A Randomized Waitlist-Control Group Study of a Culturally Tailored Parent Education Intervention for Latino Parents of Children with ASD

  • Sandy MagañaEmail author
  • Kristina Lopez
  • Kristen Salkas
  • Emily Iland
  • Miguel Angel Morales
  • Mariana Garcia Torres
  • Weiwen Zeng
  • Wendy Machalicek
Original Paper


This two-site randomized waitlist-control study (n = 96 mother–child dyads) examined the efficacy of a psychoeducation program as compared to usual care to empower Latina mothers and improve their confidence in and use of evidence-based practices (EBPs) for their children with ASD. A secondary aim was to improve child outcomes. Compared to control group, we found significant positive changes in the treatment group in maternal confidence of and frequency in use of EBPs, child social communication and the number of EB services the child received. We found no significant differences for the treatment group in family empowerment or in child challenging behaviors. This RCT presents evidence of an efficacious intervention for Latino children with ASD and their mothers in California and Illinois.


Autism Autism spectrum disorder Latinos Parent education RCT 



This study was funded by grants from the United States Department of Health and Human Services, Administration for Community Living (ACL), National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) Grant # 90IF0072-01-00, and 90RT50320-01-00. However, the content does not necessarily represent the policy of the Department of Health and Human Services (DHHS), and you should not assume endorsement by the Federal Government. This study was also funded by the Illinois Autism Program (TAP).

Author Contributions

SM & WM conceived of the study, developed the intervention content, participated in its design and coordination, and drafted the manuscript. KL participated in the design and coordination and contributed to the manuscript draft; KS participated in the coordination of the study and contributed to the manuscript draft; EL contributed to the intervention content, coordination of the study, and manuscript draft; MM & MGT conducted study analysis, and contributed to coordination of study and manuscript draft; WZ contributed to the manuscript draft and interpretation of results.

Compliance with Ethical Standards

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committees (name of universities withheld for peer review) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


  1. Alegría, M., Pescosolido, B. A., Williams, S., & Canino, G. (2011). Culture, race/ethnicity and disparities: Fleshing out the socio-cultural framework for health services disparities. In B. A. Pescosolido, J. Marin, J. McLeod, & A. Rogers (Eds.), Handbook of the sociology of health, illness, and healing: A blueprint for the 21st century (pp. 363–382). New York: Springer.CrossRefGoogle Scholar
  2. Bailey, D., Hebbeler, K., Olmsted, M., Raspa, M., & Bruder, M. (2008). Measuring family outcomes: Considerations for large-scale data collection in early intervention. Infants & Young Children, 23, 194–206.CrossRefGoogle Scholar
  3. Bearss, K., Johnson, C., Smith, T., Lecavalier, L., Swiezy, N. Aman, M., … Scahill, L. (2015). Effect of parent training vs parent education on behavioral problems in children with autism spectrum disorder: A randomized clinical trial. JAMA, 313, 1524–1533.CrossRefGoogle Scholar
  4. Blacher, J., & McIntyre, L. L. (2006). Syndrome specificity and behavioural disorders in young adults with intellectual disability: Cultural differences in family impact. Journal of Intellectual Disability Research, 50, 184–198.CrossRefGoogle Scholar
  5. Bruininks, R. H., Woodcock, R. W., Weatherman, R. F., & Hill, B. K. (1996). Scales of independent behavior—Revised comprehensive manual. Itasca, IL: Riverside Publishing.Google Scholar
  6. Buzhardt, J., Rusinko, L., Heitzman-Powell, L., Trevino-Maack, S., & McGrath, A. (2016). Exploratory evaluation and initial adaptation of a parent training program for Hispanic families of children with autism. Family Process, 55, 107–122.CrossRefGoogle Scholar
  7. California Health and Human Services. (2017). Consumers with autism spectrum disorder by regional center (CSV). Retrieved from
  8. Carr, T., & Lord, C. (2016). A pilot study promoting participation of families with limited resources in early autism intervention. Research in Autism Spectrum Disorders, 25, 87–96.CrossRefGoogle Scholar
  9. Casillas, N., Vigil, D. C., & Wang, H. T. (2017). Latino and non-Latino White parents’ experiences raising their child with ASD: An exploratory study. The Qualitative Report, 22(8), 2173–2195.Google Scholar
  10. Centers for Disease Control and Prevention. (2018). Spotlight on: Racial and ethnic differences in children identified with autism spectrum disorder (ASD). AADM Network. Retrieved from
  11. Chlebowski, C., Magaña, S., Wright, B., & Brookman-Frazee, L. (2018). Implementing an intervention to address challenging behaviors for autism spectrum disorder in publicly-funded mental health services: Therapist and parent perceptions of delivery with Latino families. Cultural Diversity and Ethnic Minority Psychology, 24(4), 552–563.CrossRefGoogle Scholar
  12. Daniels, A., & Mandel, D. (2014). Explaining difference in age at autism spectrum disorder: A critical review. Autism, 18, 583–597.CrossRefGoogle Scholar
  13. Denney, M. K., Itkonen, T., & Okamoto, Y. (2007). Early intervention systems of care for Latino families and their young children with special needs. Infants and Young Children, 30, 326–335.CrossRefGoogle Scholar
  14. Federal Interagency Forum on Child and Family Statistics. (2012). America’s children: Key national indicators of well-being, 2012, Tables POP1 and POP3. Retrieved from
  15. Fountain, C., & Bearman, P. (2011). Risk as social context: Immigration policy and autism in California. Sociological Forum, 26(2), 215–240.CrossRefGoogle Scholar
  16. Ijalba, E. (2016). Hispanic immigrant mothers of young children with autism spectrum disorders: How do they understand and cope with autism? American Journal of Speech-Language Pathology, 25(2), 1–14.CrossRefGoogle Scholar
  17. Iland, E. D., Weiner, I., & Murawski, W. W. (2012). Obstacles faced by Latina mothers of children with autism. Californian Journal of Health Promotion, 10, 25–36.CrossRefGoogle Scholar
  18. Kasari, C., Lawton, K., Shih, W., Barker, T., Landa, R., Lord, C., … Senturk, D. (2014). Caregiver-mediated intervention for low-resourced preschoolers with autism: An RCT. Pediatrics, 134, e72–e79.CrossRefGoogle Scholar
  19. Koskan, A., Friedman, D., Hilfinger Messias, D., Brandt, H., & Walsemann, K. (2013). Sustainability of promotora initiatives: Program planners’ perspectives. Journal of Public Health Management and Practice, 19, E1–E9.CrossRefGoogle Scholar
  20. Linstead, E., Dixon, D. R., Hong, E., Burns, C. O., French, R., Novack, M. N., et al. (2017). An evaluation of the effects of intensity and duration on outcomes across treatment domains for children with autism spectrum disorder. Translational Psychiatry, 7, 1–6.CrossRefGoogle Scholar
  21. Liptak, G. S., Benzoni, L. B., Mruzek, D. W., Nolan, K. W., Thingvoll, M. A., Wade, C. M., et al. (2008). Disparities in diagnosis and access to health services for children with autism: Data from the National Survey of Children’s Health. Journal of Developmental and Behavioral Pediatrics, 29, 152–160.CrossRefGoogle Scholar
  22. Lopez, K. (2014). Socio-cultural perspectives of Latino children with autism spectrum disorder. Best Practices in Behavioral Mental Health, 10(2), 15–31.Google Scholar
  23. Magaña, S., Lopez, K., Aguinaga, A., & Morton, H. (2013). Access to diagnosis and care among Latino children with ASDs. Intellectual and Developmental Disabilities, 51(3), 141–153.CrossRefGoogle Scholar
  24. Magaña, S., Lopez, K., Paradiso De Sayu, R., & Miranda, E. (2014). Use of promotoras de salud in interventions with Latino families of children with IDD. In R. Hodapp (Ed.) International Review of Research in Developmental Disabilities (Vol. 47, pp. 39-75). IRRDD, UK: Academic Press.Google Scholar
  25. Magaña, S., Parish, S., & Son, E. (2016). Functional severity and Latino ethnicity in specialty services for children with autism spectrum disorder. Journal of Intellectual Disability Research, 60, 424–434.CrossRefGoogle Scholar
  26. Magaña, S., Schwartz, S., Rubert, M., & Szapocznik, J. (2006). Hispanic caregivers of adults with mental retardation: The importance of family functioning. American Journal on Mental Retardation, 111, 250–262.CrossRefGoogle Scholar
  27. Mandell, D., Ittenbach, R. F., Levy, S. E., & Pinto-Marin, J. A. (2007). Disparities in diagnoses received prior to a diagnosis of autism spectrum disorder. Journal of Autism and Developmental Disorders, 37(9), 1795–1802.CrossRefGoogle Scholar
  28. Olmsted, M. G., Bailey, D. B., Raspa, M., Nelson, R., Robinson, N., Simpson, M. E., et al. (2010). Outcomes reported by Spanish-speaking families in early intervention. Topics in Early Childhood Special Education, 30, 46–55.CrossRefGoogle Scholar
  29. Pedersen, A., Pettygrove, S., Meaney, J., Mancilla, B., Gotschall, K., Kessler, D., ...Cunniff, C. (2012). Prevalence of autism spectrum disorders in Hispnaic and non-Hispanic White children. Pediatrics, 129, e629–e635.CrossRefGoogle Scholar
  30. Pickard, K., Kilgore, A., & Ingersoll, B. (2016). Using community partnerships to better understand the barriers to using evidence-based parent-mediated intervention for autism spectrum disorder in a Medicaid system. American Journal of Community Psychology, 57, 391–403.CrossRefGoogle Scholar
  31. Rutter, M., Bailey, A., Lord, C., & Berument, S. K. (2003). Social Communication Questionnaire. Los Angeles, CA: Western Psychological Services.Google Scholar
  32. Schieve, L. A., Boulet, S. L., Blumberg, S. J., Kogan, M. D., Yeargin-Allsopp, M., Boyle, C. A., et al. (2012). Association between parental nativity and autism spectrum disorder among US-born non-Hispanic White and Hispanic children, 2007 National Survey of Children’s Health. Disability and Health Journal, 5(1), 18–25.CrossRefGoogle Scholar
  33. Schopler, E., Van Bourgondien, M. E., Wellman, G. J., & Love, S. R. (2010). Childhood Autism Rating Scale (2nd ed.). Los Angeles, CA: Western Psychological Services.Google Scholar
  34. Tapia, B., Vigil, A., McLendon, J., Martinez, A., & Garza, N. (2016). Evaluation of an autism and developmental milestone promotora training guide as a teaching tool for South Texas Community Health Workers. Texas Public Health Journal, 68(3), 15–19.Google Scholar
  35. Thomas, K., Parish, S., Rose, R., & Kilany, M. (2012). Access to care for children with autism in the context of state Medicaid reimbursement. Maternal and Child Health Journal, 16, 1636–1644.CrossRefGoogle Scholar
  36. United States Census Bureau. (2018). Quick Facts. Available:
  37. Valicenti-McDermott, M., Hottinger, K., Seijo, R., & Shulman, L. (2012). Age at diagnosis of autism spectrum disorders. Journal of Pediatrics, 161, 554–556.CrossRefGoogle Scholar
  38. Vrancic, D., Nanclares, V., Soares, D., Kulesz, A., Mordzinski, C., Plebst, C., et al. (2002). Sensitivity and specificity of the autism diagnostic inventory-telephone screening in Spanish. Journal of Autism and Developmental Disorders, 32, 313–320.CrossRefGoogle Scholar
  39. Welterlin, A., & LaRue, R. H. (2007). Serving the needs of immigrant families of children with autism. Disability & Society, 22(7), 747–760.CrossRefGoogle Scholar
  40. WestRasmus, E. K., Pineda-Reyes, F., Tamez, M., & Westfall, J. M. (2012). Promotora de salud and community health workers: An annotated bibliography. Family Community Health, 35(2), 172–182.CrossRefGoogle Scholar
  41. Zuckerman, K. E., Lindly, O. J., Reyes, N. M., Chavez, A. E., Macias, K., Smith, K. N., et al. (2017). Disparities in diagnosis and treatment of autism in Latino and non-Latino White families. Pediatrics, 139(5), e20163010.CrossRefGoogle Scholar
  42. Zuckerman, K. E., Mattoz, K., Donelan, K., Bathbayar, O., Aghaee, A., & Bethell, C. (2013). Pediatrician identification of Latino children at risk for autism spectrum disorder. Pediatrics, 132(3), 445–454. Scholar
  43. Zuckerman, K. E., Sinche, B., Mejia, A., Cobian, M., Becker, T., & Nicolaidis, C. (2014). Latino parents’ perspectives on barriers to autism diagnosis. Academic Pediatrics, 14(3), 301–308.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Steve Hicks School of Social WorkUniversity of Texas at AustinAustinUSA
  2. 2.School of Social WorkArizona State UniversityPheonixUSA
  3. 3.Department of Disability and Human DevelopmentUniversity of Illinois at ChicagoChicagoUSA
  4. 4.Department of EducationCalifornia State University, NorthridgeNorthridgeUSA
  5. 5.Department of Special Education and Clinical SciencesUniversity of OregonEugeneUSA

Personalised recommendations