Randomized Control Trial of a Two-Site Study of a Psychoeducational Program for Latino Parents of Children with Autism Spectrum Disorder

Background and Purpose: Prevalence of Autism Spectrum Disorder (ASD) among Latino children has increased dramatically over the past decade and research has documented substantial disparities in treatments and services among Latino children with ASD compared to White children. To reduce disparities for Latino children with ASD, Parents Taking Action (PTA), a culturally informed psychoeducation program, was developed. PTA is based on an ecological validity model, which addresses specific dimensions of culture in the development of interventions. PTA is a 14-week program delivered by promotoras de salud (community health workers). Promotoras are bilingual Latina mothers of children with ASD who were been identified as active members in their community.  PTA content informs parents about ASD and their child’s rights, and teaches parents evidenced-based (EB) strategies grounded in applied behavior analysis to use with their children. The purpose of the study was to test the efficacy of PTA with respect to parent outcomes (utilizing EB strategies, family empowerment), and child outcomes (reduction of symptoms, increase in service use).

Methods: Participants included 110 mother/child dyads recruited from Illinois and California. Children were reported to have a diagnosis of or be at risk for ASD. Following a baseline assessment, dyads were randomly assigned to a treatment group or a waitlist control group. Those in treatment group (mothers mean age 37.3, SD=6.0; children mean age 5.3, SD=1.8) received PTA along with two follow-up assessments (after completing the program and 4 months later). The waitlist control group (mothers’ mean age 36.2, SD=6.5; children mean age 5.8, SD=1.9) was offered the PTA program after completing two follow-up assessments (4 and 8 months post-baseline). Measures included the Social and Communication Questionnaire (SCQ), Child Service Use, Family Outcome Survey (FOS), and measures specific to the study, Efficacy in using EB Strategies and Frequency of using the EB Strategies. Findings reported in this abstract are from baseline and time two data. Linear mixed effects models were used to assess the significance of intervention group, covarying for severity of ASD symptoms, child age group (2-5 and 6-8 years), study site (CA and IL), number of services received at baseline, and a time by intervention group interaction in explaining variations in child and parent outcomes. 

Results: for child outcomes, we found that the treatment group had reduced SCQ scores at time 2 (lower score = less impairment), and increased in the use of evidenced-based services compared to the waitlist control group. For parent outcomes, we found an increase in Efficacy in using Strategies and Frequency in Using Strategies for the treatment group compared to the control. We did not find a treatment effect for the FOS. 

Conclusions and Implications: The results show that PTA is a culturally informed program for Latino families that enhances parents’ abilities to apply evidenced based strategies with their children, which can lead to enhanced social communication skills among children. Future research will examine sustainability of the program, and adaptation of the program for other underserved communities.