Culturally Adapted RUBI-T for Spanish-Speaking Families in Texas and Mexico

ConditionAutism
Trial statusNot yet recruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18+
SponsorBaylor University

About this trial

Supporting young autistic children can sometimes be very stressful, especially when children show behaviors that are difficult to understand and/or manage in everyday life. Research has shown that teaching parents practical strategies through programs like the Research Units in Behavioral Intervention (RUBI) can reduce these behaviors and help parents feel more confident. However, most of these programs have only been studied with English-speaking families, which means Spanish-speaking caregivers often do not have access to support that feels relevant to their culture and language.

This study will test a version of RUBI that has been adapted for Spanish-speaking families in the U.S. and Mexico. We will invite 100 parents of autistic children between the ages of 2 and 9 to take part. Half will start the program right away, while the other half will wait and receive it later. Parents in the program will join eight online group sessions, use a Spanish handbook at home, and practice strategies with support from trained facilitators.

We will look at whether the program helps reduce children's challenging behaviors, lowers parent stress, and increases parents' confidence in managing behaviors. We will also ask parents to share their experiences and opinions about how well the program fits their culture and daily life.

By combining numbers (surveys) and stories (interviews), this project will show whether the adapted program works well for Spanish-speaking families. The results can help make autism services more fair, accessible, and supportive for families from diverse backgrounds.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Caregiver of a child aged 2 to 9 years.

Caregiver of a child diagnosed with autism or suspected of being autistic.

Child exhibits challenging behaviors in naturalistic environments (e.g., home, school, community).

Caregiver is willing to complete all aspects of the study, including assessments and intervention sessions.

Disqualifiers

Prior participation in the Research Units in Behavioral Intervention (RUBI) program.

Caregiver does not speak Spanish.

Caregiver unable or unwilling to provide informed consent.

Trial design

Design model

Parallel

Treatments tested in this trial

  • Adapted RUBI-Telehealth

    Behavioral

    The Adapted RUBI Parent Training is a culturally tailored version of the Research Units in Behavioral Intervention (RUBI) program, designed for Spanish-speaking caregivers of young autistic children. The intervention consists of 8 weekly sessions delivered virtually in Spanish by trained behavioral therapists. Each session incorporates behavioral skills training methods (instruction, modeling, role-play, and feedback). Caregivers use a Spanish-language RUBI handbook to complete weekly home practice activities and receive feedback during sessions. The program focuses on helping caregivers understand the functions of challenging behavior and apply evidence-based strategies to reduce these behaviors and promote positive child outcomes.

Treatment groups

120 Participants
are divided into 2 treatment groups
Group A: Adapted RUBI-TExperimental treatment 1 intervention
Group B: Waitlist Control ArmNo intervention 0 interventions

Trial outcomes

Primary outcomes

1

Change in challenging behaviors measured by the Home Situations Questionnaire-ASD (HSQ-ASD)

The HSQ-ASD (Chowdhury et al., 2016) is a 24-item caregiver-report tool assessing severity of challenging behaviors in children with autism across daily situations. Higher scores indicate more severe problem behaviors.

Time frame
Baseline (T1, pre-intervention), Post-intervention (T2, ~8 weeks after baseline), and Maintenance (T3, ~16 weeks after baseline, following waitlist group intervention)
2

Change in caregiver confidence measured by the RUBI Parent Confidence Scale (PCS)

The PCS is a 12-item measure of caregiver confidence in applying behavioral strategies from the RUBI program. Scores range from 1-3, with higher scores indicating greater confidence.

Time frame
T1 (baseline), T2 (~8 weeks), and T3 (~16 weeks)
3

Change in caregiver knowledge measured by the Caregiver Knowledge Assessment (CKA)

The CKA (Lee et al., 2022) is a 28-item multiple-choice assessment of caregiver knowledge of behavioral parent training strategies. Higher scores reflect greater knowledge.

Time frame
T1 (baseline), T2 (~8 weeks), and T3 (~16 weeks)
4

Change in treatment acceptability and satisfaction measured by the Scale of Treatment Perceptions (STP)

The STP (Berger et al., 2016) uses a 7-point Likert scale to assess acceptability, anticipated outcomes (T1), and satisfaction with the program (T2, T3).

Time frame
T1 (baseline, anticipated outcomes), T2 (~8 weeks, satisfaction), and T3 (~16 weeks, maintenance satisfaction)

Secondary outcomes

1

Change in caregiver stress measured by the Autism Parenting Stress Index (APSI)

The APSI is a caregiver-report questionnaire that measures stress related to parenting a child with autism, focusing on areas such as social communication, challenging behaviors, and daily care. Higher scores indicate higher parenting stress.

Time frame
T1 (baseline, pre-intervention), T2 (post-intervention, ~8 weeks), and T3 (maintenance, ~16 weeks after baseline, following waitlist intervention)
2

Implementation outcomes of adapted RUBI program (12-item measure)

A 12-item implementation outcome measure will be used to assess caregiver perceptions of feasibility, acceptability, appropriateness, and intention to use the strategies taught in the adapted RUBI program. Items are scored on a Likert scale, with higher scores reflecting more favorable implementation outcomes.

Time frame
T3 (maintenance, ~16 weeks after baseline, following waitlist intervention)

Other outcomes

1

Caregiver perceptions of cultural relevance, feasibility, and barriers to implementation

Qualitative data will be collected through post-intervention narrative responses and optional semi-structured focus group interviews. Analyses will explore caregivers' experiences with cultural relevance, feasibility, barriers, and facilitators of the adapted RUBI program.

Time frame
Post-intervention (T2, ~8 weeks) and Maintenance (T3, ~16 weeks)

Sponsors and contacts

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Baylor University

Lead sponsor

University of Texas Rio Grande Valley

Collaborator

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