Comparing Methods to Increase Participation in Spanish Language ASD Parent Training

Background:  Training in Applied Behavior Analysis for parents of children with ASD can be a critical support for both parents and their children (Bearss, Johnson, Smith, Lecavalier, & Swiezy, 2015). Parent trainings have been shown to be effective in helping improve problem behavior (Bearss et al., 2015), reducing feeding issues and parental stress (Sharp, Burrell, & Jaquess, 2014), and increasing children’s skill generalization across settings (Ingersoll & Dvortcsak, 2006). Unfortunately, however, these trainings are not often well attended, and programs in Spanish have been even less frequently examined.

Objectives:  The current study seeks to compare two methods for engaging participants in a parent training intervention program conducted in Spanish, for Spanish-speaking parents of school-aged children with ASD.

Methods:  This study was conducted at a clinical site where 75% of families were exclusively Spanish-speaking. Twenty families were recruited who had at least one child with ASD, aged 6-8 years old. Seventeen families ultimately participated in the training program in two separate group models (n=9 in model 1 and n=8 in model 2). In the first model, the interventionist assessed all families, and the intervention included 6 group sessions, followed by 4 individual sessions. In the second model, separate staff assessed families, and the intervention included 4 group sessions, followed by 4 individual sessions. Content was the same in both models, and focused on teaching ABA terms, strategies, and application for issues with their own children. Families completed both parent and child measures before the training began (Vineland-II, Aberrant Behavior Checklist, Parent Stress Inventory, Home-Situations Questionnaire, etc.), including a diagnostic evaluation (ADOS-2 and KBIT-2) with their child. Throughout the intervention, ABC data and parent implementation efforts were recorded, and parents repeated the self-report surveys at the end of the training.

Results:  Participating children had a variety of behavioral challenges, and each family who attended sessions consistently (in either model) successfully collected information on their child’s behavior, and reported changes in their use of strategies and reduction in their child’s behavior as a result. Parent engagement was significantly higher in the first model (6 group and 4 individual sessions) at 84.6% than in the second model (4 group and 4 individual sessions) at 43.8%. Cultural adaptations to the intervention were needed to increase participation in both models, including offering childcare, dinner for participants and children, and extending time for social engagement, but more relationship building opportunities were included in the first model.

Conclusions:  It is important to include relationship building opportunities before and throughout parent training interventions, especially for Spanish speaking families with children with ASD. The shorter number of group sessions in model 2 hindered the development of parent-to-parent and parent-to-interventionist relationships that appeared to support attendance in model 1. In this particular population, there was a wide variety of parent knowledge and advocacy, which is increasingly difficult with the language barrier. Having peer and interventionist support beyond the curriculum were critical pieces of the intervention delivery.