Culturally Adapting an Occupational Therapy Intervention for Black American Autistic Communities.

Abstract

Importance: Ayres Sensory Integration® is an evidence-based intervention for autistic children, but there is no culturally responsive adaptation to support Black American autistic children and their families.

Objective: To culturally adapt an occupational therapy intervention for Black American families.

Design: Qualitative study involving focus groups and interviews, using researcher triangulation and member-checking surveys for the trustworthiness of findings.

Setting: Zoom focus groups and interviews.

Participants: Convenience sampling resulted in 12 participants, including Black American parents and caregivers, cultural experts, and occupational therapy practitioners who provide services to Black American autistic children.

Outcomes and measures: Interviews and focus group discussions.

Results: Four parents and caregivers, two cultural experts, and six practitioners participated. Five themes emerged regarding barriers and eight for supports in accessing and utilizing occupational therapy services, including cultural humility knowledge and practices by practitioners and strategies for engaging and incorporating families' culture.

Conclusions and relevance: This study demonstrates the process of culturally adapting an occupational therapy intervention according to relevant literature and the insight and expertise of parents and caregivers, cultural experts, and occupational therapy practitioners. Plain-Language Summary: This project identified challenges and supports for Black American families of autistic children regarding access to and engagement in occupational therapy services. We adapted an occupational therapy intervention to address these challenges and to include recommended supports to guide occupational therapy practitioners to be more culturally responsive and collaborative with Black American families of autistic children throughout the therapeutic process. Positionality Statement: The inclusive term Black American is used to engage people from all cultural and ethnic backgrounds who are a part of the Black and African-American community throughout the United States (Rivera-Figueroa et al., 2022). Also, identity-first terminology and the term autistic are used according to autistic adults' preferences for embracing one's identity (Taboas et al., 2023). The research team consisted of female occupational therapists (Rachel Dumont, Roseann Schaaf, Lady Rios-Vega, and Taylor Sivori, who self-identified as White, White, Latina, and White, respectively); female and male occupational therapy students (Allison Barrett, Emily Knell, and Joshua Njoroge, who self-identified as Asian, White, and Black and White, respectively); and a male focus group facilitator (Levone Cannady, who self-identified as Black). The principal investigator (PI) for this study, Rachel Dumont, and co-PI, Roseann Schaaf, have 16 yr and more than 30 yr of research experience, respectively. The co-PI has extensive experience with occupational therapy using Ayres Sensory Integration and was the director of the Jefferson Autism Center of Excellence. The focus group facilitator had over 8 yr of experience in leading groups and workshops.