"More Than Just Taking Off Your Shoes": A Mixed Methods Study of Cultural Adaptation Practices in the Autism Service...

This mixed-methods study examined cultural adaptation practices within Applied Behavior Analysis (ABA) services for autistic children from historically marginalized communities.

Using an explanatory sequential design (QUANT → QUAL), we surveyed 519 ABA practitioners and conducted follow-up interviews with 12 participants to assess knowledge, implementation frequency, and barriers to cultural adaptation practices.

Quantitative findings revealed moderate levels of self-reported knowledge and implementation across six domains of the Cultural Adaptation Checklist: content, goals, language, methods, people/context, and process. Qualitative analysis revealed three major themes affecting implementation: (1) Individual Attitudes, Beliefs, and Cultural Responsivity; (2) Organizational and Systemic Support and Barriers; and (3) Resource Limitations and Professional Development. Key barriers included inadequate organizational support, insufficient professional development, challenges with translation services, and restrictive insurance policies.

This study demonstrates the need for comprehensive policy reforms, enhanced training initiatives, and organizational commitment to cultural sustainment to address disparities in service provision and improve outcomes for marginalized autistic children and families.