Reducing Disparities for Latinx Children with ASD and Their Families: Evidence from a Two-Site RCT Study at 8-Month Follow up

Background and Purpose: Latinx children with Autism Spectrum Disorder (ASD) experience persistent disparities in diagnosis and services, compared to their non-Latino counterparts (Liptak et al, 2008). Parents Taking Action (PTA), a culturally tailored parent education intervention program, was developed to address such disparities. A two-site randomized waitlist-control study was implemented between 2014-2017 to examine the efficacy of the intervention in empowering Latinx mothers of children with ASD. Previous analyses showed significant treatment effects: mothers in the intervention group had significantly higher confidence and frequency of using evidence-based (EB) strategies; children with ASD also showed significant improvements in social communication and use of EB services (Magaña et al, 2020). The purpose of this study is to understand whether the intervention effects are maintained from baseline to third follow-up.

Methods: 96 (intervention: N=42, control: N=54) Latina mothers of children with ASD aged 8 years or younger from two large cities were enrolled in the RCTs and completed the second follow-up survey (8 months after baseline 4 months after intervention). To discern if the treatment effects sustained across different time points, we conducted repeated measures ANCOVA for outcomes with time, treatment, and an interaction term time*treatment in all models. T3 and the control group served as the reference categories. Maternal education was adjusted for since it was the only significant between-group demographic variable. The following parent outcomes were examined: confidence in and use of EB strategies, and the family outcomes scale (FOS). Child outcomes included social communication questionnaire (SCQ) scores, number of current typical services, and number of current evidence-based services.

Findings: Consistent with findings in the original study, we found that treatment effects were carried through from baseline (T1) to the second follow-up (T3). Compared to their control group counterparts. Mothers in the treatment group on average scored 2.3 points (p=.03, 95% CI=[.2, 4.3]) higher in the confidence in using EB strategies scale, and 2.9 points (p=.04, 95% CI=[.2, 5.5]) higher in the frequency of using EB strategies scale. There were significant positive changes in child outcomes, including numbers of typical and EB services for children whose mothers received intervention. On average, children of mothers from the treatment group received 1.3 additional combined typical and EB services (p<.01, 95% CI=[.5, 2.0]) at follow-up (T3). There were no significant differences in the FOS scale and the child’s SCQ scores.

Conclusion and implications: The results of this study demonstrated the effects overtime of PTA, a culturally tailored intervention for Latinx mothers of children with ASD. Overall, Latinx mothers in the intervention group showed significant improvements in their confidence in and use of EB strategies for their children with ASD, and the children with ASD showed significant increases in receipt of both typical and EB services compared to the control group, at follow-up four months after intervention. This study demonstrates that outcomes from a culturally tailored approach to autism intervention can be maintained and can be utilized to address disparities in advocacy and services for racial/ethnic minority children with ASD and their families.