Feasibility and acceptability of parenting interventions delivered in Spanish to caregivers of children with autism and other developmental delays: a mixed-methods design

Parents of children with autism spectrum disorder (ASD) or developmental delay (DD) experience increased stress due to raising a child with a disability, particularly if the child also presents with challenging behaviors. As such, there is benefit to developing evidence-based interventions that: 1) help parents cope with stress, and 2) manage the challenging behaviors of their children. This is particularly true for underserved groups, including Spanish-speaking Hispanic/Latinx populations, who are often underrepresented in intervention research. Two promising interventions in reducing caregiver stress are psychoeducation/support groups and mindfulness-based stress reduction (MBSR); an intervention effective in reducing child challenging behaviors is Behavioral Parent Training (BPT). This study piloted these three interventions for 60 Spanish-speaking Hispanic caregivers of children with ASD or DD as part of a larger, randomized-controlled trial. We sought to examine the feasibility and acceptability of these interventions both within this Spanish-speaking cohort, and compared to previously run English-speaking cohorts. Additionally, due to unforeseen circumstances of COVID-19, the BPT intervention was modified for telehealth delivery, allowing for initial exploration of the modality for this population. Results from attendance and satisfaction data, as well as participant focus groups, showed that Spanish-speaking participants attended sessions at similar rates and demonstrated preference for psychoeducation/support groups over MBSR compared to English-speaking participants, while finding BPT strategies generally acceptable. Participants reported appreciating the knowledge gained and sense of community established in the psychoeducation/support groups. Implications and future directions, including potential cultural adaptation of materials to maximize participant engagement and buy-in, are discussed

Lessons learned: Engaging culturally diverse families in neurodevelopmental disorders intervention research.

Low-income and ethnic minority families continue to face critical disparities in access to diagnostic and treatment services for neurodevelopmental conditions, such as autism spectrum disorder and attention deficit hyperactivity disorder. Despite the growing cultural diversity of the United States, ethnic minority children and families continue to be substantially underrepresented across research on neurodevelopmental disorders, and there is a particularly concerning lack of research on the treatment of these conditions in low-income and ethnic minority communities. Of note, there are currently no published studies on adapting autism spectrum disorder treatment for low-income Latino communities and relatively few studies documenting adapted treatments for children with attention deficit hyperactivity disorder in these communities. This article describes methodological considerations and adaptations made to research procedures using a Diffusion of Innovation framework in order to effectively recruit and engage low-income, ethnic minority, particularly Latino, families of children with neurodevelopmental disorders, in a comparative effectiveness trial of two school-based interventions for executive dysfunction

Parents matter: Parent acceptance of school-based executive functions interventions relates to improved child outcomes

OBJECTIVES: School-based interventions with parent-training components might improve access among lower-income families to effective help for children with neurodevelopmental disorders. This potential might be realized, however, only if parents perceive the interventions as acceptable and therefore engage with treatment. METHODS: Parents (N = 124) of 3rd-5th grade students diagnosed with Autism Spectrum Disorder or Attention-Deficit/Hyperactivity Disorder rated the acceptability of their child\u27s treatment (one of two culturally responsive behavioral interventions). Parent engagement was measured through attendance at parent training sessions and the extent to which they read a corresponding workbook. RESULTS: Education and income correlated inversely with parent perceptions of treatment acceptability. Acceptability correlated positively with engagement, more strongly among lower-income families. Acceptability had an indirect effect on treatment outcome, mediated by parent engagement. CONCLUSIONS: Treatment providers should focus on strategies to increase parent acceptability, with particular attention to improving access for lower-income families