Cultural Adaptations to Parent-Mediated Autism Spectrum Disorder Interventions for Latin American Families: A Scoping Review

Abstract

Purpose: This scoping review maps research in parent-mediated autism spectrum disorder interventions culturally adapted for Latin American populations, to provide an overview of the available evidence across perspectives and disciplines and to identify gaps in the research knowledge base. Method: A systematic search for relevant articles was conducted using six databases and archival and forward hand searches of articles that met inclusion criteria. Titles and abstracts were reviewed by three authors, followed by full-text reviews of remaining articles. Twenty-one articles met inclusion criteria and were retained for data extraction. The ecological validity framework was used to frame data analysis and results. Results: In total, 19 studies described unique implementations of 16 different interventions, which spanned 21 articles, representing a range of study designs and implementing a variety of adaptations. Most adaptations consisted of surface-structure changes, spanning the dimensions of language, concepts, methods, context, and persons. Few articles were identified that described international studies or studies examining direct parent-mediated strategies with large sample sizes and strong methodological designs. Conclusions: Several intervention adaptations that have potential for clinical utility are presented. Clinicians working with Latin American families are encouraged to discuss potential adaptations openly with families before choosing and implementing specific strategies.

Examining Cultural and Linguistic Sensitivity of Pathways Early Autism Intervention with Hispanic Families

“…Only a handful of parent-mediated early autism interventions have been adapted or developed for use with Hispanic families experiencing low income, and few employ an NDBI model (DuBay, 2022 ; Magaña et al, 2021 ). However, previous research concerning cultural disparities associated with early autism intervention suggests that parent-mediated NDBIs for young Hispanic autistic children have the potential to address contextual, linguistic, and cultural barriers that impede access to intervention (Ferguson & Vigil, 2019 ; Magaña et al, 2021 ; Singh & Bunyak, 2019 ).…”

“…Furthermore, interventions delivered in Spanish with Spanish-speaking families may reduce language barriers and feelings of isolation imposed when there is a language mismatch between the interventionist and the family (Magaña et al, 2021 ; Singh & Bunyak, 2019 ). Finally, cultural mistrust may emerge when interventionists from the majority culture advise families from non-majority cultures to speak English as the majority status language (Dubay, 2022 ; Lim et al, 2018 ; Yu, 2013 ). Such majority language bias contradicts the emerging consensus that exposure to heritage language is favorable (Paradis et al, 2011 ; Yu, 2013 ) and may be necessary for developing cognitive skills when parents are uncomfortable or have little command of the majority status language (Winsler et al, 2014 ).…”

“…As stated above, very few parent-mediated NDBIs for young autistic children have been adapted or developed for Hispanic families experiencing low income (Dubay, 2022 ). Two recent randomized control trials (RCTs) evaluated Pathways Early Autism Intervention (Pathways) NDBI using non-overlapping samples within which Hispanic families constituted 49% of participants, whereas the remaining participants included 23% Asian, 19% White, and 9% African American families (Rollins et al, 2021 ; Rollins & De Froy, 2023 ).…”

Preliminary Outcomes and Adaptation of an NDBI for Spanish-Speaking Families

“…Cultural values include a collective set of beliefs, behaviors, ideas, philosophies, and practices shared by groups of people. Recognizing that we all have and represent a culture is a critical component of clinical practice (American Speech-Language-Hearing Association [ASHA], 2017), and yet research aiming to culturally adapt existing autism evidence-based practices or to develop new culturally and linguistically informed programs is still largely in its infancy (e.g., DuBay, 2022;Magaña et al, 2021;Xu et al, 2022).…”

“…In a review of 19 studies of autism parent-mediated interventions (including NDBIs) delivered to culturally and linguistically diverse families, most interventions were noted to include surface-level adaptations-including a direct translation of the intervention language and materials and consideration of the metaphors used in the program (DuBay, 2022). Few studies examined deeper intervention adaptations by considering the alignment of intervention goals to cultural norms and values or by understanding the extent to which intervention content was culturally responsive to SS Latinx families (DuBay, 2022).…”