Using an Iterative Process to Deliver and Culturally Adapt a Caregiver-Mediated Early Language Intervention Within a...

There is significant need for culturally responsive interventions that support Latino toddlers' early communication development. However, very few early language programs have been culturally adapted both prior to and during community implementation using best practice frameworks. In response, the overarching goal of this project was to use a qualitative approach grounded in the Ecological Validity Framework to characterize the cultural adaptation of an empirically supported caregiver-mediated early language intervention, It Takes Two to Talk (ITTT), when delivered in Spanish within a community nonprofit providing wrap-around support to underserved Latino children and caregivers.

The current study involved the delivery of ITTT in an iterative process in which information from a needs assessment and pre-implementation planning was used to inform a first and then second cohort of ITTT groups. In total, 37 Latino caregivers participated in ITTT groups. Detailed field notes during ITTT delivery were qualitatively coded using directed content analysis and used to inform the completion of the Cultural Adaptation Checklist (CAC).

Findings indicated that cultural adaptations were made in nearly all sessions. Adaptation themes centered on adjusting the ITTT delivery methods in response to contextual constraints and content adaptations to supplement language facilitation strategies with information on developmental milestones, bilingual language development, and advocacy skills.

Using the CAC to systematically track cultural adaptation helped to highlight the critical role of social context in shaping cultural adaptations and to plan for future implementation efforts within settings serving Latino caregivers and children.