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Ep. 99- Culturally responsive telehealth practice

show notes Oct 03, 2023

Resources mentioned in this episode

  1. Free 2 CEU course on Solving Clinical Challenges with Research-
  2. Sivaraman et al., 2023-

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Full Transcript (Click for downloadable copy)

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Navigating Cultural Responsiveness in Telehealth: Insights from a Recent Study


Hello, and welcome to "The Behaviorist Book Club." I'm your host, Matt Harrington, and today, we're diving into a fascinating topic that's increasingly relevant in our field: cultural responsiveness in telehealth. We'll be discussing a recent study, "An Evaluation of Ethnicity Matching for Caregiver Telehealth Training in India," by Sivaraman and colleagues in 2023. This research touches on telehealth's potential and its unique challenges, but more importantly, it brings cultural responsiveness to the forefront of our conversation.

Telehealth in Behavior Analysis

Before we get into the study, let me share my perspective on telehealth in behavior analysis. I believe it's possible to provide high-quality ABA through telehealth, and it's likely to be a crucial part of our field's future. However, I also acknowledge that delivering ABA remotely is more challenging than in-person sessions. It goes beyond logistical concerns; it's about building relationships, conducting assessments, and providing interventions effectively.

The Rise of Cultural Responsiveness

Now, let's shift our focus to cultural responsiveness, which is at the heart of this study. The researchers explored the impact of ethnicity matching on several critical variables in caregiver telehealth training. But why does culture matter in behavior analysis? Well, the answer is clear: culture affects everything. From noticeable aspects like eating utensils to subtle factors like power dynamics, culture plays a significant role in shaping human behavior.

In the past, geography limited interactions between individuals from different cultures. However, with the advent of telehealth, geographical constraints have been significantly reduced. This makes ethnicity matching more critical than ever. But how much does it matter? And does it truly affect the quality of ABA services? Let's dive deeper.

The Study's Methodology

The researchers conducted a study involving six dyads, each comprising a caregiver and a participant, all of whom were Indian mothers. The intervention consisted of a functional analysis followed by functional communication training, addressing challenging behaviors like self-injury, aggression, and property destruction. They also considered language preferences, as all caregivers spoke both English and Tamil.

The key aspect of this study was evaluating the effects of ethnicity matching on four primary variables: fidelity to the intervention, child behavior improvements, session completion, and session cancellations. To further understand the impact of ethnicity matching, they conducted a preference assessment following the intervention, asking caregivers to choose between ethnicity-matched and ethnicity-distinct trainers for follow-up consultation sessions.

Surprising Results

The results of the study were intriguing and, in some ways, unexpected. Across fidelity, child behavior outcomes, and session completion, there was virtually no difference between the ethnicity-matched and ethnicity-distinct conditions. Caregivers from both groups reported high social validity for the intervention, believing it would lead to lasting behavior change.

The sole significant difference emerged in participant preference. Every caregiver, regardless of whether they received ethnicity-matched or ethnicity-distinct training, requested an ethnicity-matched trainer for follow-up consultations. This preference for ethnicity matching raises important questions about its underlying factors and implications.

Addressing Limitations

Before we draw conclusions, it's essential to acknowledge the study's limitations. Six participants do not represent the entire Indian culture, and these caregivers were primarily urban, dual-language speakers with internet access, possibly reflecting a specific subset of the Indian population. Future research should explore these concepts in more diverse settings to gain a broader perspective.

Practical Implications

So, what can we learn from this study? As behavior analysts, it's crucial to embrace cultural responsiveness. While we can't always provide ethnicity-matched services, we can actively seek feedback from peers and caregivers to improve our practice. This means asking for observations and suggestions, as well as maintaining open dialogues about cultural preferences and comfort levels.


In conclusion, this study highlights the importance of cultural responsiveness in behavior analysis, especially in the era of telehealth. Culture matters, and understanding its impact on our clients is vital for delivering effective services. While more research is needed to uncover the nuances of participant preference for ethnicity matching, this study is a stepping stone towards a more culturally aware and responsive practice.

Thank you for joining me on this journey through the world of behavior analysis and cultural responsiveness. If you enjoyed this episode, please consider subscribing, sharing, and leaving a review. Your support helps us bring valuable content to fellow practitioners and learners in the field. Stay tuned for more insights from "The Behaviorist Book Club."

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