Parents Taking Action: A Psycho‐Educational Intervention for Latino Parents of Children With Autism Spectrum Disorder

• Published date: 01 March 2017
• Date: 01 March 2017
• Author: Wendy Machalicek,Kristina Lopez,Sandra Magaña
• DOI: http://doi.org/10.1111/famp.12169

Parents Taking Action: A Psycho-Educational

Intervention for Latino Parents of Children With

Autism Spectrum Disorder

SANDRA MAGAN

˜A

*

KRISTINA LOPEZ

†

WENDY MACHALICEK

‡

The increased prevalence of autism spectrum disorder (ASD) among Latino children,

later diagnosis, limited access to bicultural specialist support, and worsened health out-

comes when compared to non-Latinos points to the need for a culturally relevant parent

education intervention. This pilot study examined the feasibility, acceptability, and prelim-

inary outcomes of a culturally derived intervention, Parents Taking Action, for 19 Span-

ish-speaking mothers of children with ASD. This study introduces the Promotora de Salud

Model of intervention delivery to the autism field. A mixed-methods design including one

group pre- and posttest design and focus groups was used to evaluate the outcomes of PTA.

We found that the intervention was both feasible to implement and acceptable to partici-

pants. We also found significant increases in empowerment oriented outcomes for paren ts

between pre- and posttest suggesting that the intervention is promising. Suggestion s for

future research and practice are offered.

Keywords: Autism; Culture; Latino; Parent education; Promotora

Fam Proc 56:59–74, 2017

Latinos represent the largest ethnic minority population in the United States (Patten,

2012) and are one of the fastest growing autism populations (Center for Disease Con-

trol and Prevention [CDC], 2012). The prevalence of autism spectrum disorder (ASD)

among Latino children increased by 110% between 2002 and 2008, compared with a 70%

increase for White children (CDC, 2012). Recent studies also show that Latino childr en

with ASD or another developmental disability, compared to White children, have a consis-

tent pattern of worse health care access, utilization, and quality (Parish, Magan

˜a, Rose,

Timberlake, & Swaine, 2012). Additionally, Latino children are more likely to be diag-

nosed later and are less likely than White children to receive specialty autism services

including Applied Behavior al Analysis (ABA)-based interventions (Liptak et al., 2008;

Magan

˜a, Lopez, Aguinaga, & Morton, 2013; Mandell et al., 2009; Palmer, Walker,

Mandell, Bayles, & Miller, 2010). Furthermore, a needs assessment found that the

*Department of Disability and Human Development, University of Illinois at Chicago, Chicago, IL.

†

School of Social Work, California State University, Long Beach, CA.

‡

Department of Special Education and Clinical Sciences, University of Oregon, Eugene, OR.

Correspondence concerning this article should be addressed to Sandra Magan

˜a, Department of Disabil-

ity and Human Development, University of Illinois at Chicago, 1640 W Roosevelt Road, Chicago, IL

60608. E-mail: maganas@uic.edu

Support for this study was provided by the University of Wisconsin Institute for Clinical and Transla-

tional Research (NIH 1UL1RR025011), and The Illinois Autism Program (TAP). We especially thank our

community partners, promotoras, and participants.

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Family Process, Vol. 56, No. 1, 2017 ©2015 Family Process Institute

doi: 10.1111/famp.12169

majority of Latino families surveyed needed more information about autism and helping

their child, more formal and informal social support, and more financial support (Iland,

Weiner, & Murawski, 2012). Therefore, there is a growing need for the development of

effective, affordable, and culturally appropriate interventions for Latino children with

ASD and their families.

In the current paper, we describe a culturally derived psycho-educational parent educa-

tion intervention, Parents Taking Action (PTA), and present results of a pilot study that

examined the feasibility, acceptability, and preliminary outcomes of the PTA intervention

when implemented with Latino immigrant mothers of children with ASD.

PARENT TRAINING AND ASD

Recent systematic reviews show that parent training programs are considered to be an

effective evidence-based intervention for children with ASD, especially in conjunction with

traditional autism therapies (Matson, Mahan, & Matson, 2009). Research has shown that

parents and caretakers are the most effective primary interventionists because they spend

more time with their children than professional clinicians (McConachie & Diggle, 2007).

Because of their unparalleled access to their children, parents are better able to reinforce

positive behaviors as they occur and maintain treatment gains over time. In addition, par-

ents and caregivers are able to help children generalize skills learned in clinical and school

sessions to other settings, including the home and community. Furthermore, there is an

increasing need for cost-efficient interventions for ASD as the prevalence of ASD contin-

ues to rise, and researchers are relying more and more on parent training as an affordable

intervention (Steiner, Koegel, Koegel & Ence, 2012).

Most research on parent training as an intervention tool for children with ASD has

focused on middle or higher income intact families (Matson et al., 2009). The current body

of research lacks much needed studies focusing on parent training for low-income parents

of children with ASD and parents of different racial, ethnic, and cultural backgrounds.

The field would benefit from studies that evaluate parent training as an effective interven-

tion for a distinct and growing population, Latino immigrant families of children with

ASD. Existing autism parent training programs including those described in Matson

et al.’s review do not address the specific needs of Latino immigrant families, who often

lack basic information about disability, autism, services and treatments, and advocacy

(Iland et al., 2012; Lopez, 2014; Magan

˜a et al., 2013). Therefore, we decided to create a

program that addresses the specific needs of Latino immigrant families rather than trans-

lating an existing intervention into Spanish.

CULTURALLY ADAPTED OR DERIVED INTERVENTIONS WITH LATINO FAMILIES

In fact, a growing body of literature suggests the importance of taking the linguistic,

contextual, and cultural backgrounds of the target population into consideration when

developing interventions (Castro, Barrera, & Holleran Steiker, 2010; Parra Cardona

et al., 2012; Valdez, Abegglen, & Hauser, 2013; Vald ez, Padilla, Moore, & Magan

˜a, 2013).

Given the influence of family culture on caregiver knowledge, acceptance, and utilization

of interventions (Lopez, 2014; Snowden, Hu, & Jerrell, 1995), a parent education program

should consider cultural factors to be successful.

The Ecological Validity Framework (Bernal, Bonilla, & Bellido, 1995; Bernal, Jim 

enez-

Chafey, & Rodr

ıguez, 2009) outlines an eight-dimensional framework of adaptations for

interventions to enhance their ecological validity within the Latino population. The frame-

work serves as a foundation to adapt or develop culturally sensitive treatment or interven-

tions. According to Bernal and colleagues, culture, meaning, and context are critical

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