Cultural and Linguistic Adaptation of an Autism Parent Mediated Intervention for Spanish Speaking Latinos

The Caregiver Skills Training (CST) was developed by the World Health Organization (WHO) to improve access to evidence-based services for children with developmental concerns from low-income backgrounds. While the CST program has undergone four significant revisions to increase feasibility of implementation and has been adapted and implemented in more than 30 countries, currently the Spanish version is outdated and has never been implemented in the U.S. This study aimed to culturally and linguistically adapt the Spanish-version of the CST for a predominantly Spanish-speaking Latino-populated region in the United States. The present study followed a community based participatory research (CBPR) approach and used a phenomenological framework to evaluate the content and cultural appropriateness of the Spanish translation of the CST. Focus groups were conducted with Spanish-speaking and bilingual parents of children with an autism spectrum disorder (ASD) diagnosis to inform potential modifications needed to establish a culturally responsive and linguistically appropriate curriculum. Findings yielded linguistic and environmental adaptations to the program, particularly related to autism labels and common values of Latino culture, such as personalismo. Results also indicated that the overall content of the program was acceptable for the Spanish speaking Latino community. This study highlights the critical role of community engagement. By actively involving stakeholders in the adaptation process, the CST is tailored to reflect the unique cultural values, language preferences, and lived experiences of the community. In doing so, it ensures that the program truly meets their needs, improving efficacy, and reducing attrition.