Early Dyadic Communication Lab

Support for individuals with autism spectrum disorder (ASD) in Bolivia, the lowest-income country in South America, is exceedingly scarce, with a severe lack of trained providers or accessible therapeutic services, particularly for adolescents and young adults. This disparity leaves many families without necessary supports, exacerbating the developmental, social, and economic challenges faced by individuals with ASD and their families. Addressing this urgent need, our project aims to develop and pilot-test a culturally adapted, economically and geographically accessible intervention and delivery model tailored for Bolivian adolescents and young adults with ASD. We will use the PRECEDE-PROCEDE model (Crosby et al., 2011), combined with Healey and colleague’s (2017) cultural adaptation framework, to identify and culturally adapt an intervention for this population. Building on our preliminary successes with young children with ASD in Bolivia, we will conduct a needs assessment with adolescents, young adults, and their caregivers to identify specific social, behavioral, communicative, academic, and mental health-related needs. This data will inform the cultural adaptation of an existing parent-mediated intervention through iterative meetings with Bolivian stakeholders. We will use a task-shifting approach to deliver the intervention, training and supporting caregivers as they teach therapeutic strategies to groups of other caregivers, thereby reducing costs and increasing intervention dosage and ecological validity. We will then pilot-test the adapted intervention with two parent leaders and ten families to assess its feasibility, acceptability, and preliminary effectiveness using a mixed methods pre-post design.

 

After completion of the project, we expect to have developed a feasible and culturally valid intervention and delivery model for Bolivian adolescents and young adults with ASD that shows preliminary effectiveness. This will provide foundational data for further research and large-scale implementation in Bolivia and other similar low- and middle-income countries in South America. By leveraging local strengths and culturally relevant adaptations, our project aims to promote sustainable and equitable access to ASD support services for adolescents and young adults, significantly improving the quality of life for individuals with ASD and their families in low-resourced settings. 

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