Abstract
Culturally and linguistically diverse (CLD) families of autistic children face unique challenges in accessing services that are appropriate for their cultures and languages. The purpose of the current study was to evaluate the impact of training language on caregiver skill acquisition. Using behavioral skills training (BST) through telehealth, three Latino caregivers whose first language is Spanish were taught to implement two different behavioral protocols with their autistic children. For one protocol, BST was done in Spanish; for the other, BST was done in English. Overall, the training in each family’s first language was (1) more efficient at promoting the skill acquisition of both caregivers and children; (2) rated by caregivers as more socially valid, and (3) associated with higher levels of caregivers’ indices of personalismo, involvement, and happiness. Findings suggest that cultural adaptations may be necessary to provide more effective and enjoyable training for CLD families.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Data Availability
The present study was pre-registered on Open Science Framework (Vargas Londono et al., 2020). All the datasets generated during the current study, and supplementary materials (i.e., trainer’s treatment integrity score sheet, social acceptability questionnaire) for this study can be found on Texas Data Repository (Vargas Londono, 2021).
References
American Psychiatric Association. (2013). Diagnostic and statistical manual for mental disorders (5th ed.). American Psychiatric Association. https://doi.org/10.1176/appi.books.9780890425596
Antezana, L., Scarpa, A., Valdespino, A., Albright, J., & Richey, J. A. (2017). Rural trends in diagnosis and services for autism spectrum disorder. Frontiers in Psychology, 8, 590. https://doi.org/10.3389/fpsyg.2017.00590
Baer, D. M., Wolf, M. M., & Risley, T. R. (1968). Some current dimensions of applied behavior analysis. Journal of Applied Behavior Analysis, 1(1), 91–97. https://doi.org/10.1901/jaba.1968.1-91
Baires, N. A., Cañón, L. F., García-Zambrano, S., Guerrero-Wickham, P., & Castro-Hostetler, M. (2023). A contextual behavioral framework for enhancing cultural responsiveness in behavioral service delivery for Latino families. Behavior Analysis in Practice, 16, 938–962. https://doi.org/10.1007/s40617-023-00788-y
Barrera, J., Castro, F., Strycker, L., & Toobert, D. (2013). Cultural adaptations of behavioral health interventions: A progress report. Journal of Consulting & Clinical Psychology, 81(2), 196–205. https://doi.org/10.1037/a0027085
Bazzano, A., Wolfe, C., Zylowska, L., Wang, S., Schuster, E., Barrett, C., & Lehrer, D. (2015). Mindfulness based stress reduction (MBSR) for parents and caregivers of individuals with developmental disabilities: A community-based approach. Journal of Child & Family Studies, 24(2), 298–308. https://doi.org/10.1007/s10826-013-9836-9
Beeber, L., Holditch-Davis, D., Perreira, K. A., Schwartz, T., Lewis, V., Blanchard, H., Canuso, R., & Goldman, B. (2010). Short-term in-home intervention reduces depressive symptoms in Early Head Start Latina mothers of infants and toddlers. Research in Nursing & Health, 33(1), 60–76. https://doi.org/10.1002/nur.20363
Behavior Analyst Certification Board. (2020). Ethics code for behavior analysts. https://bacb.com/wp-content/ethics-code-for-behavior-analysts/
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, 67–82. https://doi.org/10.1007/BF01447045
Black, M. E., & Therrien, W. J. (2018). Parent training programs for school-age children with autism: A systematic review. Remedial & Special Education, 39(4), 243–256. https://doi.org/10.1177/0741932517730645e
Booth, C., & Lazear, K. (2015). Cultural adaptations. The cultural and linguistic competence (CLC) Hub of the technical assistance network for children’s behavioral health (pp. 1–7). http://cfclinc.org/wp-content/uploads/2018/10/CLC-Research-Brief-1-DRAFT6.pdf
Brislin, R. (1970). Back-translation for cross-cultural research. Journal of Cross-Cultural Psychology, 1(3), 185–216. https://doi.org/10.1177/135910457000100301
Brodhead, M., Durán, L., & Bloom, S. (2014). Cultural and linguistic diversity in recent verbal behavior research on individuals with disabilities: A review and implications for research and practice. Analysis of Verbal Behavior, 30(1), 75–86. https://doi.org/10.1007/s40616-014-0009-8
Casey, A. M., & McWilliam, R. A. (2008). Graphical feedback to increase teachers’ use of incidental teaching. Journal of Early Intervention, 30(3), 251–268. https://doi.org/10.1177/1053815108319038
Castro, F. G., Barrera, M., & Martinez, C. R. (2004). The cultural adaptation of prevention interventions: Resolving tensions between fidelity and fit. Prevention Science, 5(1), 41–45. https://doi.org/10.1023/B:PREV.0000013980.12412.cd
Castro-Hostetler, M., Kille, I., Lopez, L. V., & Contreras, B. P. (2022). Understanding the role of cultural values in ABA service delivery: Perspectives from Latino families. Behavior & Social Issues, 32, 210–233. https://doi.org/10.1007/s42822-022-00115-0
Ceballos, P. L., & Bratton, S. C. (2010). Empowering Latino families: Effects of a culturally responsive intervention for low-income immigrant Latino parents on children’s behaviors and parental stress. Psychology in the Schools, 47(8), 761–775. https://doi.org/10.1002/pits.20502
Chlebowski, C., Magaña, S., Wright, B., & Brookman-Frazee, L. (2018). Implementing an intervention to address challenging behaviors for autism spectrum disorder in publicly-funded mental health services: Therapist and parent perceptions of delivery with Latinx families. Cultural Diversity & Ethnic Minority Psychology, 24(4), 552–563. https://doi.org/10.1037/cdp0000215
Cooper, J. O., Heron, T. E., & Heward, W. L. (2007). Applied behavior analysis (2nd ed.). Pearson.
Dennison, A., Lund, E., Brodhead, M., 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(4), 887–898. https://doi.org/10.1007/s40617-019-00374-1
Ding, Y., Cho, S., Wang, J., & Yu, Q. (2019). Training of bilingual school psychologists in the United States: A culturally and linguistically responsive approach. School Psychology International, 40(3), 235–250. https://doi.org/10.1177/0143034319827347
Fisher, W., Luczynski, K., Blowers, A., Vosters, M., Pisman, M., Craig, A., Hood, S., Machado, M., Lesser, A., & Piazza, C. (2020). A randomized clinical trial of a virtual-training program for teaching applied-behavior-analysis skills to parents of children with autism spectrum disorder. Journal of Applied Behavior Analysis, 53(4), 1856–1875. https://doi.org/10.1002/jaba.778
Forehand, R., & Kotchick, B. A. (2016). Cultural diversity: A wake-up call for parent training – republished article. Behavior Therapy, 47(6), 981–992. https://doi.org/10.1016/j.beth.2016.11.010(Originalworkpublished1996)
Gabel, S. (2010). The integration of mental health into pediatric practice: Pediatricians and child and adolescent psychiatrists working together in new models of care. Journal of the Pediatrics, 157(5), 848–851.
Green, C. W., & Reid, D. H. (1996). Defining, validating, and increasing indices of happiness among people with profound multiple disabilities. Journal of Applied Behavior Analysis, 29(1), 67–78. https://doi.org/10.1901/jaba.1996.29-67
Griner, D., & Smith, T. (2006). Culturally adapted mental health intervention: A meta-analytic review. Psychotherapy, 43(4), 531–548. https://doi.org/10.1037/0033-3204.43.4.531
Horn, B. P., Barragan, G. N., Fore, C., & Bonham, C. A. (2016). A cost comparison of travel models and behavioural telemedicine for rural, Native American populations in New Mexico. Journal of Telemedicine & Telecare, 22(1), 47–55. https://doi.org/10.1177/1357633X15587171
Heward, W. L. (1978, May). The delayed multiple baseline design. Paper presented at the Fourth Annual Convention of the Association for Behavior Analysis.
Jackson, L., Little, S., & Akin-Little, A. (2013). The Spanish adaptation of the Gilliam Autism Rating Scale-2: Translation and psychometric analysis. Research in Autism Spectrum Disorder, 7(9), 1160–1167. https://doi.org/10.1016/j.rasd.2013.06.005
Kelley, E., Yarrington, C., Calderwood, L., Torrey Sosa, L., & Connors, P. (2020). The importance of personalismo: Navigating obstacles in recruitment strategies for Spanish speakers in marginalized communities. Journal of Genetic Counseling, 29(3), 391–398. https://doi.org/10.1002/jgc4.1240
Lakes, K. D., Kettler, R. J., Schmidt, J., Haynes, M., Feeney-Kettler, K., Kamptner, L., Swanson, J., & Tamm, L. (2009). The CUIDAR early intervention parent training program for preschoolers at risk for behavioral disorders: An innovative practice for reducing disparities in access to service. Journal of Early Intervention, 31(2), 167–178. https://doi.org/10.1177/1053815109331861
Leach, D., & Conto, H. (1999). The additional effects of process and outcome feedback following brief in-service teacher training. Educational Psychology, 19(4), 441–462. https://doi.org/10.1080/0144341990190405
Leijten, P., Raaijmakers, M. A. J., Orobio de Castro, B., Van Den Ban, E., & Matthys, W. (2017). Effectiveness of the incredible years parenting program for families with socioeconomically disadvantaged and ethnic minority backgrounds. Journal of Clinical Child & Adolescent Psychology, 46(1), 59–73. https://doi.org/10.1080/15374416.2015.1038823
Lerman, D., Valentino, A., & LeBlanc, L. (2016). Discrete trial training. In R. Lang, T. Hancock, & N. Singh (Eds.), Early intervention for young children with autism spectrum disorder (pp. 47–83). Springer International. https://doi.org/10.1007/978-3-319-30925-5_3
Li, A., Wallace, L., Ehrhardt, K., & Poling, A. (2017). Reporting participant characteristics in intervention articles published in five behavior-analytic journals, 2013–2015. Behavior Analysis, 17(1), 84–91. https://doi.org/10.1037/bar0000071
Lim, N., O’Reilly, M., Sigafoos, J., Lancioni, G. E., & Sanchez, N. J. (2020). A review of barriers experienced by immigrant parents of children with autism when accessing services. Review Journal of Autism & Developmental Disorders, 8, 366–372. https://doi.org/10.1007/s40489-020-00216-9
Lim, N., O’Reilly, M., Vargas Londono, F., & Russell-George, A. (2020). Overcoming language barriers between interventionists and immigrant parents of children with autism spectrum disorder. Journal of Autism & Developmental Disorders, 51, 2876–2890. https://doi.org/10.1007/s10803-020-04754-3
Lopez, K. (2014). Socio-cultural perspectives of Latino children with autism spectrum disorder. Best Practices in Behavioral Mental Health, 10(2), 15–31.
López, C. M., Davidson, T. M., & Moreland, A. D. (2018). Reaching Latino families through pediatric primary care: Outcomes of the CANNE parent training program. Child & Family Behavior Therapy, 40(1), 26–39.
Maenner M.J ., Warren Z., Williams A. R., Amoakohene, E., Bakian, A. V., Bilder, D. A., Durkin, M. S., Fitzgerald, R. T., Furnier, S. M., Huhues, M. M., Ladd-Acosta, C. M., McArthur, D., Pas E. T., Salinas, A., Vehorn, A., Williams, S., Esler, A., Grzybowski, A., Hall-Lande, J., Ngyyen, R. H. N., ..., Shaw, K. A. (2023). Prevalence and characteristics of autism spectrum disorder among children aged 8 years—Autism and Developmental Disabilities Monitoring Network, 11 sites, United States, 2020. Morbidity & Mortality Weekly Report, 72(No. SS-2), 1–14. https://doi.org/10.15585/mmwr.ss7202a1
Magaña, S., Lopez, K., Salkas, K., Iland, E., Morales, M., Garcia Torres, M., Zeng, W., & Machalicek, W. (2019). A randomized waitlist-control group study of a culturally tailored parent education intervention for Latino parents of children with ASD. Journal of Autism & Developmental Disorders, 50(1), 250–262. https://doi.org/10.1007/s10803-019-04252-1
Marcus, A., Sinnott, B., Bradley, S., & Grey, I. (2010). Treatment of idiopathic toe-walking in children with autism using GaitSpot auditory speakers and simplified habit reversal. Research in Autism Spectrum Disorders, 4(2), 260–267. https://doi.org/10.1016/j.rasd.2009.09.012
Marian, V., Blumenfeld, H., & Kaushanskaya, M. (2007). The Language Experience and Proficiency Questionnaire (LEAP-Q): Assessing language profiles in bilinguals and multilinguals. Journal of Speech, Language, & Hearing Research, 50(4), 940–967. https://doi.org/10.1044/1092-4388(2007/067)
Martin, N., & Brownell, R. (2010). Receptive one-word picture vocabulary test (4th ed.). Academic Therapy Publications.
Mitchell, C. (2016). Need for bilingual educators moves school recruitment abroad. Education Week, 35(17). https://www.edweek.org/ew/articles/2016/01/27/need-for-bilingual-educators-moves-school-recruitment.html
National Research Council. (2001). Educating children with autism. Committee on Educational Interventions for Children with Autism. Division of Behavioral and Social Sciences and Education. National Academy Press. https://books.google.com/books?hl=en&lr=&id=eyJoMzxTMnkC&oi=fnd&pg=PT15&dq=National+Research+Council.+(2001).+Educating+children+with+autism.+Committee+on+Educational+Interventions+for+Children+with+Autism.+Division+of+Behavioral+and+Social+Sciences+and+Education.+Washington
Olle Jane, S. Z., Dolgin, M. J., Phipps, S., Fairclough, D. L., Askins, M. A., Katz, E. R., & Butler, R. W. (2013). Specificity of problem-solving skills training in mothers of children newly diagnosed with cancer: Results of a multisite randomized clinical trial. Journal of Clinical Oncology, 31(1), 1329–1335. https://doi.org/10.1200/JCO.2011.39.1870
Pepperdine, C., & McCrimmon, A. (2018). Test Review: Vineland Adaptive Behavior Scales, Third Edition (Vineland-3) by Sparrow, S. S., Cicchetti, D. V., & Saulnier, C. A [Review of Test Review: Vineland Adaptive Behavior Scales, Third Edition (Vineland-3) by Sparrow, S. S., Cicchetti, D. V., & Saulnier, C. A,]. Canadian Journal of School Psychology, 33(2), 157–163. https://doi.org/10.1177/0829573517733845. Sage.
Pumariega, A., Rothe, E., & Pumariega, J. (2005). Mental health of immigrants and refugees. Community Mental Health Journal, 41(5), 581–597. https://doi.org/10.1007/s10597-005-6363-1
Puskin, D., Johnston, B., & Speedie S. (2006). Telemedicine, telehealth, and health information technology: An APA issue paper [.doc file]. Retrieved March 3, 2019, from https://www.who.int/goe/policies/countries/usa_support_tele.pdf.
Ramey, D., Healy, O., & McEnaney, E. (2022). Defining and measuring indices of happiness and unhappiness in children diagnosed with autism spectrum disorder. Behavior Analysis in Practice, 16, 194–209. https://doi.org/10.1007/s40617-022-00710-y
Ruppert, T., Machalicek, W., Hansen, S., Raulston, T., & Frantz, R. (2016). Training parents to implement early interventions for children with autism spectrum disorders. In R. Lang, T. Hancock, & N. Singh (Eds.), Early intervention for young children with autism spectrum disorder (pp. 219–256). Springer International. https://doi.org/10.1007/978-3-319-30925-5_8
Sindelar, P. T., Rosenberg, M. S., & Wilson, R. J. (1985). An adapted alternating treatment design for instructional research. Education & Treatment of Children, 8(1), 67–76.
Singer-Dudek, J., Oblak, M., & Greer, R. D. (2011). Establishing books as conditioned reinforcers for preschool children as a function of an observational intervention. Journal of applied behavior analysis, 44(3), 421–434. https://doi.org/10.1901/jaba.2011.44-421
Son, E., Magaña, S., Pedraza, F., & Parish, S. (2020). Providers’ guidance to parents and service use for Latino children with developmental disabilities. American Journal on Intellectual & Developmental Disabilities, 125(1), 64–75. https://doi.org/10.1352/1944-7558-125.1.64
Sparrow, S. S., Cicchetti, D. V., & Saulnier, C. A. (2016). Vineland Adaptive Behavior Scales (3(Vineland-3)). Pearson.
St. Amant, H. G., Schrager, S. M., Peña-Ricardo, C., Williams, M. E., & Vanderbilt, D. L. (2018). Language barriers impact access to services for children with autism spectrum disorders. Journal of Autism & Developmental Disorders, 48(2), 333–340. https://doi.org/10.1007/s10803-017-3330-y
Stone, W., Ousley, O., & Littleford, C. (1997). Motor imitation in young children with autism: What’s the object? Journal of Abnormal Child Psychology, 25(6), 475–485. https://doi.org/10.1023/A:1022685731726
Sump, L., Richman, D., Schaefer, A., Grubb, L., & Brewer, A. (2018). Telehealth and in-person training outcomes for novice discrete trial training therapists. Journal of Applied Behavior Analysis, 51(3), 466–481. https://doi.org/10.1002/jaba.461
Thomas, B., Charlop, M., Lim, N., & Gumaer, C. (2019). Measuring happiness behavior in functional analyses of challenging behavior for children with autism spectrum disorder. Behavior Modification, 45(3), 502–530. https://doi.org/10.1177/0145445519878673
Tommeras, T., & Kjobli, J. (2017). Family resources and effects on child behavior problem interventions: A cumulative risk approach. Journal of Child & Family Studies, 26(10), 2936–2947.
Tsami, L., Lerman, D., & Toper-Korkmaz, O. (2019). Effectiveness and acceptability of parent training via telehealth among families around the world. Journal of Applied Behavior Analysis, 52(4), 1113–1129.
Van Houten, R., Axelrod, S., Bailey, J. S., Favell, J. E., Foxx, R. M., Iwata, B. A., & Lovaas, O. I. (1988). The right to effective behavioral treatment. Journal of Applied Behavior Analysis, 21, 381–384. https://doi.org/10.1901/jaba.1988.21-381
Vargas Londono, F. (2021). Effects of training with and without cultural adaptations to Latino caregivers of children with autism. Texas Data Repository. https://doi.org/10.18738/T8/MQME52
Vargas Londono, F., Falcomata, T., Lim, N., Ramirez Cristoforo, A., & Paez, Y. (2020).Effects of training in English or Spanish to Latino caregivers of children with autism. Open Science Framework. https://osf.io/texu6
Wheeler, J., Baggett, B., Fox, J., & Blevins, L. (2006). Treatment integrity: A review of intervention studies conducted with children with autism. Focus on Autism & Other Developmental Disabilities, 21(1), 45–54. https://doi.org/10.1177/10883576060210010601
White, A. G., & Bailey, J. S. (1990). Reducing disruptive behaviors of elementary physical education students with sit and watch. Journal of Applied Behavior Analysis, 23(3), 353–359.
Wingate, M., Kirby, R. S., Pettygrove, S., Cunniff, C., Schulz, E., Ghosh, T., Wright, V., Centers for Disease Control & Prevention. (2014). Prevalence of autism spectrum disorder among children aged 8 years—Autism and Developmental Disabilities Monitoring Network, 11 sites, United States, 2010. Morbidity & Mortality Weekly Report, 63(2), 1–21. https://doi.org/10.15585/mmwr.ss7202a1
Funding
The authors did not receive support from any organization for the submitted work.
Author information
Authors and Affiliations
Contributions
Authors that contributed to the study conception and design are Fabiola Vargas Londono, Terry S. Falcomata and Nataly Lim. Material preparation, and analysis were performed by Fabiola Vargas Londono, and Terry S. Falcomata. Data collection were performed by Fabiola Vargas Londono, Nataly Lim, Andrea Ramirez-Cristoforo, Yuria Paez, and Annabel Garza. The first draft of the manuscript was written by Fabiola Vargas Londono and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
Corresponding author
Ethics declarations
Conflicts of Interest
Fabiola Vargas Londono declares that she has no conflict of interest. Terry S. Falcomata declares that he has no conflict of interest. Nataly Lim declares that she has no conflict of interest. Andrea Ramirez-Cristoforo declares that she has no conflict of interest. Yuria Paez declares that she has no conflict of interest. Annabel Garza declares that she has no conflict of interest.
Ethical Approval
This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of The University of Texas at Austin.
Consent
Informed consent was obtained from all individual participants included in the study.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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
Vargas Londono, F., Falcomata, T.S., Lim, N. et al. Do Cultural Adaptations Matter? Comparing Caregiver Training in Different Language for Latino Caregivers of Autistic Children: A Telehealth-Based Evaluation. Behav Analysis Practice (2024). https://doi.org/10.1007/s40617-024-00930-4
Accepted:
Published:
DOI: https://doi.org/10.1007/s40617-024-00930-4