Cultural adaptation of the transitioning together® program for caregivers of adolescents with autism in Accra, Ghana

For adolescents with autism and their families, transitioning to adulthood often means overcoming several social, systemic and environmental barriers (Lehman et al., 2002). In Ghana, misconceptions, limited knowledge and non-categorization of autism have contributed to delays in early detection, diagnosis, treatment and unavailability of supports for individuals and their families, which are three essential components for optimal outcomes (Danquah-Brobbey, 2018). These barriers put strenuous pressure on the caregivers who have found themselves at the center of their child's transition planning process.The purpose of this study is to address a service gap for Ghanaian families and their adolescent children with autism by culturally adapting an existing evidence-based program, Transitioning Together® (Smith, Greenberg, & Mailick, 2012). Specifically, the researcher sought to develop a set of culturally appropriate program curriculum modules, that address the suitable demographics and unique caregiving needs of families of adolescents with autism in Ghana. This study was designed to explore the central research question: What changes need to be made to the Transitioning Together® program for Ghanaian caregivers, to increase its cultural relevance, content applicability, and user-friendliness?The researcher developed a methodological framework using the Cultural Adaptation Process Model (CAPM) (Domenech- Rodriguez & Weiling, 2004) and the Ecological Validity Framework (EVF) (Bernal, Bonilla, & Bellido, 1995) in a Participatory Action Research. This methodology included focus group discussions with practitioners and individual interviews with eight caregivers to provide input on what and how they want the program to be presented. In adapting the Transitioning Together® program, content changes were integrated throughout the program instead of simply adding cultural factors to individual sessions. Changes were made to the program manual to reflect the length of the program, questions for discussion, appropriate goals for caregivers and medium of communication for facilitators and caregivers. A methodical review with nine experts to review and provide feedback on the developed program was solicited after changes were made.The results of this study show that caregivers and practitioners in Ghana will benefit from the program if implemented seamlessly. Additionally, Transitioning with Autism, Growing Up, Autism and Family and, Behavior Management are the specific topics caregivers deemed important and beneficial to discuss during group sessions. Implications for practice, policy, and future research are discussed.