Mentors: Leko, Melinda; Magaña, Sandy; Suhrheinrich, Jessica

Purpose: The Principal Investigator (PI) will conduct a program of research focused on improving outcomes for Latine transborder caregivers and their young children with or at risk for autism. The PI will also participate in mentoring and training to build skills related to community-engaged cultural adaptation, mixed methods, and single-case design research. Early intervention for Latine children on the autism spectrum is challenging as there are systemic barriers that prevent families from receiving services early on, such as limited professionals and resources available to address their specific cultural and linguistic needs. These barriers are exacerbated for Latine families that are transborder, meaning they live their lives in both Mexico and the United States, often crossing the border on a daily basis. As a result of physical and systemic barriers to intervention, there are significant disparities in autism diagnosis, access to services, service utilization, and health care quality for Latine families compared to their non-Latine counterparts. These disparities place children with autism at risk for poorer long-term outcomes. To address this, the PI will culturally adapt and test a caregiver-mediated social communication intervention in which early interventionists train and coach caregivers on naturalistic developmental behavioral interventions (NDBIs) to address the needs of Latine transborder caregivers and improve their children's social communication outcomes.

Research Plan: The three major goals of this project are to (1) explore the experiences and needs of Latine transborder caregivers of young children with or at risk for autism, (2) adapt an evidence-based, caregiver-mediated social communication intervention for these caregivers, and (3) evaluate the feasibility and promise of the intervention for improving caregiver fidelity of intervention practices, family empowerment, and child social communication outcomes. During year 1, the PI will conduct a needs assessment to understand the sociocultural contexts and the intervention fit of caregiver-mediated NDBIs for Latine transborder caregivers with children with or at risk for autism. To accomplish this, they will conduct observations of early intervention practitioners (social workers, early interventionists, and behavioral therapists) implementing NDBIs in community settings, interviews with caregivers, and focus groups with early intervention practitioners. In year 2, findings from the needs assessment will be used to inform cultural adaptations to the intervention selected by community members. Adaptations will be made by the PI in collaboration with an advisory board composed of community leaders, the intervention developer, and caregivers. The NDBI manual will also be translated into Spanish using an iterative, team-based approach. During the final 2 years, the PI will conduct an iterative series of two single-case design (SCD) studies (one per year), with intervention revisions made between each study. After each SCD study, caregivers will be interviewed and coaches will participate in focus groups. Data will be analyzed to evaluate the feasibility, acceptability, and promise of the adapted intervention as well as its cost.

Career Plan: Through a career development plan, the PI will develop knowledge and skills related to (1) community-engaged cultural adaptation research, (2) mixed methods research, and (3) SCD research. This will be accomplished through meeting with mentors, consulting with experts, conducting a literature review, participating in a mixed methods workshop, and participating in meetings for the San Diego Leadership Education in Neurodevelopmental and Other Related Disabilities (LEND) program.