Cultural Responsiveness in Community Early Intervention: A Mixed-Methods Observational Study of Coaching Practices.

BACKGROUND AND PURPOSE: Caregiver-mediated early intervention (EI) for autistic children depends on meaningful caregiver engagement, yet Latine families face persistent structural and cultural barriers to equitable participation. Despite growing recognition of cultural responsiveness (CR) as a core EI component, few studies have examined how providers enact culturally responsive practices or whether those practices relate to observed caregiver engagement. This mixed-methods study examined that relationship in community-based EI services for Latine families of autistic children. METHODS: This secondary analysis drew from a larger community effectiveness trial conducted across EI agencies in California. Using an explanatory sequential mixed-methods design, Parent Participatory Engagement (PPE) scores from 95 videos were used to purposively sample sessions reflecting high (75th percentile; n = 26) and low (25th percentile; n = 25) caregiver engagement, yielding 51 videos for all quantitative and qualitative analyses. The sample included 16 EI providers (56.3% Latine) and 24 caregivers (87.5% Latine; 95.8% mothers) of children ages 12-36 months. A novel 12-item CR codebook was applied to sampled videos. Two ordinary least square regression models examined whether CR predicted PPE scores and which provider and session-level variables predicted CR. Inductive thematic analysis explored qualitative patterns in culturally responsive and unresponsive coaching. RESULTS: CR and caregiver engagement were significantly positively associated (r = .44, p = .001; R 2 = .198). Provider and session-level predictors explained 51.1% of CR variance (F(10,40) = 4.18, p < .001); Project Improving Parents as Communication Teachers treatment condition (β = 0.30, p < .001) predicted higher CR. Qualitative analysis identified three CR domains: home language use, centering family culture, and equitable partnership. While providers often demonstrated rapport-building (personalismo) and validated caregiver concerns, non-exemplary practices were common-including failing to inquire about cultural alignment of strategies, not soliciting caregiver perspectives, and framing interventions as separate from everyday family routines. CONCLUSIONS AND IMPLICATIONS: Findings reveal a gap between Individuals with Disabilities Education Act Part C mandates for family-centered EI and actual culturally responsive practice with Latine families. Providers frequently defaulted to hierarchical, practitioner-driven models that centered dominant cultural norms over families' values and daily practices. EI professional development must intentionally build providers' capacity for cultural humility, collaborative goal-setting, and embedding strategies within families' lived contexts.