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Cultural Responsiveness in Assessment, Implementer Training, and Intervention in School, Home, and Community Settings: A Systematic Review

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Title: Cultural Responsiveness in Assessment, Implementer Training, and Intervention in School, Home, and Community Settings: A Systematic Review
Language: English
Authors: Daniel Kwak (ORCID 0000-0002-3102-7340), Marlesha C. Bell (ORCID 0000-0002-8566-1515), Kwang-Sun C. Blair (ORCID 0000-0001-9377-6585), Sarah E. Bloom (ORCID 0000-0002-8071-8981)
Source: Journal of Behavioral Education. 2025 34(3):526-573.
Availability: Springer. Available from: Springer Nature. One New York Plaza, Suite 4600, New York, NY 10004. Tel: 800-777-4643; Tel: 212-460-1500; Fax: 212-460-1700; e-mail: customerservice@springernature.com; Web site: https://link.springer.com/
Peer Reviewed: Y
Page Count: 48
Publication Date: 2025
Document Type: Journal Articles
Information Analyses
Reports - Research
Descriptors: Evaluation Methods, Research Methodology, Children, Adolescents, Diversity, Background, Educational Environment, Family Environment, Community, Educational Practices, Cultural Relevance, Participant Characteristics, Program Implementation, Training, Culturally Relevant Education, Educational Research, Intervention, Student Characteristics
DOI: 10.1007/s10864-024-09547-7
ISSN: 1053-0819
1573-3513
Abstract: The purpose of the current systematic review was to synthesize and evaluate the empirical database to assist researchers and practitioners in conducting culturally responsive research and implementing culturally responsive practices for children and adolescents from culturally diverse backgrounds. After screening 16,249 articles through journal and electronic database searches, a final selection of 22 peer-reviewed articles were included in the review. These experimental group and single-subject design studies addressed cultural responsiveness in assessment, implementer training, and intervention yielding positive behavioral, social skills, academic, and social-emotional outcomes for children and adolescents from diverse cultural backgrounds across school, home, and community settings. The studies were published across 15 journals (2010-2022) and included 281 implementers and 536 children and adolescents. Results showed that all but one study addressed most rubric items of quality indicators for culturally responsive experimental research (Bal & Trainor, Review of Educational Research, 86(2), 319-359, 2016) to some extent, and most studies addressed a majority of culturally sensitive elements of the Ecological Validity Model (EVM; Bernal et al., Journal of Abnormal Child Psychology, 23(1), 67-82, 1995). Most studies reported cultural responsiveness in intervention, whereas fewer described cultural adaptations to assessment and implementer training. Cultural adaptations that were made within the studies as well as suggestions for making adaptations within assessment, implementer training, and intervention delivery are described.
Abstractor: As Provided
Entry Date: 2025
Accession Number: EJ1489625
Database: ERIC
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  Value: <anid>AN0188353662;41z01sep.25;2025Oct03.04:57;v2.2.500</anid> <title id="AN0188353662-1">Cultural Responsiveness in Assessment, Implementer Training, and Intervention in School, Home, and Community Settings: A Systematic Review </title> <p>The purpose of the current systematic review was to synthesize and evaluate the empirical database to assist researchers and practitioners in conducting culturally responsive research and implementing culturally responsive practices for children and adolescents from culturally diverse backgrounds. After screening 16,249 articles through journal and electronic database searches, a final selection of 22 peer-reviewed articles were included in the review. These experimental group and single-subject design studies addressed cultural responsiveness in assessment, implementer training, and intervention yielding positive behavioral, social skills, academic, and social–emotional outcomes for children and adolescents from diverse cultural backgrounds across school, home, and community settings. The studies were published across 15 journals (2010–2022) and included 281 implementers and 536 children and adolescents. Results showed that all but one study addressed most rubric items of quality indicators for culturally responsive experimental research (Bal & Trainor, Review of Educational Research, 86(<reflink idref="bib2" id="ref1">2</reflink>), 319–359, 2016) to some extent, and most studies addressed a majority of culturally sensitive elements of the Ecological Validity Model (EVM; Bernal et al., Journal of Abnormal Child Psychology, 23(<reflink idref="bib1" id="ref2">1</reflink>), 67–82, 1995). Most studies reported cultural responsiveness in intervention, whereas fewer described cultural adaptations to assessment and implementer training. Cultural adaptations that were made within the studies as well as suggestions for making adaptations within assessment, implementer training, and intervention delivery are described.</p> <p>Keywords: Culturally responsive; Culturally sensitive; Cultural adaptation; Culture; Psychology and Cognitive Sciences Psychology</p> <p>Copyright comment Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</p> <hd id="AN0188353662-2">Introduction</hd> <p>The number of racially and ethnically diverse minorities in the United States is growing (U.S. Census Bureau, [<reflink idref="bib64" id="ref3">64</reflink>]). Accordingly, researchers and human service professionals will serve this growingly diverse population from various cultural backgrounds. Considering that culture influences individuals in many ways, it is important that researchers and practitioners consider cultural variables (e.g., language, race/ethnicity, age, religion, socioeconomic status [SES], gender, disability) when providing educational and related services to diverse populations. Failing to address cultural issues can have detrimental effects on racial and ethnic minorities, resulting in various negative outcomes. These include disproportionate discipline rates in schools (Losen et al., [<reflink idref="bib53" id="ref4">53</reflink>]), placing students at risk for academic failure and dropout (Harrison & Beck, [<reflink idref="bib39" id="ref5">39</reflink>]), overlooking their potential for gifted programs (Collins, [<reflink idref="bib23" id="ref6">23</reflink>]), and overrepresentation in special education services, often leading to placement in more restrictive environments than their peers (Graves & Ye, [<reflink idref="bib36" id="ref7">36</reflink>]). Moreover, a lack of cultural consideration may impact the effectiveness of interventions and quality of services provided to racial and ethnic minorities. For example, researchers have found that compared to interventions that are not tailored to specific cultural contexts, culturally responsive interventions result in higher implementation fidelity and social validity and are crucial in selecting appropriate intervention goals and designing intervention procedures (Castro-Oliva & Merrell, [<reflink idref="bib17" id="ref8">17</reflink>]; Cheremshynski et al., [<reflink idref="bib20" id="ref9">20</reflink>]; Kim, [<reflink idref="bib44" id="ref10">44</reflink>]). Literature consistently indicates that understanding cultural factors and providing culturally responsive services can expand intervention opportunities and lead to the most effective interventions (Gay, [<reflink idref="bib32" id="ref11">32</reflink>]; Villegas & Lucas, [<reflink idref="bib65" id="ref12">65</reflink>]).</p> <p>To provide culturally responsive services, assessment, implementer training, and intervention can be adapted by collaborating with stakeholders in the individual's environment, such as school staff (e.g., Castro-Olivo, [<reflink idref="bib16" id="ref13">16</reflink>]; Clinton et al., [<reflink idref="bib22" id="ref14">22</reflink>]) and caregivers (e.g., Ceballos & Bratton, [<reflink idref="bib19" id="ref15">19</reflink>]; Cheremshynski et al., [<reflink idref="bib20" id="ref16">20</reflink>]; Tsami et al., [<reflink idref="bib63" id="ref17">63</reflink>]). For example, researchers and practitioners can collaborate with caregivers to incorporate the family's cultural values and modify the delivery of intervention by embedding culturally relevant components. Assessing social validity can also help researchers and practitioners identify the need for modifications and make potential cultural adaptations. Although it would not account for capturing all culturally relevant information, assessing the social validity of services can be especially important when working with individuals from diverse backgrounds (D'Agostino et al., [<reflink idref="bib25" id="ref18">25</reflink>]; Larson et al., [<reflink idref="bib49" id="ref19">49</reflink>]).</p> <p>Bernal et al. ([<reflink idref="bib10" id="ref20">10</reflink>]) defined culturally adapted interventions as modifying an intervention "to consider language, culture, and context in such a way that it is compatible with the client's cultural patterns, meaning, and values" (p. 362). In adapting evidence-based practices, the use of a cultural adaptation model or framework has been suggested (Domenech Rodríguez & Bernal, [<reflink idref="bib27" id="ref21">27</reflink>]). Bernal et al. ([<reflink idref="bib9" id="ref22">9</reflink>]) proposed the Ecological Validity Model (EVM) to guide cultural adaptations of interventions, which consists of the following culturally sensitive elements: (a) language (e.g., providing services in relevant language), (b) persons (e.g., considering the similarities and differences in intervention recipient's and implementer's cultures), (c) metaphors (e.g., use of culturally sound images, symbols, and idioms), (d) content (e.g., using cultural information to inform the content of intervention), (e) concepts (e.g., aligning the intervention concept or theoretical model that is relevant to the culture), (f) goals (e.g., establishing goals that are of value to the target group), (g) method (e.g., methodological and procedural modification made with consideration of recipient's culture), and (h) context (e.g., consideration of changing contexts in intervention provision; Bernal et al., [<reflink idref="bib9" id="ref23">9</reflink>]). Bernal et al. ([<reflink idref="bib10" id="ref24">10</reflink>]) stressed the importance of using conceptual frameworks to guide the process of adapting evidence-based practices to best describe their modifications and help others replicate their work. Therefore, we used Bernal et al.'s ([<reflink idref="bib9" id="ref25">9</reflink>]) culturally sensitive elements in analyzing the empirical studies included in the current review.</p> <p>Additionally, we analyzed the empirical studies included in in the current review using the rubric proposed by Bal and Trainor ([<reflink idref="bib5" id="ref26">5</reflink>]). Bal and Trainor's rubric guides culturally responsive research for experimental intervention studies and was developed based on the American Education Research Association (AERA) standards for reporting of empirical research (AERA, [<reflink idref="bib1" id="ref27">1</reflink>]). The rubric includes 15 items designed to evaluate the following six domains: (a) problem formulation (e.g., conceptualizing problems and developing research questions while taking into account the cultural backgrounds of the intervention recipients), (b) design and logic (e.g., considering contextual factors that may influence the relationship between researchers and recipients, which in turn informs the study design), (c) sources of evidence (e.g., considering the design of instruments, measurements techniques, and ecological aspects of the intervention to yield reliable and valid outcomes), (d) measurement/assessment process (e.g., use of measurements that are culturally responsive and congruent to recipients' preferences and experiences), (e) analysis and interpretation (e.g., avoiding drawing conclusions that are monolithic toward historically marginalized group or deficit-oriented and fail to emphasize the importance of social environmental change), and (f) dissemination (e.g., translating the findings into practical application and promote immediate use; Bal & Trainor, [<reflink idref="bib5" id="ref28">5</reflink>]). Full descriptions of the culturally sensitive elements and rubric items on culturally responsive research for experimental intervention studies can be found in Bernal et al. ([<reflink idref="bib9" id="ref29">9</reflink>]) and Bal and Trainor ([<reflink idref="bib5" id="ref30">5</reflink>]), respectively.</p> <p>Although researchers have suggested the models for adaptation and frameworks as described above, limited information exists regarding how researchers have made specific cultural adaptations to meet the needs of these populations from diverse cultural backgrounds in providing culturally responsive interventions. This lack of information is particularly evident in the areas of assessment, implementer training, and intervention. As a result, the evaluation of service outcomes across cultures is often incomplete, and there may be missing data, leaving research consumers unaware of the populations being served and any potential discrepancies in outcomes for various cultural groups (Jones et al., [<reflink idref="bib42" id="ref31">42</reflink>]). This knowledge gap calls for further research and efforts to incorporate cultural considerations more comprehensively in intervention studies, ultimately leading to more effective and equitable practices.</p> <p>A few literature reviews have summarized information about consideration of culture during provision of interventions. For example, previous literature reviews examined social skills interventions for culturally and linguistically diverse student populations (Kim et al., [<reflink idref="bib45" id="ref32">45</reflink>]), culturally adapted caregiver training for disruptive behavior (Butler & Titus, [<reflink idref="bib13" id="ref33">13</reflink>]), and English early literacy interventions for dual language learners (Hur et al., [<reflink idref="bib41" id="ref34">41</reflink>]). Nevertheless, these review studies did not use cultural adaptation frameworks or guidelines to examine the extent to which the researchers and practitioners addressed cultural variables or adapted services to meet the needs of the culturally diverse populations. In a systematic review, Brown et al. ([<reflink idref="bib12" id="ref35">12</reflink>]) used several cultural adaptation frameworks (Backer, [<reflink idref="bib4" id="ref36">4</reflink>]; Bernal et al., [<reflink idref="bib9" id="ref37">9</reflink>]; Castro et al., [<reflink idref="bib14" id="ref38">14</reflink>]) to analyze culturally adapted school-based interventions, but the authors only examined studies involving students with or at-risk for emotional or behavioral disorder (EBD) or who had challenging behavior. Thus, it is unclear exactly what supports were necessary for students without EBD.</p> <p>Across existing reviews, the specific cultural adaptations made in the empirical studies are often unclear due to a lack of detail that may be needed for researchers and practitioners to replicate the findings. The lack of detail may partially be attributed to the empirical studies not including sufficient information, but it may also be attributed to the review studies extracting information that focus on broad themes instead of reporting the details of the specific cultural adaptations that were made. Additionally, limited empirical research exists that address culture as a critical component of service provision for children and adolescents with or without disabilities (Cheremshynski et al., [<reflink idref="bib20" id="ref39">20</reflink>]). This gap in empirical evidence may hinder the development of culturally responsive interventions and services, potentially leading to disparities in outcomes for diverse populations. Thus, the purpose of this study was to conduct a systematic review of literature on intervention studies to identify and examine empirical studies that incorporated culturally responsive practices to address the needs of children and adolescents from diverse cultural backgrounds.</p> <p>The specific objectives of the study were to: (a) identify general characteristics of the studies, including characteristics of the intervention implementers and intervention recipients (children and adolescents), (b) identify the extent to which the studies addressed the quality indicators for culturally responsive research suggested by Bal and Trainor ([<reflink idref="bib5" id="ref40">5</reflink>]) and addressed the culturally sensitive elements within the EVM (Bernal et al., [<reflink idref="bib9" id="ref41">9</reflink>]) in the areas of assessment, implementer training, and intervention, (c) summarize the culturally responsive components in assessment, implementer training, and intervention, and (d) provide recommendations based on the findings to improve current practices.</p> <hd id="AN0188353662-3">Method</hd> <p></p> <hd id="AN0188353662-4">Article Search Procedures</hd> <p>To identify the empirical studies for the systematic review, a comprehensive search was conducted across selected journals and electronic databases. The final selection process resulted in 22 articles that were included in the systematic review. The search encompassed articles published from 2010 to 2022 to evaluate the most recent literature and ensure that recommendations are made to improve current practices, rather than examine patterns of publication or effects across time.</p> <hd id="AN0188353662-5">Journal Search Procedures and Expert Review</hd> <p>Fifteen journals (5 in behavior analysis, 5 in special education, and 5 in school psychology) were hand-searched. Journal selections were made based on recommendations from experts in the respective fields, journal influence (i.e., impact factor), and relevance to the current study. Seventeen doctoral-level university faculty participated in the expert review (5 in behavior analysis, 5 in special education, and 6 in school psychology). To be eligible as experts in the study, they needed to have a minimum of five publications in their respective fields, but most experts who participated had more than 40 publications. The experts were provided with a list of journals from the respective fields (a list of 7 journals in behavior analysis, 9 in special education, and 6 in school psychology) with options to add journals that were not listed and were subsequently asked to rank the journals based on prominence in the field. The Journal Citation Reports (Clarivate Analytics, [<reflink idref="bib21" id="ref42">21</reflink>]) was used to retrieve information on the impact factor of journals. Relevance of the journals to the current study was considered by reviewing journal descriptions, number of articles that were identified when the term 'culture' was used to search within each journal, and the number of articles that appeared to be empirical studies that focused on assessment, implementer training, or intervention. The journals were ranked in order of higher rank for expert recommendation, higher impact factor for journal influence, and higher number of relevant articles yielded for relevance. Then, the authors examined all three indices within a comprehensive review process and arrived at a consensus regarding the specific journals to be hand-searched. No cut-off criteria were applied to these indices to avoid eliminating potentially appropriate journals due to discipline-specific differences in impact factor or number of relevant articles.</p> <p>Journals selected for behavior analysis included <emph>Journal of Applied Behavior Analysis</emph>, <emph>Behavior Analysis in Practice</emph>, <emph>Behavioral Interventions</emph>, <emph>Behavior Modification</emph>, and <emph>The Analysis of Verbal Behavior</emph>. Journals selected for special education included <emph>Journal of Special Education</emph>, <emph>Journal of Positive Behavior Interventions</emph>, <emph>Exceptional Children</emph>, <emph>Remedial and Special Education</emph>, and <emph>Topics in Early Childhood Special Education</emph>. Journals selected for school psychology included <emph>Journal of School Psychology</emph>, <emph>School Psychology</emph> (previously <emph>School Psychology Quarterly</emph>), <emph>School Psychology Review</emph>, <emph>Psychology in the Schools</emph>, and <emph>School Psychology International</emph>.</p> <hd id="AN0188353662-6">Database Search Procedures</hd> <p>Electronic databases including Academic Search Premier, Educational Resources Information Center (ERIC), PsychARTICLES, PsychINFO, Social Services Abstracts, and Web of Science were used to search a combination of the following Boolean terms: (a) "cultur*," "cultural adaptation," "divers*," "multicultural," "culturally derived," "culturally sensitive," "culturally responsive," "culturally appropriate," and "cultural humility"; (b) "behavior* intervention," "behavior* assessment," and "behavior* training"; (c) "applied behavior* analytic service" and "applied behavior* analysis"; and (d) "language," "linguistic," "socioeconomic," "gender," "ethnicity," "race," "religion," "spirituality," "values," "disability," "age," "rural," and "urban." The search terms were selected to include general (Boolean terms a) and specific terms (Boolean terms b) related to culturally responsive service provision. The terms were also chosen to yield articles focusing on behavior change (Boolean terms b) and broadly related to the field of behavior analysis (Boolean terms c). The database searches were filtered to include only peer-reviewed studies except for PubMed and Web of Science, as they lacked this filtering function. Nevertheless, none of the articles selected for review were exclusively found in PubMed or Web of Science.</p> <hd id="AN0188353662-7">Article Selection Criteria</hd> <p>As displayed in Fig. 1, the searches yielded a total of 16,249 articles, and they were downloaded as CSV files for the review process. A total of 225 duplicate articles were found across the database and journal searches. All articles identified from the searches underwent title, abstract, method, and full reviews. The titles and abstracts were reviewed to exclude studies that did not meet the inclusion criteria, examining if the article focused on service provision (i.e., assessment, implementer training, intervention) and included key terms related to culture (e.g., culture, race, ethnicity, language, SES). This process resulted in 76 remaining articles. Then, a method review was conducted to determine whether each of the remaining 76 articles was experimental. Following this assessment, 45 experimental studies were selected for further review. For the full review, articles had to meet the following criteria: (a) peer reviewed, (b) published between 2010 and 2022, (c) in English, (d) addressed the needs of children and adolescents from culturally diverse backgrounds in the areas of assessment, implementer training, or intervention, (e) described cultural adaptations made to assessment, implementer training, or intervention, (f) used experimental study design, and (g) reported outcomes for the intervention recipients (children or adolescents) or intervention implementors. For criterion 'e', the assessment, implementer training, or intervention was considered culturally adapted if adaptations were made based on at least one cultural variable (e.g., language, race, ethnicity, nationality, SES, sex, gender identity, religion or spirituality, age, disability, geographical areas). Of the 45 articles that underwent full review, 21 articles met the inclusion criteria.</p> <p>Graph: Fig. 1 Flow chart of study selection process</p> <p>Review studies that were found through the searches were also examined to identify any empirical articles that met the inclusion criteria among the reviewed articles. Two hundred forty-one of the referenced articles were published since 2010. The title and abstract reviews of the 241 articles resulted in 17 remaining articles, the method review resulted in six articles, and the full review resulted in two articles (Lo et al., [<reflink idref="bib51" id="ref43">51</reflink>]; Shum et al., [<reflink idref="bib59" id="ref44">59</reflink>]). Thus, the complete search process yielded 23 articles that met the full inclusion criteria. However, one of these articles (Kanter et al., [<reflink idref="bib43" id="ref45">43</reflink>]) was excluded from analysis because it targeted adults, included individuals with a diagnosis of a mental disorder, and was conducted in a mental health clinic. Consequently, the final number of articles included in the current review was 22.</p> <hd id="AN0188353662-8">Variable Coding</hd> <p>For each article that was analyzed, information on the characteristics of studies, demographics of intervention implementer and intervention recipients, and cultural responsiveness of intervention delivery in the areas of assessment, implementer training, and intervention were gathered. Additionally, information on the extent to which each study addressed the components of the EVM proposed by Bernal et al. ([<reflink idref="bib9" id="ref46">9</reflink>]) and rubric items developed by Bal and Trainor ([<reflink idref="bib5" id="ref47">5</reflink>]) was gathered. For the study characteristics, coded variables included: the author(s), year of publication, journal name, research design, setting, dependent variables, methods of assessing and reporting social validity, and cultural variables considered. Implementer demographic variables included the number of implementors, job title, sex, language spoken, and race, ethnicity, or nationality. Intervention recipient demographic variables included the number of recipients, sex, age or grade, SES, language spoken, disability, and race, ethnicity, or nationality. Variables were coded to examine the extent to which the studies addressed the 15 rubric items of quality indicators for culturally responsive research developed by Bal and Trainor, which encompass areas including problem formulation, design and logic, sources of evidence, measurement process, analysis and interpretation, and dissemination. Variables were also coded to examine whether the studies addressed the culturally sensitive elements described by Bernal et al., which include language, persons, metaphors, content, concepts, goals, methods, and context. The rubric items by Bal and Trainor and culturally sensitive elements by Bernal et al. were coded as dichotomous variables: as "yes" or "no." All variables were uniquely coded.</p> <hd id="AN0188353662-9">Interrater Agreement</hd> <p>Interrater agreement was assessed for an average of 69.42% of articles for journal searches, an average of 67.67% of articles for database searches, and an average of 55.89% of articles found in review studies across the title, abstract, method, and full reviews. Interrater agreement was also assessed for 31.82% of the articles across coding variables and summaries of culturally responsive service provision. The interrater agreement averaged 99.04% for journal searches, 99.87% for database searches, and 97.31% for articles found in review studies. For coding variables, agreement averaged 90.79% for the selected articles and 90.48% for summaries of culturally responsive components. When raters disagreed on coding of variables, the descriptions of variables were reviewed and articles re-examined until 100% consensus was reached on included articles and coding variables.</p> <hd id="AN0188353662-10">Results</hd> <p>The search identified 22 peer-reviewed articles after screening 16,249 articles. The analysis included 281 implementers from 18 studies and 536 intervention recipients from 21 studies. Four studies did not specify the number of implementers (e.g., Durán et al., [<reflink idref="bib28" id="ref48">28</reflink>]; Graves et al., [<reflink idref="bib37" id="ref49">37</reflink>]) and one did not specify the number of recipients (Bradshaw et al., [<reflink idref="bib11" id="ref50">11</reflink>]).</p> <hd id="AN0188353662-11">General Characteristics of Studies</hd> <p></p> <hd id="AN0188353662-12">Journal</hd> <p>Table 1 presents characteristics of the 22 studies analyzed in the current review. As shown in the table, the articles selected for review were published across 15 journals. The following journals published more than one article that met the inclusion criteria: <emph>Journal of Positive Behavior Interventions</emph> (14%), <emph>Psychology in the Schools</emph> (14%), <emph>School Psychology Review</emph> (14%), and <emph>School Psychology</emph> (formerly <emph>School Psychology Quarterly</emph>; 9%).</p> <p>Table 1 Characteristics of studies</p> <p> <ephtml> <table frame="hsides" rules="groups"><thead><tr><th align="left"><p>Author (Year)</p></th><th align="left"><p>Journal</p></th><th align="left"><p>Research design</p></th><th align="left"><p>Setting</p></th><th align="left"><p>Dependent variable</p></th><th align="left"><p>Social validity assessment method</p></th><th align="left"><p>Social validity report</p></th><th align="left"><p>Cultural variables considered</p></th></tr></thead><tbody><tr><td align="left"><p>Bradshaw et al. (<xref ref-type="bibr" rid="bibr11">2018</xref>)</p></td><td align="left"><p>School Psychology Review (SPR)</p></td><td align="left"><p>RCT</p></td><td align="left"><p>School</p></td><td align="left"><p>ODR, CB; teacher–student interaction, teacher self-efficacy, stress, social desirability bias</p></td><td align="left"><p>Questionnaire (modified valid scale)</p></td><td align="left"><p>Descriptive</p></td><td align="left"><p>Race/ethnicity</p></td></tr><tr><td align="left"><p>Castro-Olivo (<xref ref-type="bibr" rid="bibr16">2014</xref>)</p></td><td align="left"><p>School Psychology</p></td><td align="left"><p>QED</p></td><td align="left"><p>School</p></td><td align="left"><p>Social–emotional (SE) resiliency, knowledge of SE learning</p></td><td align="left"><p>Questionnaire (author-developed)</p></td><td align="left"><p>Descriptive</p></td><td align="left"><p>Language, race/ethnicity, age</p></td></tr><tr><td align="left"><p>Castro-Olivo et al. (<xref ref-type="bibr" rid="bibr18">2018</xref>)</p></td><td align="left"><p>Psychology in the Schools</p></td><td align="left"><p>MBL</p></td><td align="left"><p>School</p></td><td align="left"><p>Academic engagement, CB, early reading skills</p></td><td align="left"><p>Questionnaire (author-developed)</p></td><td align="left"><p>Descriptive</p></td><td align="left"><p>Language, race/ethnicity</p></td></tr><tr><td align="left"><p>Ceballos and Bratton (<xref ref-type="bibr" rid="bibr19">2010</xref>)</p></td><td align="left"><p>Psychology in the Schools</p></td><td align="left"><p>RCT</p></td><td align="left"><p>School & home</p></td><td align="left"><p>CB; caregiver stress</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>Language, race/ethnicity, SES</p></td></tr><tr><td align="left"><p>Cheremshynski et al. (<xref ref-type="bibr" rid="bibr20">2013</xref>)</p></td><td align="left"><p>JPBI</p></td><td align="left"><p>ABAB</p></td><td align="left"><p>Home</p></td><td align="left"><p>CB, completion of routine, latency to termination</p></td><td align="left"><p>Questionnaire (modified valid scale)</p></td><td align="left"><p>Descriptive</p></td><td align="left"><p>Language, nationality</p></td></tr><tr><td align="left"><p>Clinton et al. (<xref ref-type="bibr" rid="bibr22">2015</xref>)</p></td><td align="left"><p>SPI</p></td><td align="left"><p>One group pre-post</p></td><td align="left"><p>School</p></td><td align="left"><p>Social–emotional skills</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>Language, nationality, SES, age</p></td></tr><tr><td align="left"><p>Durán et al. (<xref ref-type="bibr" rid="bibr28">2013</xref>)</p></td><td align="left"><p>ETC</p></td><td align="left"><p>ALT, AB</p></td><td align="left"><p>School</p></td><td align="left"><p>CB, communication, ODR</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>Language</p></td></tr><tr><td align="left"><p>Gladney et al. (<xref ref-type="bibr" rid="bibr33">2021</xref>)</p></td><td align="left"><p>PSF: AECY</p></td><td align="left"><p>Multiple probe</p></td><td align="left"><p>School</p></td><td align="left"><p>Implementation fidelity; noncompliance</p></td><td align="left"><p>Questionnaire (self-developed) + open-ended questions</p></td><td align="left"><p>Descriptive statistics</p></td><td align="left"><p>Race/ethnicity</p></td></tr><tr><td align="left"><p>Graves and Aston (<xref ref-type="bibr" rid="bibr35">2018</xref>)</p></td><td align="left"><p>Psychology in the Schools</p></td><td align="left"><p>One group Pre-post</p></td><td align="left"><p>School</p></td><td align="left"><p>Identity development, social–emotional skills</p></td><td align="left"><p>Interview</p></td><td align="left"><p>Qualitative</p></td><td align="left"><p>Race/ethnicity, geographic region, religion/spirituality</p></td></tr><tr><td align="left"><p>Graves et al. (<xref ref-type="bibr" rid="bibr37">2017</xref>)</p></td><td align="left"><p>SP</p></td><td align="left"><p>RCT</p></td><td align="left"><p>School</p></td><td align="left"><p>Social–emotional skills, CB</p></td><td align="left"><p>Questionnaire (author-developed) + interview</p></td><td align="left"><p>Qualitative</p></td><td align="left"><p>SES, sex race/ethnicity, geographic region</p></td></tr><tr><td align="left"><p>Hansen et al. (<xref ref-type="bibr" rid="bibr38">2017</xref>)</p></td><td align="left"><p>Behavior Modification</p></td><td align="left"><p>MBL w/ ABAB</p></td><td align="left"><p>School</p></td><td align="left"><p>On-task; Teacher behavior management</p></td><td align="left"><p>Questionnaire (author-developed)</p></td><td align="left"><p>Descriptive + qualitative</p></td><td align="left"><p>Language</p></td></tr><tr><td align="left"><p>Kim (<xref ref-type="bibr" rid="bibr44">2016</xref>)</p></td><td align="left"><p>RPPSD</p></td><td align="left"><p>MBL</p></td><td align="left"><p>Home</p></td><td align="left"><p>Play</p></td><td align="left"><p>Questionnaire (modified valid scale) + open-ended questions</p></td><td align="left"><p>Descriptive + qualitative</p></td><td align="left"><p>Language, sex, nationality</p></td></tr><tr><td align="left"><p>Knochel et al. (<xref ref-type="bibr" rid="bibr46">2021</xref>)</p></td><td align="left"><p>JPBI</p></td><td align="left"><p>MBL w/ ABC</p></td><td align="left"><p>School</p></td><td align="left"><p>On-task; Staff praise</p></td><td align="left"><p>Questionnaire (modified valid scale)</p></td><td align="left"><p>Descriptive</p></td><td align="left"><p>Language, race/ethnicity, disability</p></td></tr><tr><td align="left"><p>Kunze et al. (<xref ref-type="bibr" rid="bibr47">2019</xref>)</p></td><td align="left"><p>Behavior Analysis in Practice</p></td><td align="left"><p>ALT</p></td><td align="left"><p>Clinic</p></td><td align="left"><p>Communication</p></td><td align="left"><p>Objective assessment</p></td><td align="left"><p>Descriptive</p></td><td align="left"><p>Language, disability</p></td></tr><tr><td align="left"><p>Lo et al. (<xref ref-type="bibr" rid="bibr51">2011</xref>)</p></td><td align="left"><p>Exceptionality</p></td><td align="left"><p>Multiple probe</p></td><td align="left"><p>School</p></td><td align="left"><p>Social skills, CB</p></td><td align="left"><p>Questionnaire (author-developed)</p></td><td align="left"><p>Descriptive + qualitative</p></td><td align="left"><p>Sex, race/ethnicity, disability</p></td></tr><tr><td align="left"><p>Lo et al. (<xref ref-type="bibr" rid="bibr52">2015</xref>)</p></td><td align="left"><p>JPBI</p></td><td align="left"><p>Multiple probe</p></td><td align="left"><p>School</p></td><td align="left"><p>Social skills</p></td><td align="left"><p>Questionnaire (author-developed)</p></td><td align="left"><p>Qualitative</p></td><td align="left"><p>Language, sex race/ethnicity, age</p></td></tr><tr><td align="left"><p>Luevano and Collins (<xref ref-type="bibr" rid="bibr54">2020</xref>)</p></td><td align="left"><p>SPR</p></td><td align="left"><p>MBL</p></td><td align="left"><p>School</p></td><td align="left"><p>Academic</p></td><td align="left"><p>Questionnaire (modified valid scale)</p></td><td align="left"><p>Descriptive</p></td><td align="left"><p>Language, race/ethnicity</p></td></tr><tr><td align="left"><p>Robinson-Ervin et al. (<xref ref-type="bibr" rid="bibr58">2016</xref>)</p></td><td align="left"><p>Behavioral Disorders</p></td><td align="left"><p>Multiple probe</p></td><td align="left"><p>School</p></td><td align="left"><p>Cooperation</p></td><td align="left"><p>Questionnaire (author-developed)</p></td><td align="left"><p>Qualitative</p></td><td align="left"><p>Race/ethnicity, disability, age, geographic region</p></td></tr><tr><td align="left"><p>Shum et al. (<xref ref-type="bibr" rid="bibr59">2019</xref>)</p></td><td align="left"><p>JADD</p></td><td align="left"><p>RCT</p></td><td align="left"><p>Community service centers</p></td><td align="left"><p>Social skills</p></td><td align="left"><p>Objective assessment</p></td><td align="left"><p>Descriptive</p></td><td align="left"><p>Language, nationality, age, geographic region</p></td></tr><tr><td align="left"><p>Spencer et al. (<xref ref-type="bibr" rid="bibr62">2019</xref>)</p></td><td align="left"><p>TECSE</p></td><td align="left"><p>MBL, One group pre-post</p></td><td align="left"><p>School</p></td><td align="left"><p>Academic</p></td><td align="left"><p>Questionnaire (author-developed)</p></td><td align="left"><p>Descriptive</p></td><td align="left"><p>Language, age</p></td></tr><tr><td align="left"><p>Tsami et al. (<xref ref-type="bibr" rid="bibr63">2019</xref>)</p></td><td align="left"><p>JABA</p></td><td align="left"><p>MBL w/ALT</p></td><td align="left"><p>University, EI center, or home</p></td><td align="left"><p>CB</p></td><td align="left"><p>Questionnaire (modified valid scale)</p></td><td align="left"><p>Descriptive</p></td><td align="left"><p>Language, nationality</p></td></tr><tr><td align="left"><p>Weddle et al. (<xref ref-type="bibr" rid="bibr66">2016</xref>)</p></td><td align="left"><p>SPR</p></td><td align="left"><p>MBL</p></td><td align="left"><p>School</p></td><td align="left"><p>Academic</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>Language</p></td></tr></tbody></table> </ephtml> </p> <p> <emph>ALT</emph> Alternating intervention design (multielement design), ETC Education and Intervention of Children, <emph>JABA</emph> Journal of Applied Behavior Analysis, <emph>JADD</emph> Journal of Autism and Developmental Disorders, <emph>JPBI</emph> Journal of Positive Behavior Interventions, <emph>ODR</emph> office disciplinary referrals, <emph>MBL</emph> multiple baseline design, <emph>CB</emph> challenging behavior, <emph>PSF</emph> AECY Preventing School Failure: Alternative Education for Children and Youth, <emph>RCT</emph> randomized controlled trial, <emph>RPPSD</emph> Research and Practice for Persons with Severe Disabilities, <emph>SPI</emph> School Psychology International, <emph>SPR</emph> School Psychology Review, <emph>TECSE</emph> Topics in Early Childhood Special Education, <emph>QED</emph> quasi-experimental design</p> <hd id="AN0188353662-13">Research Design</hd> <p>The studies used varied experimental designs. Of the 22 studies, 32% (<emph>n</emph> = 7) used group designs, 64% (<emph>n</emph> = 14) used single subject designs, and 5% (<emph>n</emph> = 1) used both. Among group design studies, most used either randomized controlled trials (50%) or pre-post designs (38%); only one study (Castro-Olivo, [<reflink idref="bib16" id="ref51">16</reflink>]) used a quasi-experimental design. Among single subject design studies, most used multiple baseline design (29%), multiple probe design (24%), combination designs (24%), or alternating treatment design (12%); only two studies (12%) used either a ABAB design or AB design. One study (Spencer et al., [<reflink idref="bib62" id="ref52">62</reflink>]) used both single subject design (multiple baseline) and group design (pre-post), whereas Durán et al. ([<reflink idref="bib28" id="ref53">28</reflink>]) used alternating treatment and AB designs to evaluate the effects of the culturally responsive assessments and interventions. Knochel et al. ([<reflink idref="bib46" id="ref54">46</reflink>]) used a multiple baseline design with an ABC sequence to compare staff's behavior-specific praise with staff's culturally adapted praise.</p> <hd id="AN0188353662-14">Setting</hd> <p>Most studies were conducted at school (73%; <emph>n</emph> = 16), whereas the remaining studies took place at home (9%), clinic (5%), or community service center (5%), and the rest in multiple settings (Ceballos & Bratton, [<reflink idref="bib19" id="ref55">19</reflink>]; Tsami et al., [<reflink idref="bib63" id="ref56">63</reflink>]). Ceballos and Bratton ([<reflink idref="bib19" id="ref57">19</reflink>]) conducted the study in both school and home settings to examine the use of Child Parent Relationship Therapy. Tsami et al. ([<reflink idref="bib63" id="ref58">63</reflink>]) evaluated functional communication training at home or at an early intervention center for the families and at a university center for the therapists (telehealth).</p> <hd id="AN0188353662-15">Dependent Variable</hd> <p>Various dependent variables were evaluated for intervention recipients (children and adolescents) across studies with five studies (23%) including dependent variables evaluated for implementers (Bradshaw et al., [<reflink idref="bib11" id="ref59">11</reflink>]; Ceballos & Bratton, [<reflink idref="bib19" id="ref60">19</reflink>]; Gladney et al., [<reflink idref="bib33" id="ref61">33</reflink>]; Hansen et al., [<reflink idref="bib38" id="ref62">38</reflink>]; Knochel et al., [<reflink idref="bib46" id="ref63">46</reflink>]). Common variables measured for the recipients included challenging behavior (36%), social–emotional skills (18%), academic skills (18%), on-task behavior (14%), social skills (14%), communication (9%), office discipline referrals (9%), cooperation (9%), routine completion (5%), and play skills (5%). The dependent variables for the implementers across the five studies (23%) included implementation fidelity, staff praise, teacher–student interaction, teacher self-efficacy, social desirability bias, stress, and behavior management.</p> <hd id="AN0188353662-16">Social Validity Assessment</hd> <p>Most studies (82%; <emph>n</emph> = 17) assessed social validity. Subjective questionnaires were used most frequently (68%). To assess the social validity of the assessment, implementer training, or intervention, the researchers used questionnaires that were self-developed (39%), questionnaires that were modified from a validated scale (28%), combination of methods (17%), objective assessment (11%), or interview method (6%). Combination of methods involved a self-developed questionnaire that included open-ended questions (e.g., Gladney et al., [<reflink idref="bib33" id="ref64">33</reflink>]), a self-developed questionnaire and an interview (e.g., Graves et al., [<reflink idref="bib37" id="ref65">37</reflink>]), and a questionnaire that was modified from a validated scale (e.g., Bradshaw et al., [<reflink idref="bib11" id="ref66">11</reflink>]).</p> <hd id="AN0188353662-17">Cultural Variables Considered</hd> <p>The authors of the reviewed studies considered a variety of cultural variables in designing, implementing, and evaluating interventions for children and adolescents from diverse cultural backgrounds, although they may not have made modifications based on each isolated cultural variable. Researchers considered various cultural variables in designing, implementing, and evaluating interventions for children and adolescents from diverse cultural backgrounds. The most frequently considered variables were race, ethnicity, or nationality (77%) and language (73%) of the intervention recipients and implementers. Other variables included age (27%), SES (14%), sex (18%), geographic region (18%), and religion or spirituality (5%).</p> <hd id="AN0188353662-18">Characteristics of Implementers and Intervention Recipients</hd> <p>Table 2 presents the characteristics of implementers and intervention recipients who were included in the reviewed studies. Most studies (86%; <emph>n</emph> = 19) specified the number of implementers and included three or fewer implementers (55%), six to 18 implementers (18%), or 48 or 158 implementers (9%). Most studies included teachers (27%), caregivers (18%), authors (18%), graduate students (14%), or peers (14%) as implementers. In two studies, other classroom staff or certified providers served as the implementers. Of the 22 studies, 55% specified the race, ethnicity, or nationality of the implementers. Most frequently specified implementers were Latino (21%; <emph>n</emph> = 58) and Black (13%; <emph>n</emph> = 36). Of the 22 studies, 68% specified the sex of the implementers; most of the implementers (77%; <emph>n</emph> = 216) were female. In addition, 41% of the studies provided information on the language spoken by implementers; Spanish and English were the languages most frequently identified.</p> <p>Table 2 Characteristics of implementers and intervention recipients</p> <p> <ephtml> <table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="2"><p>Author (Year)</p></th><th align="left" colspan="5"><p>Implementer</p></th><th align="left" colspan="7"><p>Service recipient</p></th></tr><tr><th align="left"><p>N</p></th><th align="left"><p>Title</p></th><th align="left"><p>Race/Ethnicity or Nationality (#)</p></th><th align="left"><p>Sex (#)</p></th><th align="left"><p>Language (#)</p></th><th align="left"><p><italic>N</italic></p></th><th align="left"><p>Race/Ethnicity/ or Nationality</p></th><th align="left"><p>Sex (#)</p></th><th align="left"><p>Age or grade</p></th><th align="left"><p>SES</p></th><th align="left"><p>Language</p></th><th align="left"><p>Disability</p></th></tr></thead><tbody><tr><td align="left"><p>Bradshaw et al. (<xref ref-type="bibr" rid="bibr11">2018</xref>)</p></td><td align="left"><p>158</p></td><td align="left"><p>Teachers</p></td><td align="left"><p>W (119), B (19), O (14), Miss. (6)</p></td><td align="left"><p>F (135)</p><p>M (23)</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>School demo. only</p></td><td align="left"><p>–</p></td><td align="left"><p>E or M</p></td><td align="left"><p>School demo. only</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td></tr><tr><td align="left"><p>Castro-Olivo (<xref ref-type="bibr" rid="bibr16">2014</xref>)</p></td><td align="left"><p>2</p></td><td align="left"><p>Teachers</p></td><td align="left"><p>Latina</p></td><td align="left"><p>F</p></td><td align="left"><p>Spanish & English</p></td><td align="left"><p>102</p></td><td align="left"><p>Latino</p></td><td align="left"><p>F (51),</p><p>M (50),</p><p>NR (1)</p></td><td align="left"><p>Avg. 13.9</p></td><td align="left"><p>FRLP (94%)</p></td><td align="left"><p>Spanish</p></td><td align="left"><p>–</p></td></tr><tr><td align="left"><p>Castro-Olivo et al. (<xref ref-type="bibr" rid="bibr18">2018</xref>)</p></td><td align="left"><p>2</p></td><td align="left"><p>GS, Pro., Teachers, Caregivers</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>Spanish & English</p></td><td align="left"><p>3</p></td><td align="left"><p>Latino</p></td><td align="left"><p>M (2)</p></td><td align="left"><p>5</p></td><td align="left"><p>FRLP</p></td><td align="left"><p>Spanish</p></td><td align="left"><p>–</p></td></tr><tr><td align="left"><p>Ceballos and Bratton (<xref ref-type="bibr" rid="bibr19">2010</xref>)</p></td><td align="left"><p>48</p></td><td align="left"><p>Caregivers</p></td><td align="left"><p>Latino</p></td><td align="left"><p>F (47)</p><p>M (1)</p></td><td align="left"><p>Spanish</p></td><td align="left"><p>48</p></td><td align="left"><p>Latino</p></td><td align="left"><p>M (27)</p><p>F (21)</p></td><td align="left"><p>Avg. 4.3</p></td><td align="left"><p>Low-income households</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td></tr><tr><td align="left"><p>Cheremshynski et al. (<xref ref-type="bibr" rid="bibr20">2013</xref>)</p></td><td align="left"><p>1</p></td><td align="left"><p>Caregiver</p></td><td align="left"><p>Japanese American</p></td><td align="left"><p>F</p></td><td align="left"><p>Japanese & English</p></td><td align="left"><p>1</p></td><td align="left"><p>Japanese American</p></td><td align="left"><p>M</p></td><td align="left"><p>5</p></td><td align="left"><p>Middle-class neighborhood</p></td><td align="left"><p>–</p></td><td align="left"><p>ASD</p></td></tr><tr><td align="left"><p>Clinton et al. (<xref ref-type="bibr" rid="bibr22">2015</xref>)</p></td><td align="left"><p>2</p></td><td align="left"><p>Teachers</p></td><td align="left"><p>–</p></td><td align="left"><p>F</p></td><td align="left"><p>–</p></td><td align="left"><p>100</p></td><td align="left"><p>Guatemalan</p></td><td align="left"><p>F (50)</p><p>M (50)</p></td><td align="left"><p>0 to 6</p></td><td align="left"><p>High-poverty areas</p></td><td align="left"><p>Spanish</p></td><td align="left"><p>–</p></td></tr><tr><td align="left"><p>Durán et al. (<xref ref-type="bibr" rid="bibr28">2013</xref>)</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>1</p></td><td align="left"><p>–</p></td><td align="left"><p>M</p></td><td align="left"><p>4</p></td><td align="left"><p>–</p></td><td align="left"><p>Spanish</p></td><td align="left"><p>–</p></td></tr><tr><td align="left"><p>Gladney et al. (<xref ref-type="bibr" rid="bibr33">2021</xref>)</p></td><td align="left"><p>3</p></td><td align="left"><p>Teachers</p></td><td align="left"><p>White</p></td><td align="left"><p>F</p></td><td align="left"><p>–</p></td><td align="left"><p>3</p></td><td align="left"><p>African American</p></td><td align="left"><p>M (2) F (1)</p></td><td align="left"><p>3rd</p></td><td align="left"><p>School demo. only</p></td><td align="left"><p>–</p></td><td align="left"><p>None (2), OHI (1)</p></td></tr><tr><td align="left"><p>Graves and Aston (<xref ref-type="bibr" rid="bibr35">2018</xref>)</p></td><td align="left"><p>1</p></td><td align="left"><p>Author</p></td><td align="left"><p>Black</p></td><td align="left"><p>M</p></td><td align="left"><p>–</p></td><td align="left"><p>14</p></td><td align="left"><p>African American</p></td><td align="left"><p>M</p></td><td align="left"><p>12 to 13</p></td><td align="left"><p>School demo, only</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td></tr><tr><td align="left"><p>Graves et al. (<xref ref-type="bibr" rid="bibr37">2017</xref>)</p></td><td align="left"><p>–</p></td><td align="left"><p>Author,</p><p>GS</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>61</p></td><td align="left"><p>African American</p></td><td align="left"><p>M</p></td><td align="left"><p>Avg. 7.2</p></td><td align="left"><p>All eligible for FRLP</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td></tr><tr><td align="left"><p>Hansen et al. (<xref ref-type="bibr" rid="bibr38">2017</xref>)</p></td><td align="left"><p>3</p></td><td align="left"><p>Teachers</p></td><td align="left"><p>White</p></td><td align="left"><p>F</p></td><td align="left"><p>–</p></td><td align="left"><p>74</p></td><td align="left"><p>School demo. only</p></td><td align="left"><p>School demo. only</p></td><td align="left"><p>2nd to 4th</p></td><td align="left"><p>–</p></td><td align="left"><p>English</p></td><td align="left"><p>–</p></td></tr><tr><td align="left"><p>Kim (<xref ref-type="bibr" rid="bibr44">2016</xref>)</p></td><td align="left"><p>3</p></td><td align="left"><p>Caregivers</p></td><td align="left"><p>Korean American</p></td><td align="left"><p>F</p></td><td align="left"><p>Korean (2), Korean & English (1)</p></td><td align="left"><p>3</p></td><td align="left"><p>Korean American</p></td><td align="left"><p>M (2)</p><p>F (1)</p></td><td align="left"><p>6 to 9</p></td><td align="left"><p>–</p></td><td align="left"><p>English (1),</p><p>Korean & English (2)</p></td><td align="left"><p>ASD</p></td></tr><tr><td align="left"><p>Knochel et al. (<xref ref-type="bibr" rid="bibr46">2021</xref>)</p></td><td align="left"><p>4</p></td><td align="left"><p>Class staff</p></td><td align="left"><p>Ghanaian</p></td><td align="left"><p>M (3) F (1)</p></td><td align="left"><p>–</p></td><td align="left"><p>4</p></td><td align="left"><p>Ghanaian</p></td><td align="left"><p>M (3) F (1)</p></td><td align="left"><p>7 to 17</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>ASD (3), ASD & OCD (1)</p></td></tr><tr><td align="left"><p>Kunze et al. (<xref ref-type="bibr" rid="bibr47">2019</xref>)</p></td><td align="left"><p>–</p></td><td align="left"><p>Authors</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>1</p></td><td align="left"><p>Latino</p></td><td align="left"><p>M</p></td><td align="left"><p>10</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>Down syndrome</p></td></tr><tr><td align="left"><p>Lo et al. (<xref ref-type="bibr" rid="bibr51">2011</xref>)</p></td><td align="left"><p>3</p></td><td align="left"><p>Peers</p></td><td align="left"><p>African American</p></td><td align="left"><p>M</p></td><td align="left"><p>–</p></td><td align="left"><p>4</p></td><td align="left"><p>African American</p></td><td align="left"><p>M</p></td><td align="left"><p>8 to 12</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>None (1), ID (1)</p></td></tr><tr><td align="left"><p>Lo et al. (<xref ref-type="bibr" rid="bibr52">2015</xref>)</p></td><td align="left"><p>8</p></td><td align="left"><p>Peers</p></td><td align="left"><p>Latino</p></td><td align="left"><p>M</p></td><td align="left"><p>Spanish</p></td><td align="left"><p>8</p></td><td align="left"><p>Latino</p></td><td align="left"><p>M</p></td><td align="left"><p>9 to 12</p></td><td align="left"><p>–</p></td><td align="left"><p>Spanish</p></td><td align="left"><p>–</p></td></tr><tr><td align="left"><p>Luevano and Collins (<xref ref-type="bibr" rid="bibr54">2020</xref>)</p></td><td align="left"><p>1</p></td><td align="left"><p>Author</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>4</p></td><td align="left"><p>Latinx</p></td><td align="left"><p>–</p></td><td align="left"><p>8 to 9</p></td><td align="left"><p>School demo. only</p></td><td align="left"><p>Spanish</p></td><td align="left"><p>–</p></td></tr><tr><td align="left"><p>Robinson-Ervin et al. (<xref ref-type="bibr" rid="bibr58">2016</xref>)</p></td><td align="left"><p>6</p></td><td align="left"><p>Peers</p></td><td align="left"><p>African American</p></td><td align="left"><p>F (5)</p><p>M (1)</p></td><td align="left"><p>–</p></td><td align="left"><p>6</p></td><td align="left"><p>African American</p></td><td align="left"><p>M (4), F (2)</p></td><td align="left"><p>12 to 13</p></td><td align="left"><p>FRLP</p></td><td align="left"><p>–</p></td><td align="left"><p>EBD (4), OHI (1), EB/ID (1)</p></td></tr><tr><td align="left"><p>Shum et al. (<xref ref-type="bibr" rid="bibr59">2019</xref>)</p></td><td align="left"><p>18</p></td><td align="left"><p>PEERS® certified providers</p><p>(Caregiver-assisted)</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>Cantonese</p></td><td align="left"><p>72</p></td><td align="left"><p>Chinese</p></td><td align="left"><p>M (57), F (15)</p></td><td align="left"><p>11 to 15</p></td><td align="left"><p>–</p></td><td align="left"><p>Cantonese</p></td><td align="left"><p>ASD</p><p>[IQ > 70]</p></td></tr><tr><td align="left"><p>Spencer et al. (<xref ref-type="bibr" rid="bibr62">2019</xref>)</p></td><td align="left"><p>3</p></td><td align="left"><p>Teachers</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>Spanish & English</p></td><td align="left"><p>8</p></td><td align="left"><p>Latino (7), White (1)</p></td><td align="left"><p>F (4),</p><p>M (4)</p></td><td align="left"><p>3 to 5</p></td><td align="left"><p>Low-income households</p></td><td align="left"><p>Spanish (7), Spanish & English (1)</p></td><td align="left"><p>–</p></td></tr><tr><td align="left"><p>Tsami et al. (<xref ref-type="bibr" rid="bibr63">2019</xref>)</p></td><td align="left"><p>12</p></td><td align="left"><p>Caregivers</p></td><td align="left"><p>–</p></td><td align="left"><p>F</p></td><td align="left"><p>–</p></td><td align="left"><p>12</p></td><td align="left"><p>–</p></td><td align="left"><p>M (8),</p><p>F (4)</p></td><td align="left"><p>3 to 13</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>ASD</p></td></tr><tr><td align="left"><p>Weddle et al. (<xref ref-type="bibr" rid="bibr66">2016</xref>)</p></td><td align="left"><p>3</p></td><td align="left"><p>SLP, GS, or under-</p><p>GS</p></td><td align="left"><p>–</p></td><td align="left"><p>F (2)</p><p>M (1)</p></td><td align="left"><p>Spanish & English (1), NR (2)</p></td><td align="left"><p>7</p></td><td align="left"><p>Latino (6),</p><p>American Indian/</p><p>Latino (1)</p></td><td align="left"><p>M (4),</p><p>F (3)</p></td><td align="left"><p>3 to 4</p></td><td align="left"><p>–</p></td><td align="left"><p>Spanish (4), Spanish & English (2), English (1)</p></td><td align="left"><p>–</p></td></tr></tbody></table> </ephtml> </p> <p> <emph>ASD</emph> autism spectrum disorder, <emph>Avg</emph>. average, <emph>B</emph> Black, <emph>EBD</emph> emotional and behavioral disorders, <emph>ELL</emph> English language learner, <emph>F</emph> female, <emph>FRLP</emph> free or reduced-price lunch, <emph>GS</emph> graduate student; <emph>ID</emph> intellectual disability, <emph>M</emph> male, <emph>Miss.</emph> missing, <emph>NR</emph> not reported, <emph>O</emph> other, <emph>OCD</emph> obsessive–compulsive disorder, <emph>OHI</emph> other health impairment, <emph>Pro.</emph> Professional, <emph>SES</emph> socioeconomic status, <emph>SLP</emph> speech-language pathologist, <emph>W</emph> White</p> <p>All studies except one (96%) specified the number of intervention recipients (see Table 2). Most studies included eight or fewer (59%), 48–102 (27%), or 11–14 (9%) recipients. Most studies (77%) specified recipients' race, ethnicity, or nationality. Of 536 recipients, the most common was Latino (52%; <emph>n</emph> = 280), with four identifying as Latinx (Luevano & Collins, [<reflink idref="bib54" id="ref67">54</reflink>]), and 100 living outside of the United States (Guatemala; Clinton et al., [<reflink idref="bib22" id="ref68">22</reflink>]). The second most common was Black (17%; <emph>n</emph> = 92), with four living in Ghana (Knochel et al., [<reflink idref="bib46" id="ref69">46</reflink>]). All studies (100%) reported recipients' age or grade. Thirty-six percent of the studies (<emph>n</emph> = 8) reported recipients' SES indicating that they received free or reduced-cost lunch (18%), lived in low-income households (9%), middle-class neighborhoods (5%), or high-poverty areas (5%). Among the studies (86%) specifying the sex of the intervention recipients, males were the majority (57%; <emph>n</emph> = 304). Half of the studies provided information on language spoken by them; mainly Spanish and English, along with French (Hansen et al., [<reflink idref="bib38" id="ref70">38</reflink>]), Korean (Kim, [<reflink idref="bib44" id="ref71">44</reflink>]), or Cantonese (Shum et al., [<reflink idref="bib59" id="ref72">59</reflink>]). Forty-one percent of the studies specified the recipients' disability; autism spectrum disorder (ASD) was most common (17%; <emph>n</emph> = 92).</p> <hd id="AN0188353662-19">Quality Assessment for Culturally Responsive Experimental Studies</hd> <p>The studies were further examined to identify which of the 15 rubric items of quality indicators within six domains of culturally responsive intervention research suggested by Bal and Trainor ([<reflink idref="bib5" id="ref73">5</reflink>]) were addressed to some extent. All studies addressed the 'relevancy of the research problem,' 'critical and comprehensive review of the relevant literature,' 'description of research setting,' 'description of data collection strategies,' 'intervention design,' and 'analysis and interpretation' rubric items to some extent. In addition, most studies addressed the 'justification of the theoretical framework,' 'description of participants,' 'description of sampling procedures,' and 'ecology of the intervention' rubric items to some extent. Other rubric items were more inconsistently addressed across the studies, and the details of which specific rubric items were addressed to some extent within each article can be found in Table 3.</p> <p>Table 3 Quality assessment for culturally responsive experimental studies</p> <p> <ephtml> <table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="2"><p>Study</p></th><th align="left" colspan="4"><p>Problem formulation</p></th><th align="left" colspan="4"><p>Design and logic</p></th><th align="left" colspan="3"><p>Sources of evidence</p></th><th align="left"><p>Measurement process</p></th><th align="left" colspan="2"><p>Analysis and interpretation</p></th><th align="left"><p>Disse.</p></th></tr><tr><th align="left"><p>Construct</p></th><th align="left"><p>Problem</p></th><th align="left"><p>Review</p></th><th align="left"><p>Framework</p></th><th align="left"><p>Partici pants</p></th><th align="left"><p>Researchers</p></th><th align="left"><p>Sampling</p></th><th align="left"><p>Setting</p></th><th align="left"><p>Data collection</p></th><th align="left"><p>Ecology</p></th><th align="left"><p>IN</p></th><th align="left"><p>Assessment</p></th><th align="left"><p>Findings</p></th><th align="left"><p>Analysis</p></th><th align="left"><p>Disse.</p></th></tr></thead><tbody><tr><td align="left"><p>1</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td></tr><tr><td align="left"><p>2</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>N/A</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td></tr><tr><td align="left"><p>3</p></td><td align="left"><p>N/A</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>N/A</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td></tr><tr><td align="left"><p>4</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>N/A</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td></tr><tr><td align="left"><p>5</p></td><td align="left"><p>N/A</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>N/A</p></td><td align="left"><p>N/A</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td></tr><tr><td align="left"><p>6</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td></tr><tr><td align="left"><p>7</p></td><td align="left"><p>N/A</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>N/A</p></td><td align="left"><p>N/A</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td></tr><tr><td align="left"><p>8</p></td><td align="left"><p>N/A</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>N/A</p></td><td align="left"><p>N/A</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td></tr><tr><td align="left"><p>9</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>N/A</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td></tr><tr><td align="left"><p>10</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>N/A</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td></tr><tr><td align="left"><p>11</p></td><td align="left"><p>N/A</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>N/A</p></td><td align="left"><p>N/A</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td></tr><tr><td align="left"><p>12</p></td><td align="left"><p>N/A</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>N/A</p></td><td align="left"><p>N/A</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td></tr><tr><td align="left"><p>13</p></td><td align="left"><p>N/A</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>N/A</p></td><td align="left"><p>N/A</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td></tr><tr><td align="left"><p>14</p></td><td align="left"><p>N/A</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>N/A</p></td><td align="left"><p>N/A</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td></tr><tr><td align="left"><p>15</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>N/A</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td></tr><tr><td align="left"><p>16</p></td><td align="left"><p>N/A</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>N/A</p></td><td align="left"><p>N/A</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td></tr><tr><td align="left"><p>17</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>N/A</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td></tr><tr><td align="left"><p>18</p></td><td align="left"><p>N/A</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>N/A</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td></tr><tr><td align="left"><p>19</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>N/A</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td></tr><tr><td align="left"><p>20</p></td><td align="left"><p>N/A</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>N/A</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td></tr><tr><td align="left"><p>21</p></td><td align="left"><p>N/A</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>N/A</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td></tr><tr><td align="left"><p>22</p></td><td align="left"><p>N/A</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>N/A</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td></tr></tbody></table> </ephtml> </p> <p>This table identifies the culturally responsive elements included in the articles following the rubric from Bal & Trainor (date);<emph> X</emph> ncluded culturally responsive elements. disse. = dissemination; <emph>IN </emph> intervention; 1 = Bradshaw et al. ([<reflink idref="bib11" id="ref74">11</reflink>]); 2 = Castro-Olivo ([<reflink idref="bib16" id="ref75">16</reflink>]); 3 = Castro-Olivo et al. ([<reflink idref="bib18" id="ref76">18</reflink>]); 4 = Ceballos and Bratton ([<reflink idref="bib19" id="ref77">19</reflink>]); 5 = Cheremshynski et al. ([<reflink idref="bib20" id="ref78">20</reflink>]); 6 = Clinton et al. ([<reflink idref="bib22" id="ref79">22</reflink>]); 7 = Durán et al. ([<reflink idref="bib28" id="ref80">28</reflink>]); 8 = Gladney et al. ([<reflink idref="bib33" id="ref81">33</reflink>]); 9 = Graves and Aston ([<reflink idref="bib35" id="ref82">35</reflink>]); 10 = Graves et al. ([<reflink idref="bib37" id="ref83">37</reflink>]); 11 = Hansen et al. ([<reflink idref="bib38" id="ref84">38</reflink>]); 12 = Kim ([<reflink idref="bib44" id="ref85">44</reflink>]); 13 = Knochel et al. ([<reflink idref="bib46" id="ref86">46</reflink>]); 14 = Kunze et al. ([<reflink idref="bib47" id="ref87">47</reflink>]); 15 = Lo et al. ([<reflink idref="bib51" id="ref88">51</reflink>]); 16 = Lo et al. ([<reflink idref="bib52" id="ref89">52</reflink>]); 17 = Luevano and Collins ([<reflink idref="bib54" id="ref90">54</reflink>]); 18 = Robinson-Ervin et al. ([<reflink idref="bib58" id="ref91">58</reflink>]); 19 = Shum et al. ([<reflink idref="bib59" id="ref92">59</reflink>]); 20 = Spencer et al. ([<reflink idref="bib62" id="ref93">62</reflink>]); 21 = Tsami et al. ([<reflink idref="bib63" id="ref94">63</reflink>]); 22 = Weddle et al. ([<reflink idref="bib66" id="ref95">66</reflink>])</p> <hd id="AN0188353662-20">Problem Formulation</hd> <p>The following includes examples of how the four items of 'Problem Formulation' domain were addressed: (a) foundational constructs of the study by Graves and Aston ([<reflink idref="bib35" id="ref96">35</reflink>]), who defined identity development as a construct and the intervention concept; (b) relevancy of the research problem by Graves and Aston ([<reflink idref="bib35" id="ref97">35</reflink>]), who described problems with suspensions and expulsions as they related to the school-to-prison pipeline for Black boys and described culturally appropriate ways the problem could be addressed through identity development; (c) critical and comprehensive review of the relevant literature by Clinton et al. ([<reflink idref="bib22" id="ref98">22</reflink>]), who discussed social-emotional learning could be a part of addressing youth violence and described the aspects of the program as well as other fields that addressed the problem, such as developmental psychopathology, public and mental health, and educational psychology; and (d) justification of the theoretical framework by Robinson-Ervin et al. ([<reflink idref="bib58" id="ref99">58</reflink>]), who described the social skills instruction being based on the social modeling paradigm (i.e., demonstration, practice, feedback, and reinforcement) with an emphasis in observational learning.</p> <p>The problem addressed in a research study informs subsequent steps in intervention implementation. Information gathered from the reviewed studies suggest that it is important for researchers, who are aiming to address problems within culturally diverse communities, to select socially issues directly relevant to the population. This might entail an exhaustive literature review to explore ways of addressing the problem while culturally adapting assessment, implementer training, or intervention. The published work should also include a concise overview of the importance of the issues, the alignment of cultural adaptation with the problem at hand, or the rationale for incorporating an existing study feature (e.g., assessment) within the community context. Researchers should ensure that they provide detailed and thorough justification for their chosen framework, elucidating how its application will enrich service provision.</p> <hd id="AN0188353662-21">Design and Logic</hd> <p>The following includes examples of how the four items of 'Design and Logic' domain were addressed: (a) description of participants by Cheremshynski et al. ([<reflink idref="bib20" id="ref100">20</reflink>]), who reported that the caregivers of the intervention recipient being raised in Japan and considered the family's close alignment with the traditional Japanese culture but also incorporated the values of Canadian society, (b) description of researchers and interventionists by Weddle et al. ([<reflink idref="bib66" id="ref101">66</reflink>]), who described the researchers' sex, language, profession, highest degree completed, and certifications held, (c) description of sampling procedures by Castro-Olivo ([<reflink idref="bib16" id="ref102">16</reflink>]) who recruited participants from schools in which the majority of students were ethnic minorities and about a third were English Language Learners (ELLs), and (d) description of research setting by Bradshaw et al. ([<reflink idref="bib11" id="ref103">11</reflink>]), who reported information on race and ethnicity as well as percentage of students receiving free and reduced-price meals.</p> <p>The reviewed studies exhibited a dearth of information pertaining to the 'Design and Logic' domain, which concerns contextual factors that influence relationship between researchers and participants to inform study design. When planning for design and logic of the research study, the researchers should provide thorough explanations of the demographic variables of all individuals involved. The demographics reported should be comprehensive, extending beyond just race, ethnicity, age, and language. Variables such as SES, disability diagnosis or absence of disability, and religion should be reported if the information is accessible. Provision of comprehensive demographic information will allow a way to describe intersectionalities and can be a starting point for including adaptations from the service recipient's perspective and from the researcher's perspective. As Brown et al. ([<reflink idref="bib12" id="ref104">12</reflink>]) suggests, service providers are more likely to best meet the needs of individuals they serve when they have more information on the individuals' backgrounds and variables that should be considered during the adaptation process. Furthermore, the description of the research context is important. The researchers should provide a comprehensive description of the research setting, which may include more than the location and type of setting. Other important variables may be political, social, and historical context. These contextual variables could provide a reason why an intervention or training is effective or provide a rationale for why the researchers made certain decisions in their choice of intervention designs.</p> <hd id="AN0188353662-22">Sources of Evidence</hd> <p>The following includes examples of how the three items of 'Sources of Evidence' domain were addressed: (a) description of data collection strategies by Ceballos and Bratton ([<reflink idref="bib19" id="ref105">19</reflink>]), who provided Spanish versions of instruments based on caregivers' requests and provided free childcare while completing questionnaires to ensure data collection integrity; (b) ecology of the intervention by Hansen et al. ([<reflink idref="bib38" id="ref106">38</reflink>]), who trained teachers on classroom management strategies and implementation of a classroom-based intervention in the school setting; and (c) intervention design by Graves et al. ([<reflink idref="bib37" id="ref107">37</reflink>]), who made modifications to the social-emotional intervention by enhancing its relevance for Black boys, which involved getting to know the students and their experiences, getting to know the community, modifying the delivery of interventions, encouraging critical thinking of others' viewpoints, examining accuracy of assumptions, and seeking feedback.</p> <p>In the area of 'Sources of Evidence,' which concerns designing instruments, measurements techniques, and ecology of intervention to yield reliable and valid outcomes, the reviewed studies included information on data collection. However, within the studies reviewed, limited emphasis was placed on integrating participants' preferences and for maximizing accessibility. Researchers should consider using a multifaced approach to data collection integrating the preferences and needs of the service recipients and data collector. This might entail simple modifications such as considering reading comprehension through conducting an interview instead of written formats, translating materials and including culturally relevant example, phrases and metaphors, or using an instrument that is more feasible to use (e.g., avoid using laborious instruments or modalities inaccessible to recipients for data collection). Moreover, in relation to ecological validity, researchers are encouraged to conducting studies in the participants' typical environments. If conducting research in such settings are not feasible, the focus could shift to targeting skills that would directly benefit the service recipient in those environments.</p> <hd id="AN0188353662-23">Measurement Process</hd> <p>The 'Measurement Process' domain was addressed through a rubric item assessing intervention efficacy. Shum et al. ([<reflink idref="bib59" id="ref108">59</reflink>]) reported psychometric properties of multiple instruments including Social Responsiveness Scale, 2nd Edition (Constantino & Gruber, [<reflink idref="bib24" id="ref109">24</reflink>]) and Adaptative Behavior Assessment System, 2nd Edition (Harrison & Oakland, [<reflink idref="bib40" id="ref110">40</reflink>]), which were used to measure social impairment severity and adaptive behavior, respectively.</p> <p>The results of this review also suggest that standardized and norm-referenced measures that are inclusive of the target population be used for measurement when providing culturally adapted service provision (Shum et al., [<reflink idref="bib59" id="ref111">59</reflink>]). However, there may be outcome variables and data collection methods that do not necessitate standardized and norm-referenced measures. For example, directly observable behaviors can reliably be measured with appropriate data collection systems. Still, researchers should consider providing a detailed description of the assessment and measurement tools that were used. Additionally, they should provide an explanation regarding the reliability and validity of assessments as well as their cultural congruence with the participants (APA, [<reflink idref="bib2" id="ref112">2</reflink>]; Solano-Flores, [<reflink idref="bib61" id="ref113">61</reflink>]).</p> <hd id="AN0188353662-24">Analysis and Interpretation</hd> <p>The 'Analysis and Interpretation' domain were addressed by the following examples: (a) Bradshaw et al. ([<reflink idref="bib11" id="ref114">11</reflink>]) presented findings in which the results for Black and White students were disaggregated and (b) Clinton et al. ([<reflink idref="bib22" id="ref115">22</reflink>]) considered both SES (low and high) and nationality when analyzing and interpreting their results.</p> <p>The 'Analysis and Interpretation' domain focuses on avoiding conclusions that are monolithic towards the historically marginalized group or deficit-oriented and that fail to emphasize the importance of social environmental change. The results of the review indicate that although many studies described the participants' backgrounds and contextual factors, only a limited number analyzed them within a dynamic, complex, and dialogical framework. Thus, the results highlight the significance of considering the identification of participants' backgrounds or contextual variables in a dynamic manner (e.g., considering organizational structures and power distribution), moving beyond a narrow focus on static variables such as race, ethnicity, and socioeconomic status.</p> <hd id="AN0188353662-25">Dissemination</hd> <p>The one item in the 'Dissemination' domain (discussion of dissemination is assessed) was addressed by Knochel et al. ([<reflink idref="bib46" id="ref116">46</reflink>]). In their work, the authors explained that developing behavior-analytic services tailored to specific cultures and actively reducing barriers for practitioners in low-income countries would contribute to the global dissemination evidence-based practices.</p> <p>Only two of the 22 studies addressed 'Dissemination' of the research findings beyond mere discussion of results and recommendations for future research. A vital aspect of research involves strategizing ways to disseminate learned findings and practices to pertinent individuals and communities (e.g., presentation to communities, sharing of data with policymakers, use of accessible language). Therefore, researchers need to extend their contemplation beyond the research process itself and take into account the direct impact and advantage their work can offer to the communities they serve. By ensuring effective dissemination, research can be more meaningful and actionable for those it is intended to benefit.</p> <hd id="AN0188353662-26">Culturally Sensitive Elements within Assessment, Implementer Training, and Intervention</hd> <p>The studies were also examined to identify which culturally sensitive elements of EVM by Bernal et al. ([<reflink idref="bib9" id="ref117">9</reflink>]) were incorporated for cultural adaptation in intervention (see Table 4). Of the 22 studies, most studies addressed the culturally sensitive elements in the dimensions of <emph>Language</emph> (91%), <emph>Persons</emph> (77%), <emph>Goals</emph> (77%), <emph>Methods</emph> (73%), and <emph>Content</emph> (64%), whereas less than half of the studies addressed the culturally sensitive elements in <emph>Metaphors</emph> (50%), <emph>Concepts</emph> (46%), and <emph>Context</emph> (41%) of the EVM framework within assessment, implementer training, or intervention. Examples of how these elements were addressed are described below.</p> <p>Table 4 Culturally sensitive elements within the ecological validity model</p> <p> <ephtml> <table frame="hsides" rules="groups"><thead><tr><th align="left"><p>Author (Year)</p></th><th align="left"><p>Language</p></th><th align="left"><p>Persons</p></th><th align="left"><p>Metaphors</p></th><th align="left"><p>Content</p></th><th align="left"><p>Concepts</p></th><th align="left"><p>Goals</p></th><th align="left"><p>Methods</p></th><th align="left"><p>Context</p></th></tr></thead><tbody><tr><td align="left"><p>Bradshaw et al. (<xref ref-type="bibr" rid="bibr11">2018</xref>)</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td></tr><tr><td align="left"><p>Castro-Olivo (<xref ref-type="bibr" rid="bibr16">2014</xref>)</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td></tr><tr><td align="left"><p>Castro-Olivo et al. (<xref ref-type="bibr" rid="bibr18">2018</xref>)</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td></tr><tr><td align="left"><p>Ceballos and Bratton (<xref ref-type="bibr" rid="bibr19">2010</xref>)</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td></tr><tr><td align="left"><p>Cheremshynski et al. (<xref ref-type="bibr" rid="bibr20">2013</xref>)</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td></tr><tr><td align="left"><p>Clinton et al. (<xref ref-type="bibr" rid="bibr22">2015</xref>)</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td></tr><tr><td align="left"><p>Durán et al. (<xref ref-type="bibr" rid="bibr28">2013</xref>)</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td></tr><tr><td align="left"><p>Gladney et al. (<xref ref-type="bibr" rid="bibr33">2021</xref>)</p><p>Graves and Aston (<xref ref-type="bibr" rid="bibr35">2018</xref>)</p></td><td align="left"><p>–</p><p>x</p></td><td align="left"><p>–</p><p>x</p></td><td align="left"><p>–</p><p>x</p></td><td align="left"><p>x</p><p>x</p></td><td align="left"><p>x</p><p>x</p></td><td align="left"><p>x</p><p>x</p></td><td align="left"><p>x</p><p>x</p></td><td align="left"><p>–</p><p>–</p></td></tr><tr><td align="left"><p>Graves et al. (<xref ref-type="bibr" rid="bibr37">2017</xref>)</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td></tr><tr><td align="left"><p>Hansen et al. (<xref ref-type="bibr" rid="bibr38">2017</xref>)</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td></tr><tr><td align="left"><p>Kim (<xref ref-type="bibr" rid="bibr44">2016</xref>)</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td></tr><tr><td align="left"><p>Knochel et al. (<xref ref-type="bibr" rid="bibr46">2021</xref>)</p><p>Kunze et al. (<xref ref-type="bibr" rid="bibr47">2019</xref>)</p></td><td align="left"><p>x</p><p>x</p></td><td align="left"><p>x</p><p>–</p></td><td align="left"><p>–</p><p>–</p></td><td align="left"><p>–</p><p>–</p></td><td align="left"><p>–</p><p>–</p></td><td align="left"><p>x</p><p>–</p></td><td align="left"><p>x</p><p>–</p></td><td align="left"><p>x</p><p>–</p></td></tr><tr><td align="left"><p>Lo et al. (<xref ref-type="bibr" rid="bibr51">2011</xref>)</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td></tr><tr><td align="left"><p>Lo et al. (<xref ref-type="bibr" rid="bibr52">2015</xref>)</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td></tr><tr><td align="left"><p>Luevano and Collins (<xref ref-type="bibr" rid="bibr54">2020</xref>)</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td></tr><tr><td align="left"><p>Robinson-Ervin et al. (<xref ref-type="bibr" rid="bibr58">2016</xref>)</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td></tr><tr><td align="left"><p>Shum et al. (<xref ref-type="bibr" rid="bibr59">2019</xref>)</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td></tr><tr><td align="left"><p>Spencer et al. (<xref ref-type="bibr" rid="bibr62">2019</xref>)</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td></tr><tr><td align="left"><p>Tsami et al. (<xref ref-type="bibr" rid="bibr63">2019</xref>)</p></td><td align="left"><p>x</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td></tr><tr><td align="left"><p>Weddle et al. (<xref ref-type="bibr" rid="bibr66">2016</xref>)</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td><td align="left"><p>–</p></td><td align="left"><p>x</p></td></tr></tbody></table> </ephtml> </p> <p>This table identifies the culturally sensitive elements included in the articles as described in Bernal et al., [<reflink idref="bib9" id="ref118">9</reflink>]; X = culturally sensitive element included</p> <hd id="AN0188353662-27">Assessment</hd> <p>Table 5 presents summaries of the general type of assessment and cultural responsiveness considered for assessment. Forty-one percent of the studies (<emph>n</emph> = 9) described using an assessment in intervention design. Of these, eight studies (Cheremshynski et al., [<reflink idref="bib20" id="ref119">20</reflink>]; Durán et al., [<reflink idref="bib28" id="ref120">28</reflink>]; Knochel et al., [<reflink idref="bib46" id="ref121">46</reflink>]; Kunze et al., [<reflink idref="bib47" id="ref122">47</reflink>]; Luevano & Collins, [<reflink idref="bib54" id="ref123">54</reflink>]; Shum et al., [<reflink idref="bib59" id="ref124">59</reflink>]; Tsami et al., [<reflink idref="bib63" id="ref125">63</reflink>]; Weddle et al., [<reflink idref="bib66" id="ref126">66</reflink>]) described the culturally sensitive components of the assessments they used. Cheremshynski et al. ([<reflink idref="bib20" id="ref127">20</reflink>]) conducted a self-assessment in which the experimenter kept a written journal to reflect on her experiences, thoughts, and perceptions to better provide behavior support services for both child and caregiver participants and used a cultural assessment tool in which questions were asked regarding planning and family assessment to inform intervention. Knochel et al. ([<reflink idref="bib46" id="ref128">46</reflink>]) interviewed classroom staff to make the intervention adaptation process more collaborative, which focused on incorporating cultural values in the delivery of praise. Durán et al. ([<reflink idref="bib28" id="ref129">28</reflink>]) used a translated questionnaire, an interpreter, and caregiver's native language during initial screening and functional analysis of challenging behavior. Tsami et al. ([<reflink idref="bib63" id="ref130">63</reflink>]) also used caregiver's native language during functional analysis to identify functions of challenging behavior and design interventions.</p> <p>Table 5 Cultural responsiveness within assessment, training, and intervention</p> <p> <ephtml> <table frame="hsides" rules="groups"><thead><tr><th align="left" /><th align="left" colspan="2"><p>Assessment for training/intervention</p></th><th align="left" colspan="2"><p>Implementer training</p></th><th align="left" colspan="2"><p>Intervention for recipients</p></th></tr><tr><th align="left"><p>Author (Year)</p></th><th align="left"><p>Type</p></th><th align="left"><p>Cultural responsiveness</p></th><th align="left"><p>Type</p></th><th align="left"><p>Cultural responsiveness</p></th><th align="left"><p>Type</p></th><th align="left"><p>Cultural responsiveness</p></th></tr></thead><tbody><tr><td align="left"><p>Bradshaw et al. (<xref ref-type="bibr" rid="bibr11">2018</xref>)</p></td><td align="left"><p>NR</p></td><td align="left"><p>N/A</p></td><td align="left"><p><italic>Double Check</italic> Model (augmented SW-PBIS, <italic>Double Check</italic> professional development, and augmented <italic>Classroom Check-Up</italic> (CCU) coaching)</p></td><td align="left"><p>•Additional coaching to SW-PBIS team on data-based decision making and support for other school-wide approaches to increase use of culturally responsive practices</p><p>•Professional development training on cultural responsivity and student engagement addressing 5 Double Check CARES domains including connection of curriculum to student culture and sensitivity to student culture; Individual coaching using an augmented CCU to reflect Double Check's focus on culturally responsive practices</p></td><td align="left"><p>Tier 1 School-Wide Positive Behavioral Interventions and Supports (SW-PBIS)</p></td><td align="left"><p>Implementation of Tier 1 SW-PBIS supports through adoption of classroom management and culturally responsive practices taught in the professional development, focusing on strengths of students' cultural backgrounds, positive interactions, limiting judgment, facility with code-switching, and alignment of student's culture to behavioral expectations</p></td></tr><tr><td align="left"><p>Castro-Olivo (<xref ref-type="bibr" rid="bibr16">2014</xref>)</p></td><td align="left"><p>NR</p></td><td align="left"><p>N/A</p></td><td align="left"><p>Didactic training; Performance feedback</p></td><td align="left"><p>Training by bilingual/bicultural researcher; Use of the Ecological Validity Model in providing cultural-specific examples during feedback</p></td><td align="left"><p><italic>Strong Teens</italic></p></td><td align="left"><p>Using adapted <italic>Strong Teens</italic> translated into Spanish; Delivery of program by bilingual/bicultural teachers; Lessons and examples on how to apply social emotional learning skills pertaining to Latino immigrant youth</p></td></tr><tr><td align="left"><p>Castro-Olivo et al. (<xref ref-type="bibr" rid="bibr18">2018</xref>)</p></td><td align="left"><p>NR</p></td><td align="left"><p>N/A</p></td><td align="left"><p>•Teacher—didactic training</p><p>•Caregiver— didactic training & role-play</p></td><td align="left"><p>Teacher training on risk factors for Latino ELLs and best practices for working with Spanish-speaking students and caregivers; Caregiver training in Spanish at home; suggestion cards in the language of choice; inclusion of supplemental lesson on main difference between the U.S. school systems and the school systems in their country of origin; social-emotional skills to be used with families in the acculturation process</p></td><td align="left"><p><italic>•First Steps to Success</italic> (FSS)</p><p>•Literacy intervention</p></td><td align="left"><p>•Provision of FSS intervention in Spanish by bilingual/bicultural teachers</p><p>•Incorporation of language development into reading lessons</p><p>•Delivery of reading/language intervention by a trained bilingual graduate research assistant</p></td></tr><tr><td align="left"><p>Ceballos and Bratton (<xref ref-type="bibr" rid="bibr19">2010</xref>)</p></td><td align="left"><p>NR</p></td><td align="left"><p>N/A</p></td><td align="left"><p>Group caregiver training—didactic training & role-plays; Performance feedback</p></td><td align="left"><p>Group training in Spanish; Translation of the treatment manual and caregiver handbook in Spanish; change of American names to Latino names; Incorporation of Latino values for socialization and interpersonal relationships during weekly training; Being flexible with training times and session agendas, Incorporation of <italic>personalismo</italic> through weekly phone calls; Provision of materials free of charge, childcare, and snacks for families</p></td><td align="left"><p><italic>Child Parent Relationship Therapy</italic> (CPRT)</p></td><td align="left"><p>Provision of intervention either at home or at a special designated area at the school site based on caregiver choice</p></td></tr><tr><td align="left"><p>Cheremshynski et al. (<xref ref-type="bibr" rid="bibr20">2013</xref>)</p></td><td align="left"><p>Self-assessment</p><p>Interview</p></td><td align="left"><p>Experimenter's written journal recording of thoughts and perceptions of collaborating with family; cultural assessment tool during interview</p></td><td align="left"><p>Behavioral caregiver training including modeling, rehearsal, in-vivo coaching, self-monitoring, and problem-solving discussions</p></td><td align="left"><p>•Addressing communication barrier by therapist, evaluating and adapting communication style, and learning some key Japanese phrases; Guidance from a cultural interpreter who was familiar with Japanese culture and language</p><p>•Recognizing and accommodating a cross-cultural belief system</p></td><td align="left"><p>Individualized positive behavior support</p></td><td align="left"><p>•Incorporation of both Japanese and Canadian cultures into the behavior support plan</p><p>•Use of picture symbols and gestures for communication; use of physical contact and the Japanese language to deliver praise in a culturally appropriate way</p></td></tr><tr><td align="left"><p>Clinton et al. (<xref ref-type="bibr" rid="bibr22">2015</xref>)</p></td><td align="left"><p>NR</p></td><td align="left"><p>N/A</p></td><td align="left"><p>Teacher training—didactic, feedback, consultation</p></td><td align="left"><p>Teacher training and orientation in Spanish</p></td><td align="left"><p><italic>Second Step: A Violence Prevention Program</italic></p></td><td align="left"><p>Use of <italic>Segundo Paso</italic>, a Spanish version of the Second Step; Provision of instruction in Spanish in public schools and both in English and Spanish in private schools</p></td></tr><tr><td align="left"><p>Durán et al. (<xref ref-type="bibr" rid="bibr28">2013</xref>)</p></td><td align="left"><p>FAST; Interview; Functional analysis (FA)</p></td><td align="left"><p>Translation of FAST; Using an interpreter during interview; FA sessions in Spanish</p></td><td align="left"><p>NR</p></td><td align="left"><p>N/A</p></td><td align="left"><p>Function-based intervention</p></td><td align="left"><p>NR</p></td></tr><tr><td align="left"><p>Gladney et al. (<xref ref-type="bibr" rid="bibr33">2021</xref>)</p></td><td align="left"><p>NR</p></td><td align="left"><p>N/A</p></td><td align="left"><p>School-wide and grade-level professional development, multilevel coaching</p></td><td align="left"><p>Professional development training on culturally responsive social skill instruction and CRAFTSS framework</p></td><td align="left"><p>Social skill instruction</p></td><td align="left"><p>Components integrated to promote social engagement and interaction, to make connection between academic content and personal lives, and to vary instructional methods</p></td></tr><tr><td align="left"><p>Graves and Aston (<xref ref-type="bibr" rid="bibr35">2018</xref>)</p></td><td align="left"><p>NR</p></td><td align="left"><p>N/A</p></td><td align="left"><p>NR</p></td><td align="left"><p>N/A</p></td><td align="left"><p><italic>Brothers of Ujima</italic></p></td><td align="left"><p>Intervention developed for African American boys to develop creative thinking/leadership skills, increase appreciation of culture, and learn coping skills when faced with discrimination</p></td></tr><tr><td align="left"><p>Graves et al. (<xref ref-type="bibr" rid="bibr37">2017</xref>)</p></td><td align="left"><p>NR</p></td><td align="left"><p>N/A</p></td><td align="left"><p>NR</p></td><td align="left"><p>N/A</p></td><td align="left"><p><italic>Strong Start</italic></p></td><td align="left"><p>Understanding students' experiences, community, and variations within cultures; Including content examples, scripts, and book recommendations within lessons</p></td></tr><tr><td align="left"><p>Hansen et al. (<xref ref-type="bibr" rid="bibr38">2017</xref>)</p></td><td align="left"><p>NR</p></td><td align="left"><p>N/A</p></td><td align="left"><p>Initial meeting and coaching</p></td><td align="left"><p>NR</p></td><td align="left"><p>Class-wide Function-Related Intervention Teams (CW-FIT)</p></td><td align="left"><p>Delivery of instruction in French; translated social skills posters and other materials; provision of praise statements that native French speakers would use within CW-FIT</p></td></tr><tr><td align="left"><p>Kim (<xref ref-type="bibr" rid="bibr44">2016</xref>)</p></td><td align="left"><p>Interview; direct observation; developmental assessment</p></td><td align="left"><p>NR</p></td><td align="left"><p>NR</p></td><td align="left"><p>N/A</p></td><td align="left"><p>Video</p><p>Modeling</p></td><td align="left"><p>Consideration of child language developmental level and child and mother dominant languages to develop play script; Use of varied video vignettes and sessions across children and language formality</p></td></tr><tr><td align="left"><p>Knochel et al. (<xref ref-type="bibr" rid="bibr46">2021</xref>)</p></td><td align="left"><p>Interview</p></td><td align="left"><p>Open-ended questions to determine cultural adequacy of BSP</p></td><td align="left"><p>BST, self-monitoring, and performance feedback</p></td><td align="left"><p>Weekly team meetings conducted using "pigeon" English and local languages</p></td><td align="left"><p>Praise</p></td><td align="left"><p>Consideration of cultural relevancy and cognitive functioning to adapt the topography of praise</p></td></tr><tr><td align="left"><p>Kunze et al. (<xref ref-type="bibr" rid="bibr47">2019</xref>)</p></td><td align="left"><p>Language correspondence analysis; Discrimination & preference assessments</p></td><td align="left"><p>Choices on edible items & speech generating device in preferred language</p></td><td align="left"><p>NR</p></td><td align="left"><p>N/A</p></td><td align="left"><p>NR</p></td><td align="left"><p>N/A</p></td></tr><tr><td align="left"><p>Lo et al. (<xref ref-type="bibr" rid="bibr51">2011</xref>)</p></td><td align="left"><p>NR</p></td><td align="left"><p>N/A</p></td><td align="left"><p>Explanation, modeling, prompting, practice, and performance feedback</p></td><td align="left"><p>NR</p></td><td align="left"><p><italic>Working Together (WT) social skills curriculum</italic></p></td><td align="left"><p>Adapted <italic>WT</italic> curriculum (using folk stories, role play scenarios, and multimedia images depicting children from varying racial backgrounds); Role play, model-lead-test, and feedback from African American peers</p></td></tr><tr><td align="left"><p>Lo et al. (<xref ref-type="bibr" rid="bibr52">2015</xref>)</p></td><td align="left"><p>NR</p></td><td align="left"><p>N/A</p></td><td align="left"><p>Explanation, modeling, practice, and performance feedback</p></td><td align="left"><p>NR</p></td><td align="left"><p><italic>Ssocial skills curriculumkillstreaming the Elementar School Child (SESC) social skills curriculum</italic></p></td><td align="left"><p>Consisted of cross-cultural friendship skills, scenarios familiar to students, authentic and socially relevant images, videos, photographs, and conversation topics, Latino peer video models, and scenarios with Latino male students' popular & preferred activities; Prompting & feedback from Latino peers</p></td></tr><tr><td align="left"><p>Luevano and Collins (<xref ref-type="bibr" rid="bibr54">2020</xref>)</p></td><td align="left"><p>Culture & preference assessment</p></td><td align="left"><p>Assessment to determine reinforcers, common words used, names of family and friends, favorite foods, and cultural practices</p></td><td align="left"><p>NR</p></td><td align="left"><p>NA</p></td><td align="left"><p>Multi-component problem-solving instruction</p></td><td align="left"><p>Culturally appropriate problem-solving instruction with word problems read in both English and Spanish and video models, relevant word problems and examples, and individualized reinforcers</p></td></tr><tr><td align="left"><p>Robinson-Ervin et al. (<xref ref-type="bibr" rid="bibr58">2016</xref>)</p></td><td align="left"><p>NR</p></td><td align="left"><p>N/A</p></td><td align="left"><p>Description, rationale, role-play, and feedback</p></td><td align="left"><p>NR</p></td><td align="left"><p>Social skills instruction</p></td><td align="left"><p>Culturally responsive stories, scenarios, questions, videos, music, and reinforcers; culturally competent peer models in role plays and video models; Role plays reflecting students' experiences</p></td></tr><tr><td align="left"><p>Shum et al. (<xref ref-type="bibr" rid="bibr59">2019</xref>)</p></td><td align="left"><p>Survey</p></td><td align="left"><p>Amendments made to intervention based on survey completed by local peers</p></td><td align="left"><p>Homework review, description, discussion, and role-play</p></td><td align="left"><p>Inclusion of role-play</p></td><td align="left"><p>PEERS® intervention</p></td><td align="left"><p>Translation of manual; Content, example, and activity modification based on survey (e.g., replacement of common conversational topics)</p></td></tr><tr><td align="left"><p>Spencer et al. (<xref ref-type="bibr" rid="bibr62">2019</xref>)</p></td><td align="left"><p>NR</p></td><td align="left"><p>N/A</p></td><td align="left"><p>Description, modeling, and coaching</p></td><td align="left"><p>NR</p></td><td align="left"><p>Narrative intervention</p></td><td align="left"><p>Delivering Spanish lessons before the corresponding English lessons; Including equivalent linguistic features and vocabulary targets in Spanish stories; take-home activities involving featured stories in English or Spanish</p></td></tr><tr><td align="left"><p>Tsami et al. (<xref ref-type="bibr" rid="bibr63">2019</xref>)</p></td><td align="left"><p>Functional analysis (FA)</p></td><td align="left"><p>Using family's' native language when conducting FA</p></td><td align="left"><p>Description, prompting, & feedback</p></td><td align="left"><p>Sessions conducted by caregivers with coaching from therapist or by therapist through the interpreter using family's native language</p></td><td align="left"><p>Functional communication training (FCT)</p></td><td align="left"><p>Using family's native language when implementing FCT</p></td></tr><tr><td align="left"><p>Weddle et al. (<xref ref-type="bibr" rid="bibr66">2016</xref>)</p></td><td align="left"><p>Multitiered systems of support (MTSS)</p></td><td align="left"><p>Assessment and monitoring to determine the need for intensified supports for CLD students</p></td><td align="left"><p>Role-play</p></td><td align="left"><p>NR</p></td><td align="left"><p>Narrative intervention</p></td><td align="left"><p>Providing intensified supports to CLD students if they performed below set criteria to differentiate between disabilities and language differences and to separate external factors of CLD students</p></td></tr></tbody></table> </ephtml> </p> <p> <emph>BSP</emph> behavior-specific praise; <emph>BST</emph> behavioral skills training; <emph>CLD</emph> culturally and linguistically diverse; <emph>CRAFTSS</emph> Culturally Responsive Academic Framework for Teaching Social Skills; <emph>FAST</emph> Functional Assessment Screening Tool; <emph>NA</emph> not applicable; <emph>NR</emph> not reported; <emph>PEERS</emph> Program for the Education and Enrichment of Relational Skills</p> <p>Luevano and Collins ([<reflink idref="bib54" id="ref131">54</reflink>]) completed culture and preference assessments with students to identify reinforcers and develop word problems that incorporate their culture. Student responses regarding common cultural practices, favorite activities and foods, common words used in the home and names of families and friends were used to develop mathematics word problems. Shum et al. ([<reflink idref="bib59" id="ref132">59</reflink>]) surveyed similar-aged adolescents in local schools for feedback on cultural sensitivity of a social skills intervention, asking about common conversations, areas of interest, means of making friends, commonly used social media platforms, and locations of get-togethers to make amendments to the Program for the Education and Enrichment of Relational Skills (PEERS®) intervention for Chinese adolescents with ASD in Hong Kong. Kunze et al. ([<reflink idref="bib47" id="ref133">47</reflink>]) analyzed a language correspondence to determine the child's choice of language outputs when using speech generating devices. Weddle et al. ([<reflink idref="bib66" id="ref134">66</reflink>]) conducted assessments and monitoring within the multitiered systems of support for culturally and linguistically diverse students to rule out external factors, such as English proficiency, cultural differences, and poverty, that may impact disability identification of the students and to determine the need for intensified supports.</p> <hd id="AN0188353662-28">Implementer Training</hd> <p>The studies in this review involved delivery of interventions by a variety of implementers, including teachers, caregivers, peers, researchers, graduate students, and other professionals. Table 5 presents summaries of the general type of implementer training and cultural responsiveness considered for training across the studies. Seventy-three percent of the studies (<emph>n</emph> = 16) described training procedures used with the implementer. Of these studies, 10 studies (Bradshaw et al., [<reflink idref="bib11" id="ref135">11</reflink>]; Castro-Olivo, [<reflink idref="bib16" id="ref136">16</reflink>]; Castro-Olivo et al., [<reflink idref="bib18" id="ref137">18</reflink>]; Ceballos & Bratton, [<reflink idref="bib19" id="ref138">19</reflink>]; Cheremshynski et al., [<reflink idref="bib20" id="ref139">20</reflink>]; Clinton et al., [<reflink idref="bib22" id="ref140">22</reflink>]; Gladney et al., [<reflink idref="bib33" id="ref141">33</reflink>]; Knochel et al., [<reflink idref="bib46" id="ref142">46</reflink>]; Shum et al., [<reflink idref="bib59" id="ref143">59</reflink>]; Tsami et al., [<reflink idref="bib63" id="ref144">63</reflink>]) described the culturally responsive component of implementer training, which typically involved some combination of didactic training, modeling, role-play or rehearsal, feedback, and coaching.</p> <p>The following are examples of how the culturally sensitive elements of Bernal et al.'s ([<reflink idref="bib9" id="ref145">9</reflink>]) EVM were considered for implementer training. Among the dimensions of EVM, <emph>Language</emph> was addressed in Cheremshynski et al. ([<reflink idref="bib20" id="ref146">20</reflink>]) in which the researchers adjusted their nonverbal and verbal communication styles through readings, evaluation, and guidance from a cultural interpreter. The <emph>Person</emph> dimension was also addressed in Cheremshynaski et al., as they sought guidance from the cultural interpreter who was familiar with Japanese culture. <emph>Content</emph> was addressed in Ceballos and Bratton ([<reflink idref="bib19" id="ref147">19</reflink>]), in which caregiver training was extended to incorporate the value of <emph>allocentrism</emph>, pertinent to socialization and interpersonal relationships. The value of <emph>personalismo</emph> was incorporated by having weekly phone calls to remind caregivers about sessions. Castro-Olivo et al. ([<reflink idref="bib18" id="ref148">18</reflink>]) addressed <emph>Concepts</emph> by providing caregiver training that encompasses concepts tied to risk and protective factors relevant to Latinos, including acculturation and the acculturative gap. The study also addressed <emph>Goals,</emph> with training aiming to assist caregivers in maintaining adaptive values of Latino culture while navigating their children in the U.S. to better match their cultural reality as a participating caregiver. <emph>Methods</emph> was addressed by conducting training in the home, providing training on cultural responsivity across domains, and using culturally specific examples during feedback as well as increasing flexibility of sessions to incorporate culturally relevant issues and increase socialization (Bradshaw et al., [<reflink idref="bib11" id="ref149">11</reflink>]; Castro-Olivo, [<reflink idref="bib16" id="ref150">16</reflink>]; Castro-Olivo et al., [<reflink idref="bib18" id="ref151">18</reflink>]; Ceballos & Bratton, [<reflink idref="bib19" id="ref152">19</reflink>]; Cheremshynski et al., [<reflink idref="bib20" id="ref153">20</reflink>]). Ceballos and Bratton ([<reflink idref="bib19" id="ref154">19</reflink>]) considered participants' SES and immigrant background and made accommodations to provide materials and childcare without cost, addressing <emph>Context</emph> of the EVM.</p> <hd id="AN0188353662-29">Interventions</hd> <p>Table 5 also presents summaries of the general type of intervention and cultural adaptations considered across the studies. Most studies (96%; <emph>n</emph> = 21) described the intervention procedures that were delivered to the children and adolescents. Of these, 86% of studies described the component of the intervention that was culturally responsive. The types of intervention implemented by teachers included behavioral (e.g., school-wide positive behavioral interventions and supports; Bradshaw et al., [<reflink idref="bib11" id="ref155">11</reflink>]), social-emotional (e.g., <emph>Jóvenes Fuertes</emph>; Castro-Olivo, [<reflink idref="bib16" id="ref156">16</reflink>]), and academic (e.g., narrative intervention; Spencer et al., [<reflink idref="bib62" id="ref157">62</reflink>]) interventions. The types of intervention implemented by caregivers were individualized interventions and mostly conducted in the home. For example, a function-based intervention was used to address challenging behavior during family routines (Cheremshynski et al., [<reflink idref="bib20" id="ref158">20</reflink>]), and <emph>Child Parent Relationship Therapy</emph> intervention was used to strengthen child-parent relationship (Ceballos & Bratton, [<reflink idref="bib19" id="ref159">19</reflink>]). The types of intervention implemented by peers included social skills (Lo et al., [<reflink idref="bib51" id="ref160">51</reflink>], [<reflink idref="bib52" id="ref161">52</reflink>]) and behavior interventions that included role-plays, video modeling, and token economy designed to increase following adult directions (Robinson-Ervin et al., [<reflink idref="bib58" id="ref162">58</reflink>]). The interventions implemented by researchers, graduate students, or other professionals included social-emotional, social skills, behavior, and academic interventions. For example, Graves and Aston ([<reflink idref="bib35" id="ref163">35</reflink>]) used a strength-based social-emotional learning curriculum based on an Afrocentric world view. Shum et al. ([<reflink idref="bib59" id="ref164">59</reflink>]) used the PEERS® training program to improve social skills of adolescents with ASD. Durán et al. ([<reflink idref="bib28" id="ref165">28</reflink>]) implemented function-based communication training. Luevano and Collins ([<reflink idref="bib54" id="ref166">54</reflink>]) used culturally appropriate math problem-solving instructions.</p> <p>The following are some examples of how the studies addressed the culturally sensitive elements of the Bernal et al.'s ([<reflink idref="bib9" id="ref167">9</reflink>]) EVM in adapting the intervention. <emph>Language</emph> was addressed by having teachers focus on facility with code-switching to recognize students' social interaction styles and respond differentially (Bradshaw et al., [<reflink idref="bib11" id="ref168">11</reflink>]), having class staff determine the topography of praise used as social reinforcer, which included singing, drumming, and use of local verbiage (e.g., "Ayaako!"; Knochel et al., [<reflink idref="bib46" id="ref169">46</reflink>]), developing scripts of a video model by considering children's dominant languages and using honorific language (Kim, [<reflink idref="bib44" id="ref170">44</reflink>]), and integrating familiar language used among the group of students in videos and scenarios (Lo et al., [<reflink idref="bib52" id="ref171">52</reflink>]).</p> <p> <emph>Persons</emph> was typically addressed through matching intervention recipients based on language, cultural background, or age (e.g., Bradshaw et al., [<reflink idref="bib11" id="ref172">11</reflink>]; Lo et al., [<reflink idref="bib52" id="ref173">52</reflink>]; Kim, [<reflink idref="bib44" id="ref174">44</reflink>]), in particular, involving caregivers as play partner (Kim, [<reflink idref="bib44" id="ref175">44</reflink>]), involving peers who shared similar cultural backgrounds and demonstrated relevant social skills as models within social skills instruction (Lo et al., [<reflink idref="bib52" id="ref176">52</reflink>]), and delivering intervention through implementer's self-reflection and learning of students' experiences and community (Bradshaw et al., [<reflink idref="bib11" id="ref177">11</reflink>]). <emph>Metaphors</emph> was addressed within intervention by incorporating metaphors, images, examples, folktales, stories, conversation topics, videos, music, and reinforcers that reflect intervention recipient's cultural values or backgrounds and those that enhance the relevance of the intervention for the target population (e.g., Clinton et al., [<reflink idref="bib22" id="ref178">22</reflink>]; Luevano & Collins, [<reflink idref="bib54" id="ref179">54</reflink>]).</p> <p> <emph>Content</emph> was addressed by considering cultural values, embedding relevant content, and incorporating intervention recipients' experiences. In Graves and Aston ([<reflink idref="bib35" id="ref180">35</reflink>]), the social-emotional curriculum was specifically developed for African American boys. Other examples included delivering lessons on applying social-emotional skills that reflect cultural values and customs of the Latino immigrant youth (Castro-Olivo, [<reflink idref="bib16" id="ref181">16</reflink>]), making role-plays of social skills directly relevant to the intervention recipients' experiences (Lo et al., [<reflink idref="bib51" id="ref182">51</reflink>]; Robinson-Ervin et al., [<reflink idref="bib58" id="ref183">58</reflink>]), and modifying the content of sessions, examples embedded, and activities based on survey responses from local Chinese adolescents living in Hong Kong (Shum et al., [<reflink idref="bib59" id="ref184">59</reflink>]).</p> <p> <emph>Concepts</emph> was addressed through explanations of the approach to intervention, including reframing and problem-solving skills to cope with acculturative stress and familial acculturative gaps as well as promoting ethnic pride (Castro-Olivo, [<reflink idref="bib16" id="ref185">16</reflink>]), and designing intervention that incorporate culturally relevant information, both language and background knowledge (Luevano & Collins, [<reflink idref="bib54" id="ref186">54</reflink>]). <emph>Goals</emph> was addressed by either framing goals within the values and customs of the intervention recipients or establishing their importance to the target group. For example, Graves and Aston ([<reflink idref="bib35" id="ref187">35</reflink>]) had a goal of helping intervention recipients assess myths and stereotypes of African Americans, develop creative thinking and leadership skills, increase appreciation of their culture, and learn how to cope with discrimination.</p> <p> <emph>Methods</emph> was addressed by making modifications to the intervention to better support the target population. The overall approaches included: (a) considering recipients' cultural values and beliefs, matching the recipients' and therapists' ethnic backgrounds, and allowing for increased accessibility of the intervention (Castro-Olivo, [<reflink idref="bib16" id="ref188">16</reflink>]; Castro-Olivo et al., [<reflink idref="bib18" id="ref189">18</reflink>]; Ceballos & Bratton, [<reflink idref="bib19" id="ref190">19</reflink>]); (b) adjusting the curriculum by understanding recipient' experiences (e.g., challenging life situations), familiarizing with their community, encouraging different viewpoints to recognize within culture variation, and seeking feedback (Graves et al., [<reflink idref="bib37" id="ref191">37</reflink>]); (c) incorporating culturally responsive practices (e.g., focusing on strengths, facilitating positive interactions, limiting judgment) within Tier 1 school-wide positive behavioral interventions and supports (Bradshaw et al., [<reflink idref="bib11" id="ref192">11</reflink>]); and (d) engaging in self-reflection and active learning to incorporate family's culture in behavior support plans (Cheremshynski et al., [<reflink idref="bib20" id="ref193">20</reflink>]).</p> <p> <emph>Context</emph> was addressed by considering the socio-economic, historical, and political contexts in which service provision was delivered. Castro-Olivo ([<reflink idref="bib16" id="ref194">16</reflink>]) considered the life circumstances of the intervention recipients and the relevancy of intervention effects. Lessons reflected student contexts and focused on helping Latino immigrant adolescents with acculturation. Cheremshynski et al. ([<reflink idref="bib20" id="ref195">20</reflink>]) recognized that family's values and practices were influenced by both Japanese and Canadians cultures. Therefore, they considered both place of birth and current residence, and incorporated both cultures in the behavior support plan.</p> <hd id="AN0188353662-30">Discussion</hd> <p>This systematic review examined 22 peer-reviewed group and single subject design studies, published in 15 journals, which incorporated culturally responsive assessment, implementer training, or intervention to yield positive outcomes for children and adolescents from diverse cultural backgrounds. The studies included in the review provide information on how culturally responsive methodologies could be incorporated into service provision when working with culturally diverse individuals in the school, home, and community settings. Major findings and considerations as they relate to incorporating cultural adaptations in assessment, implementer training, and intervention are discussed below.</p> <hd id="AN0188353662-31">General Characteristics of Studies</hd> <p>The dependent variables measured for the intervention recipients can be categorized as challenging behavior (e.g., disruption, aggression, property destruction, and self-injury), desired behavior (e.g., on-task behavior and completion of routine), social skills (e.g., aggression-resolution), social-emotional skills (e.g., social–emotional resiliency and identity development), and academic skills (e.g., nonsense word fluency and mathematics word problems). Although some of the targeted dependent variables may not seem culturally relevant, many studies provided descriptions in their introduction sections on the relevance of the dependent variables. For instance, Bradshaw et al. ([<reflink idref="bib11" id="ref196">11</reflink>]), who targeted office disciplinary referrals, explained in the introduction that the reason for targeting this dependent variable was to minimize the large disproportional discipline rates between Black and White students. Castro-Olivo ([<reflink idref="bib16" id="ref197">16</reflink>]) targeted social-emotional resiliency skills with explanation that Latino English language learners need this skill to effectively cope with acculturative stress and discrimination. Shum et al. ([<reflink idref="bib59" id="ref198">59</reflink>]) targeted social skills with Chinese adolescents with ASD living in Hong Kong because developing high-quality friendships and minimizing risk for victimization of bullying is generally considered important and reportedly difficult for the targeted population to achieve. Like the researchers have done in previous studies (e.g., Bradshaw et al., [<reflink idref="bib11" id="ref199">11</reflink>]; Castro-Olivo, [<reflink idref="bib16" id="ref200">16</reflink>]; Shum et al., [<reflink idref="bib59" id="ref201">59</reflink>]), researchers and practitioners may need to be intentional in selecting goals that are culturally relevant. This may necessitate conducting research on areas of need for specific cultural groups, learning about the community where the individuals live, and learning about the values of the individual families (Bradshaw et al., [<reflink idref="bib11" id="ref202">11</reflink>]; Castro-Olivo, [<reflink idref="bib16" id="ref203">16</reflink>]; Cheremshynski et al., [<reflink idref="bib20" id="ref204">20</reflink>]; Shum et al., [<reflink idref="bib59" id="ref205">59</reflink>]). While many intervention goals may benefit diverse cultural groups and not all goals must be selected based on culture, cultural relevancy should still be considered when selecting goals (Fong & Tanaka, [<reflink idref="bib30" id="ref206">30</reflink>]).</p> <p>Social validity holds particular significance for culturally responsive services. Although numerous studies included in this review attempted to assess social validity, they primarily relied on subjective questionnaires, which is consistent with previous findings from reviews of behavioral intervention studies (Ferguson et al., [<reflink idref="bib29" id="ref207">29</reflink>]; Park & Blair, [<reflink idref="bib57" id="ref208">57</reflink>]). Questionnaires offer insight into the social significance of goals, social appropriateness of the procedures, and social importance of the effects. Additionally, considering that social validity, more generally, is typically not reported at all within empirical studies (Ledford et al., [<reflink idref="bib50" id="ref209">50</reflink>]; Snodgrass et al., [<reflink idref="bib60" id="ref210">60</reflink>]), the outcomes within the current study indicating that most studies reported the results of social validity assessment is encouraging. However, the results from subjective measurements, often Likert-type scale ratings, that are conducted at the end of services are likely to be positive, regardless of the effectiveness of the treatment and lead to invalid and undifferentiated outcomes (Ledford et al., [<reflink idref="bib50" id="ref211">50</reflink>]; Machalicek et al., [<reflink idref="bib55" id="ref212">55</reflink>]). Therefore, alternative methods of and approaches for assessing social validity of intervention could offer further insight. For instance, Kunze et al. ([<reflink idref="bib47" id="ref213">47</reflink>]) used choice as a potential way to assess social validity. Other means include the use of focus groups, evaluating sustained use of a procedure after removal of support, and conducting social and normative comparisons, among other approaches (Park & Blair, [<reflink idref="bib57" id="ref214">57</reflink>]). Shum et al. ([<reflink idref="bib59" id="ref215">59</reflink>]) examined weekly attendance, homework completion, and overall intervention completion to evaluate the feasibility of the intervention. These measures can provide objective ways of evaluating social validity, extending beyond participant feedback. Future researchers might consider employing various methods to comprehensively measure social validity with target populations.</p> <hd id="AN0188353662-32">Characteristics of Implementers and Intervention Recipients</hd> <p>The results of this review suggest that when implementers and intervention recipients were matched, they were matched based on race, ethnicity, nationality, or language. However, it is important to note that such matching is only valuable when there are shared variables associated with individuals from similar backgrounds (Fong et al., [<reflink idref="bib31" id="ref216">31</reflink>]). For example, merely sharing a racial background may not hold significance if their values do not align. Furthermore, the lack of diversity among professionals providing services can hinder the feasibility of matching culturally diverse service providers with intervention recipients (American Psychological Association [APA], [<reflink idref="bib3" id="ref217">3</reflink>]; Behavior Analyst Certification Board [BACB], [<reflink idref="bib8" id="ref218">8</reflink>]; Goforth et al., [<reflink idref="bib34" id="ref219">34</reflink>]). Therefore, researchers should evaluate alternative approaches in which service providers who are not matched across these characteristics (e.g., race, ethnicity) deliver culturally responsive services and investigate whether there still would be differences in outcomes (e.g., caregivers' adherence, service recipients' behavioral outcomes) based on cultural backgrounds of the service providers and recipients.</p> <p>Approximately half of the studies involved teachers and caregivers as implementers, which is appropriate given their roles in the immediate environments of the intervention recipients. Although intervention delivery might be suitable for researchers and professionals in certain contexts, future researchers should consider training change agents in the natural environment to implement interventions and provide support (e.g., coaching) during implementation, which may promote provision of culturally responsive interventions (Fong & Tanaka, [<reflink idref="bib30" id="ref220">30</reflink>]). Although some studies (e.g., translational study) may be conducted in more contrived contexts and cultural variables can be examined in these contexts, it would be important to consider cultural factors (e.g., religious practices, accessibility of services, responsibilities that may compete with intervention implementation, values regarding appropriateness of goals or procedures; Kwak et al., in press) in applied settings if the purpose of the research is to ensure generalization of outcomes and social relevance. When SES of the service recipients was indicated, it mainly referred to low SES indicators (e.g., free or reduced-cost lunches), without any representation of high SES indicators. Authors should consider reporting the SES of participants even if they are not from low-income backgrounds. Additionally, the authors inconsistently reported demographics on whether the service recipients had disabilities. Overall, researchers should include comprehensive data on cultural variables so that the readers are able to identify who were being serviced and to whom the results could be generalized to.</p> <hd id="AN0188353662-33">Cultural Responsiveness in Assessment, Implementer Training, and Intervention</hd> <p></p> <hd id="AN0188353662-34">Assessments</hd> <p>As shown across several studies, incorporating meaningful adaptations to assessment may be important to design culturally responsive interventions (Brown et al., [<reflink idref="bib12" id="ref221">12</reflink>]). Determining which assessment method to use or what kind of adaptations should be made to the assessment is important in informing implementer training and intervention delivery. For example, Luevano and Collins ([<reflink idref="bib54" id="ref222">54</reflink>]) conducted a cultural assessment directly with the intervention recipients to inform adaptations to the content of the intervention, whereas Knochel et al. ([<reflink idref="bib46" id="ref223">46</reflink>]) received input from multiple stakeholders on the cultural adequacy of the intervention. A commonality across several studies is that the researchers explicitly asked questions to gather information that would be used for intervention design. However, the difficulty for many researchers and practitioners may be that they may not know what questions to ask. Although the questions may differ based on the intervention delivered and goals targeted, researchers and practitioners may consider using cultural assessment tools that consist of a set list of questions (e.g., Kwak et al., in press; McCabe et al., [<reflink idref="bib56" id="ref224">56</reflink>]).</p> <p>Assessments may also be used with implementers to engage them in self-reflection throughout intervention to identify biases and areas for improvement. For example, the implementer in Cheremshynski et al. ([<reflink idref="bib20" id="ref225">20</reflink>]) self-evaluated interactions with the family to better provide behavior support services for both child and caregiver participants and used a cultural assessment tool in which questions were asked to inform intervention design. Knochel et al. ([<reflink idref="bib46" id="ref226">46</reflink>]) conducted interviews with classroom staff to make the intervention adaptation process more collaborative, which focused on incorporating cultural values in the delivery of praise. These are examples of how an assessment can be used to make appropriate and intentional efforts to provide culturally appropriate interventions instead of simply matching demographic characteristics between the implementer and the intervention recipient. Based on the articles that were reviewed, it may be helpful for researchers and practitioners to challenge their own thoughts, ask questions to clarify rather than make assumptions, and conduct self-assessment of attitudes and biases, especially when first meeting with service recipients who need intervention services (Beene, [<reflink idref="bib7" id="ref227">7</reflink>]; Dennison et al., [<reflink idref="bib26" id="ref228">26</reflink>]).</p> <hd id="AN0188353662-35">Implementer Training</hd> <p>The studies included in the current review employed a diverse array of strategies, such as the implementer adapting their nonverbal and verbal communication styles, obtaining guidance from a cultural interpreter, incorporating the values of caregivers, conducting training in the home, increasing flexibility of sessions, and considering SES of the participants to provide culturally responsive implementer training. Based on the articles reviewed, providing training in the preferred language of the intervention implementer, which can necessitate hiring an interpreter, may be needed when collaborating with implementers from culturally and linguistically diverse backgrounds (Castro-Hostetler et al., [<reflink idref="bib15" id="ref229">15</reflink>]; Fong & Tanaka, [<reflink idref="bib30" id="ref230">30</reflink>]). Language adaptations can allow researchers and practitioners to build rapport with the implementers and show authenticity in their efforts. This aligns with recommendations for professionals to overcome barriers by addressing differences in language when serving individuals from diverse backgrounds (Dennison et al., [<reflink idref="bib26" id="ref231">26</reflink>]). It is also important to consider the communication style in addition to language. Ways of adapting "language" to be culturally responsive could extend beyond formal language and include the use of appropriate nonverbal communication, phrasing of statements, and culture-specific colloquialisms (Cheremshynski et al., [<reflink idref="bib20" id="ref232">20</reflink>]). Researchers and practitioners can proactively consult with stakeholders as well as confirm that culturally appropriate statements and methods of communication are used (Graves et al., [<reflink idref="bib37" id="ref233">37</reflink>]).</p> <p>One way to incorporate implementer's values is by providing flexibility in training to ensure that their input is considered, so that the researchers and practitioners can adjust a preplanned method of training (Bradshaw et al., [<reflink idref="bib11" id="ref234">11</reflink>]; Castro-Olivo, [<reflink idref="bib16" id="ref235">16</reflink>]). For example, when there are opportunities for researchers to provide examples or feedback, they may consider using culturally specific examples and culturally responsive feedback (Castro-Olivo, [<reflink idref="bib16" id="ref236">16</reflink>]). In Ceballos and Bratton ([<reflink idref="bib19" id="ref237">19</reflink>]), the caregiver training was extended to incorporate the value of <emph>allocentrism</emph> related to socialization and interpersonal relationships. The value of <emph>personalismo</emph> was incorporated by having weekly phone calls to remind caregivers about sessions. As demonstrated in Ceballos and Bratton ([<reflink idref="bib19" id="ref238">19</reflink>]), embedding important cultural values within implementer training may be warranted when working with a group of individuals from similar cultural backgrounds.</p> <hd id="AN0188353662-36">Interventions</hd> <p>When tailoring interventions, researchers and practitioners can consider designing interventions for a specific target population. For example, Castro-Olivo ([<reflink idref="bib16" id="ref239">16</reflink>]) delivered lessons to apply social-emotional skills that reflect cultural values and customs of the Latino immigrant youth. Researchers and practitioners can also consider gathering relevant information and incorporating cultural values and beliefs of individuals to make interventions as closely relevant to the individual recipient's culture (Cheremshynski et al., [<reflink idref="bib20" id="ref240">20</reflink>]). Researchers could consult with focus groups and experts and make efforts to learn directly from the setting or community as suggested by Barrera et al. ([<reflink idref="bib6" id="ref241">6</reflink>]). This is consistent with recommendations for practitioners to increase conversations with intervention recipients from diverse cultural backgrounds (Beene, [<reflink idref="bib7" id="ref242">7</reflink>]) and to engage with as many stakeholders as possible when considering adaptations (Brown et al., [<reflink idref="bib12" id="ref243">12</reflink>]). Researchers and practitioners may need to learn about challenging life circumstances (e.g., limited access to services or resources) and consider common barriers to develop the most appropriate intervention or adapt the delivery of intervention. This is in alignment with the recommendation that professionals should conduct individual analysis of cultural and contextual factors that may affect the intervention recipients' environment when possible (Dennison et al., [<reflink idref="bib26" id="ref244">26</reflink>]).</p> <hd id="AN0188353662-37">Limitations, Future Directions, and Conclusion</hd> <p>Some limitations with the current review need to be considered. The majority of the selected articles were identified through the journal search process. The 15 journals selected for hand-search were generally considered to represent the fields of behaviors analysis, special education, and school psychology. Expanding the search to include additional journals might have enhanced the comprehensiveness of the findings. Nevertheless, the search was deemed sufficiently comprehensive, considering the inclusion of articles from six electronic databases in addition to the journal searches. Additionally, articles that made cultural adaptations could have been excluded if the adaptations were not explicitly and sufficiently described. However, it was important that the included studies provide detailed descriptions for the information extracted for this systematic review to be valuable to the readers. Although limitations are inherent in any search and review process, it is notable that only 22 studies were met the inclusionary criteria for analysis from a pool of 16,249 articles. Brown et al. ([<reflink idref="bib12" id="ref245">12</reflink>]) also noted the limited number of empirical articles as their systematic review only identified 10 studies that evaluated culturally adapted school-based interventions for students with or at-risk for EBD or had challenging behavior. While conceptual articles and replication studies were encountered during the search, the scarcity of culturally responsive experimental studies is evident. There is a clear need for more rigorous experimental evaluation of culturally responsive interventions to gather evidence for interventions that are proven to work in practical settings. In addition, it is worth highlighting that despite some studies used methodologically rigorous research designs, only one study (Knochel et al., [<reflink idref="bib46" id="ref246">46</reflink>]) included in the review specifically assessed the additional benefit of cultural adaptation from the standard intervention. Another avenue for future researchers lies in examining which outcome variables are significantly affected by cultural responsiveness within assessment, implementer training, or intervention. Future researchers could also conduct review studies that focus on cultural adaptations that are made within specific assessment, training, or intervention (e.g., cultural adaptations within functional communication training). However, at this time, it may be difficult to find a sufficient number of studies that would be included in those reviews if the inclusion criteria are similar to the current review.</p> <p>In summary, this review provides researchers and practitioners with information regarding the characteristics of the included studies (e.g., characteristics of the implementers and recipients), the alignment of studies with quality indicators for culturally responsive research suggested by Bal and Trainor ([<reflink idref="bib5" id="ref247">5</reflink>]), and the integration of culturally sensitive elements proposed by Bernal et al. ([<reflink idref="bib9" id="ref248">9</reflink>]). Additionally, this review offers an overview of cultural adaptations that were made within assessment, implementer training, and intervention, presenting specific examples of cultural adaptations and recommendations for both research and practice. Given the limited pool of studies that address cultural responsiveness, this review aspires to equip researchers and practitioners with valuable insights to enhance culturally responsive research and practice endeavors.</p> <hd id="AN0188353662-38">Declarations</hd> <p></p> <hd id="AN0188353662-39">Conflict of interest</hd> <p>The authors declare that there is no conflict of interest regarding the publication of this article.</p> <hd id="AN0188353662-40">Publisher's Note</hd> <p>Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.</p> <ref id="AN0188353662-41"> <title> References </title> <blist> <bibl id="bib1" idref="ref2" type="bt">1</bibl> <bibtext> American Educational Research Association [AERA]. Standards for reporting on empirical social science research in AERA publications. 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  Data: Cultural Responsiveness in Assessment, Implementer Training, and Intervention in School, Home, and Community Settings: A Systematic Review
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  Data: English
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  Data: <searchLink fieldCode="AR" term="%22Daniel+Kwak%22">Daniel Kwak</searchLink> (ORCID <externalLink term="http://orcid.org/0000-0002-3102-7340">0000-0002-3102-7340</externalLink>)<br /><searchLink fieldCode="AR" term="%22Marlesha+C%2E+Bell%22">Marlesha C. Bell</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-8566-1515">0000-0002-8566-1515</externalLink>)<br /><searchLink fieldCode="AR" term="%22Kwang-Sun+C%2E+Blair%22">Kwang-Sun C. Blair</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0001-9377-6585">0000-0001-9377-6585</externalLink>)<br /><searchLink fieldCode="AR" term="%22Sarah+E%2E+Bloom%22">Sarah E. Bloom</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-8071-8981">0000-0002-8071-8981</externalLink>)
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  Data: <searchLink fieldCode="SO" term="%22Journal+of+Behavioral+Education%22"><i>Journal of Behavioral Education</i></searchLink>. 2025 34(3):526-573.
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  Data: Springer. Available from: Springer Nature. One New York Plaza, Suite 4600, New York, NY 10004. Tel: 800-777-4643; Tel: 212-460-1500; Fax: 212-460-1700; e-mail: customerservice@springernature.com; Web site: https://link.springer.com/
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  Data: 48
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  Label: Publication Date
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  Data: 2025
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  Data: Journal Articles<br />Information Analyses<br />Reports - Research
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  Label: Descriptors
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  Data: <searchLink fieldCode="DE" term="%22Evaluation+Methods%22">Evaluation Methods</searchLink><br /><searchLink fieldCode="DE" term="%22Research+Methodology%22">Research Methodology</searchLink><br /><searchLink fieldCode="DE" term="%22Children%22">Children</searchLink><br /><searchLink fieldCode="DE" term="%22Adolescents%22">Adolescents</searchLink><br /><searchLink fieldCode="DE" term="%22Diversity%22">Diversity</searchLink><br /><searchLink fieldCode="DE" term="%22Background%22">Background</searchLink><br /><searchLink fieldCode="DE" term="%22Educational+Environment%22">Educational Environment</searchLink><br /><searchLink fieldCode="DE" term="%22Family+Environment%22">Family Environment</searchLink><br /><searchLink fieldCode="DE" term="%22Community%22">Community</searchLink><br /><searchLink fieldCode="DE" term="%22Educational+Practices%22">Educational Practices</searchLink><br /><searchLink fieldCode="DE" term="%22Cultural+Relevance%22">Cultural Relevance</searchLink><br /><searchLink fieldCode="DE" term="%22Participant+Characteristics%22">Participant Characteristics</searchLink><br /><searchLink fieldCode="DE" term="%22Program+Implementation%22">Program Implementation</searchLink><br /><searchLink fieldCode="DE" term="%22Training%22">Training</searchLink><br /><searchLink fieldCode="DE" term="%22Culturally+Relevant+Education%22">Culturally Relevant Education</searchLink><br /><searchLink fieldCode="DE" term="%22Educational+Research%22">Educational Research</searchLink><br /><searchLink fieldCode="DE" term="%22Intervention%22">Intervention</searchLink><br /><searchLink fieldCode="DE" term="%22Student+Characteristics%22">Student Characteristics</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1007/s10864-024-09547-7
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 1053-0819<br />1573-3513
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: The purpose of the current systematic review was to synthesize and evaluate the empirical database to assist researchers and practitioners in conducting culturally responsive research and implementing culturally responsive practices for children and adolescents from culturally diverse backgrounds. After screening 16,249 articles through journal and electronic database searches, a final selection of 22 peer-reviewed articles were included in the review. These experimental group and single-subject design studies addressed cultural responsiveness in assessment, implementer training, and intervention yielding positive behavioral, social skills, academic, and social-emotional outcomes for children and adolescents from diverse cultural backgrounds across school, home, and community settings. The studies were published across 15 journals (2010-2022) and included 281 implementers and 536 children and adolescents. Results showed that all but one study addressed most rubric items of quality indicators for culturally responsive experimental research (Bal & Trainor, Review of Educational Research, 86(2), 319-359, 2016) to some extent, and most studies addressed a majority of culturally sensitive elements of the Ecological Validity Model (EVM; Bernal et al., Journal of Abnormal Child Psychology, 23(1), 67-82, 1995). Most studies reported cultural responsiveness in intervention, whereas fewer described cultural adaptations to assessment and implementer training. Cultural adaptations that were made within the studies as well as suggestions for making adaptations within assessment, implementer training, and intervention delivery are described.
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  Data: 2025
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        PageCount: 48
        StartPage: 526
    Subjects:
      – SubjectFull: Evaluation Methods
        Type: general
      – SubjectFull: Research Methodology
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      – SubjectFull: Children
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      – SubjectFull: Adolescents
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      – SubjectFull: Intervention
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