging multiculturalism and diversity within organizational behavior management. Journal of Organizational Behavior Management, 40(3-4), 186–209. https://doi.org/10.1080/01608061.2020.1832014
American Public Health Association. (2020). Racism is an ongoing public health crisis that needs our attention now [Press release]. Retrieved April 15, 2023, from http://www.apha.org/news-and-media/news-releases/apha-news-releases/2020/racism-is-a-public-health-crisis
Aggarwal, N. K., Cedeno, K., John, D., & Lewis-Fernandez, R. (2017). Adoption of the national CLAS standards by state mental health agencies: A nationwide policy analysis. Psychiatric Services, 68(8), 856–858. https://doi.org/10.1176/appi.ps.201600407
Barksdale, Rodick, W. H., Hopson, R., Kenyon, J., Green, K., & Jacobs, C. G. (2017). Literature review of the National CLAS Standards: Policy and practical implications in reducing health disparities. Journal of Racial and Ethnic Health Disparities, 4(4), 632–647. https://doi.org/10.1007/s40615-016-0267-3
Beaulieu, L., Addington, J., & Almeida, D. (2018). Behavior analysts' training and practices regarding cultural diversity: The case for culturally competent care. Behavior Analysis in Practice, 12(3), 557–575. https://doi.org/10.1007/s40617-018-00313-6
Beene, N. (2019). Letter to the editor: One perspective on diversity in ABA. Behavior Analysis in Practice, 12(4), 899–901. https://doi.org/10.1007/s40617-019-00378-x
Behavior Analyst Certification Board. (2023). BACB certificant data. Retrieved April 16, 2023, from https://www.bacb.com/BACB-certificant-data
Behavior Analyst Certification Board. (2020). Ethics code for behavior analysts. https://bacb.com/wp-content/ethics-code-for-behavior-analysts/. Accessed 16 Apr 2023.
Behavior Analyst Certification Board. (2018). RBT task list (2nd ed.). Littleton, CO: Author. https://www.bacb.com/wp-content/uploads/2020/05/RBT-2nd-Edition-Task-List_230130-a.pdf. Accessed 16 Apr 2023.
Behavior Analyst Certification Board. (2017). BCBA task list (5th ed.). Littleton, CO: Author. https://www.bacb.com/wp-content/uploads/2020/08/BCBA-task-list-5th-ed-230130-a.pdf. Accessed 16 Apr 2023.
Behavior Analyst Certification Board (2022). BCBA Test Content Outline (6th ed.). https://www.bacb.com/wp-content/uploads/2022/01/BCBA-6th-Edition-TestContent-Outline-230206-a.pdf. Retrieved on April 19, 2023
Bernier, R., Mao, A., & Yen, J. (2010). Psychopathology, families, and culture: Autism. Child & Adolescent Psychiatric Clinics, 19(4), 855–867. https://doi.org/10.1016/j.chc.2010.07.005
Čolić, M., Araiba, S., Lovelace, T. S., & Dababnah, S. (2021). Black caregivers’ perspectives on racism in ASD services: Toward culturally responsive ABA practice. Behavior Analysis in Practice, 15, 1032–1041. https://doi.org/10.1007/s40617-021-00577-5
Conners, B. M., & Capell, S. T. (Eds.). (2020). Multiculturalism and diversity in applied behavior analysis: Bridging theory and application. Routledge.
Conners, B., Johnson, A., Duarte, J., Murriky, R., & Marks, K. (2019). Future directions of training and fieldwork in diversity issues in applied behavior analysis. Behavior Analysis in Practice, 12(4), 767–776. https://doi.org/10.1007/s40617-019-00349-2
Delphin-Rittmon, M. E., Boynton, E. S., Ortiz, J., Davidson, L., & Flanagan, E. H. (2021). The organizational multicultural competence assessment (OMCA): A tool to assess an organization’s multicultural competence and adherence to the National Standards for culturally and linguistically appropriate Services in Health and Healthcare (the national CLAS standards). Psychiatric Rehabilitation Journal, 44(2), 99–106. https://doi.org/10.1037/prj0000478
Dennison, A., Lund, E. M., Brodhead, M. T., Mejia, L., Armenta, A., & Leal, J. (2019). Delivering home-supported applied behavior analysis therapies to culturally and linguistically diverse families. Behavior Analysis in Practice, 12, 887–898. https://doi.org/10.1007/s40617-019-00374-1
Diener, M. (2021). American hospital association: Evaluation of the National CLAS Standards. Retrieved April 16, 2023, https://www.aha.org/node/679516
Doshi, Tilford, J. M., Ounpraseuth, S., Kuo, D. Z., & Payakachat, N. (2017). Do insurance mandates affect racial disparities in outcomes for children with autism? Maternal and Child Health Journal, 21(2), 351–366. https://doi.org/10.1007/s10995-016-2120-z
Fong, E. H., Catagnus, R. M., Brodhead, M. T., Quigley, S., & Field, S. (2016). Developing the cultural awareness skills of behavior analysts. Behavior Analysis in Practice, 9(1), 84–94. https://doi.org/10.1007/s40617-016-0111-6
Fong, E. H., Ficklin, S., & Lee, H. Y. (2017). Increasing cultural understanding and diversity in applied behavior analysis. Behavior Analysis: Research & Practice, 17(2), 103–113. https://doi.org/10.1037/bar0000076
Goldman, B. M., & Kernis, M. H. (2002). The role of authenticity in healthy psychological functioning and subjective well-being. Annals of the American Psychotherapy Association, 5(6), 18+. https://link.gale.com/apps/doc/A95844662/AONE?u=googlescholar&sid=bookmark-AONE&xid=653a4dfd. Accessed 16 Apr 2023.
Hyman, S. L., Levey, S. E., Myers, S. M., & Council on Children with Disabilities, Section on Developmental & Behavioral Pediatrics. (2020). Identification, evaluation, and management of children with autism spectrum disorder. Pediatrics, 145(1), e20193447. https://doi.org/10.1542/peds.2019-3447
Jones, D. R., & Mandell, D. S. (2020). To address racial disparities in autism research, we must think globally, act locally. Autism, 24, 1587–1589. https://doi.org/10.1177/1362361320948313
Levy, S., Siebold, A., Vaidya, J., Truchon, M.-M., Dettmering, J., & Mittelman, C. (2021). A look in the Mirror: How the field of behavior analysis can become anti-racist. Behavior Analysis in Practice, 15, 1112–1125. https://doi.org/10.1007/s40617-021-00630-3
Luo, H. (2019). Diversity, equity, and inclusion SIG https://contextualscience.org/diversity_equity_and_inclusion_sig
Magaña, S., Parish, S. L., Rose, R. A., Timberlake, M., & Swaine, J. G. (2012). Racial and ethnic disparities in quality of health care among children with autism and other developmental disabilities. Intellectual & Developmental Disabilities, 50(4), 287–299. https://doi.org/10.1352/1934-9556-50.4.287
Magaña, S., Parish, S. L., & Son, E. (2015). Have racial and ethnic disparities in the quality of health care relationships changed for children with developmental disabilities and ASD? American Journal on Intellectual & Developmental Disabilities, 120(6), 504–513. https://doi.org/10.1352/1944-7558-120.6.504
Mandell, D. S., Listerud, J., Levy, S. E., & Pinto-Martin, J. A. (2002). Race differences in the age at diagnosis among Medicaid-eligible children with autism. Journal of the American Academy of Child & Adolescent Psychiatry, 41(12), 1447–1453. https://doi.org/10.1097/00004583-200212000-00016
Mandell, D. S., Wiggins, L. D., Carpenter, L. A., Daniels, J., DiGuiseppi, C., Durkin, M. S., Giarelli, E., Morrier, M. J., Nicholas, J. S., Pinto-Martin, J. A., Shattuck, P. T., Thomas, K. C., Yeargin-Allsopp, M., & Kirby, R. S. (2009). Racial/ethnic disparities in the identification of children with autism spectrum disorders. American Journal of Public Health, 99(3), 493–498.
Mathur, S. K., & Rodriguez, K. A. (2021). Cultural responsiveness curriculum for behavior analysts: A meaningful step toward social justice. Behavior Analysis in Practice, 15, 1023–1031. https://doi.org/10.1007/s40617-021-00579-3
Miller, K. L., Cruz, A. R., & Ala’i-Rosales, S. (2019). Inherent tensions and possibilities: Behavior analysis and cultural responsiveness. Behavior & Social Issues, 28(1), 16–36. https://doi.org/10.1007/s42822-019-00010-1
Najdowski, A. C., Gharapetian, L., & Jewett, V. (2021). Toward the development of antiracist and multicultural graduate training programs in behavior analysis. Behavior Analysis in Practice, 14, 462–477. https://doi.org/10.1007/s40617-020-00504-0
Pope-Davis, D. B., Breaux, C., & Liu, W. M. (1997). A multicultural immersion experience: Filling the void in multicultural training. In D. B. Pope-Davis & H. L. K. Coleman (Eds.), Multicultural counseling competencies: Assessment, education and training, and supervision (pp. 227–241). Sage.
Pritchett, M., Ala’i-Rosales, S., Re Cruz, A., & Cihon, T. M. (2021). Social justice is the spirit and aim of an applied science of human behavior: An examination and reflection on the variables related to moving from colonial to participatory research practices [special section]. Behavior Analysis Practice, 10. https://doi.org/10.31234/osf.io/t87p4
Sánchez, L. (2010). Positionality. In B. Warf (Ed.), Encyclopedia of geography (pp. 2257–2258). Sage.
U.S. Department of Health & Human Services. (2016). National standards for culturally and linguistically appropriate services in health and health care. https://thinkculturalhealth.hhs.gov/clas. Accessed 16 Apr 2023.
Veneziano, J., & Shea, S. (2022). They have a voice; are we listening? Behavior Analysis in Practice, 16, 127–144. https://doi.org/10.1007/s40617-022-00690-z
Yingling, Hock, R. M., & Bell, B. A. (2018). Time-lag between diagnosis of autism spectrum disorder and onset of publicly-funded early intensive behavioral intervention: Do race–ethnicity and neighborhood matter? Journal of Autism and Developmental Disorders, 48(2), 561–571. https://doi.org/10.1007/s10803-017-3354-3
Wang, Kang, S., Ramirez, J., & Tarbox, J. (2019). Multilingual diversity in the field of applied behavior analysis and autism: A brief review and discussion of future directions. Behavior Analysis in Practice, 12(4), 795–804. https://doi.org/10.1007/s40617-019-00382-1
Wolf, M. M. (1978). Social validity: The case for subjective measurement or how applied behavior analysis is finding its heart. Journal of Applied Behavior Analysis, 11(2), 203–214. https://doi.org/10.1901/jaba.1978.11-203
Author information
Authors and Affiliations
Corresponding author
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Footnotes 1.Here we are referring to ABA services for ABA therapy.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Hernandez, C.D., Williams Awodeha, N.F. & Cameron, M.J. Culture and Language Inclusion in the Practice of Applied Behavior Analysis: Next Steps for Improving Outcomes for Autistic Clients. Behav Analysis Practice 16, 1280–1289 (2023). https://doi.org/10.1007/s40617-023-00791-3
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40617-023-00791-3