Cultural Competency Training for ABA Practitioners: Best Practices and Benefits

Cultural competency refers to the ability of individuals or organizations to understand and effectively interact with people from diverse cultural backgrounds (Cross et al., 1989). In the context of Applied Behavior Analysis (ABA), cultural competency is crucial for practitioners to provide effective and ethical services to learners with diverse cultural backgrounds and identities. BCBAs must strive to develop cultural competency in order to ensure their interventions are respectful, relevant, and meaningful for their learners and their families.

One of the fundamental principles of ABA is individualized interventions based on the unique needs and characteristics of the learner. Culture significantly influences a learner’s beliefs, values, preferences, and behaviors, as well as those of his or her family. ABA practitioners must recognize and respect these cultural factors to design interventions that are culturally sensitive and appropriate.

Despite the obvious importance of this skill, it’s not something that’s commonly taught in the verified course sequence, making it difficult for BCBAs to acquire the skill.

It’s important to note that although we are describing people as belonging to different cultural groups and making the assumption that they share a common system of values and beliefs, this is not always true and you must be sensitive to each individual’s expression of their culture (Kirmayer, 2012).

Contents

Importance of Cultural Competency
Types of Diversity
Continuum of Cultural Competency
Key Components of Cultural Competency
Developing a Culturally Competent System of Care
Barriers to Developing a Culturally Competent System of Care
Ethical Considerations When Developing a Culturally Competent System of Care
Research Related to Developing a Culturally Competent System of Care
References and Related Reading

Importance of Cultural Competency

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Key Components of Cultural Competency

Let’s break down this complex concept of cultural competency into its component parts to better understand and learn the skill, like we do when creating a task analysis for one of our learners. Trompenaars (2012) identified the key components of cultural competency as:

• Understanding different cultural values and beliefs: BCBAs must understand the different cultural values and beliefs that their clients may hold. This includes understanding things like the importance of family, the role of religion, and the views on education and disability.
• Being flexible and adaptable: BCBAs need to be flexible and adaptable when working with clients from different cultures. This means being willing to change their approach to therapy if necessary, and being open to new ideas and perspectives.
• Building relationships with clients and their families: BCBAs need to build relationships with their clients and their families in order to provide effective services. This means being respectful of their cultural values and beliefs, and being willing to listen to their concerns.

These components are just a small piece of a much larger puzzle of building a culturally competent system of care which refers to building cultural competence on a broader level including the agency as a whole.

The word culture is used because it implies the integrated pattern of human behavior that includes thoughts, communications, actions, customs, beliefs, values, and institutions of a racial, ethnic, religious, or social group.The word competence is used because it implies having the capacity to function effectively.

Cross et al, 1989

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Developing a Culturally Competent System of Care

Cross et al. (1998) described a framework for improving cultural competency by addressing it as a systems issue and seeking to build a culturally competent system of care. Although BCBAs developing cultural competency themselves is an important step, true cultural competency is supported as a system of care. A culturally competent system of care builds competency across institutions, agencies, and professionals (Trompenaars, 2012). Trompenaars (2012) described 5 critical elements to a culturally competent system:

1. Value diversity
2. Have the capacity for cultural self-assessment
3. Be conscious of the dynamics inherent when cultures interact
4. Have institutionalized cultural knowledge
5. Have developed adaptations to diversity

If you’re a leader within an agency, you’re easily able to influence the development of these elements. If you’re among the lower ranks of an agency, you may be able to shape the practices of an agency by sharing important resources and modeling these values. When the entire organization adopts a culturally competent system of care, families become partners in the journey to help their child.

As stated earlier, cultural competency exists on a continuum and you should expect to build competency gradually through the continuum. When building a culturally competent system of care, incorporate these steps into your practice:

1. Be aware of your own cultural biases. We all have our own cultural biases, which are the beliefs and attitudes we have about people from different cultures. It is important to be aware of our own biases so that we can avoid making assumptions about others.
2. Learn about different cultures. There are many different cultures in the world, and it is impossible to learn about all of them. However, we can learn about the cultures that are most relevant to our work. We can do this by reading books and articles, taking courses, and talking to people from different cultures.
3. Be respectful of different cultures. Even if we do not understand all aspects of a culture, we can still be respectful of it. This means being open-minded, avoiding stereotypes, and being willing to learn more.
4. Be willing to adapt your practices. If we are working with clients from different cultures, we may need to adapt our practices to be more culturally appropriate. This may involve using different communication styles, materials, or activities.
5. Seek feedback from others. We can get feedback on our cultural competency from our clients, colleagues, and other professionals. This feedback can help us to identify areas where we need to improve.

There are many different activities BCBAs can engage in to improve their cultural competency along the continuum described earlier. These activities should provide insight into the culture of the family you’re working with, helping to inform treatment decisions. Trompenaars (2012) described several activities to develop cultural competency including:

• The Cultural Assimilator: The Cultural Assimilator is a computer-based training program that helps BCBAs learn about different cultures. The program presents users with scenarios that involve people from different cultures, and asks them to choose how they would react in each situation. The program then provides feedback on the user’s choices, and helps them to understand the cultural factors that may influence their responses.
• The Cultural Self-Assessment: The Cultural Self-Assessment is a tool that helps BCBAs reflect on their own cultural biases. The assessment asks users to rate their agreement with a series of statements about different cultures. The assessment then provides feedback on the user’s scores, and helps them to identify areas where they may need to develop their cultural competency. The Cultural Competence Self-Assessment Questionnaire: A manual for users developed by Mason (1995) provides a structured method for assessing your understanding of cultural differences along with information about scoring and practical considerations.
• The Cultural Encounter: The Cultural Encounter is an experiential learning activity that helps BCBAs to develop skills for working with clients from different cultures. The activity involves placing BCBAs in simulated situations where they must interact with people from different cultures. The activity provides BCBAs with an opportunity to practice their cultural skills, and to receive feedback from facilitators.
• The Cultural Immersion: Cultural immersion is a process of spending time in a different culture in order to learn about it firsthand. Cultural immersion can be a valuable way for BCBAs to develop cultural competency, as it allows them to experience different cultures from the inside.

In addition to the activities listed above, BCBAs should incorporate the following practices:

• Continuous learning: Practitioners should seek opportunities to educate themselves about different cultures, traditions, and beliefs. This can involve reading books, attending workshops or conferences, and engaging in discussions with learners from diverse backgrounds.
• Self-reflection: Practitioners should reflect on their own cultural biases and assumptions, acknowledging and challenging them to promote a more inclusive mindset.
• Collaboration: Collaborating with colleagues from diverse backgrounds can foster a better understanding of cultural perspectives and provide opportunities to learn from one another.
• Building relationships: Developing relationships with learners and their families based on trust and respect is essential. Actively listening to their perspectives, seeking their input, and incorporating their cultural values into interventions can strengthen these relationships and improve outcomes.

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Barriers to Developing a Culturally Competent System of Care

Many BCBAs understand the importance of cultural competency but several barriers prevent them from developing this framework into a system of care. These barriers include:

• Lack of awareness of cultural differences: This is perhaps the most fundamental barrier. If people are not aware of the different cultures that exist in their community, they cannot possibly understand how to be culturally competent.
• Lack of resources: Evaluators may not have the resources they need to conduct culturally competent evaluations, such as time, money, and training.
• Lack of cultural knowledge: Evaluators may not have the knowledge they need to understand the cultural factors that might influence the evaluation process.
• Resistance from community members: Community members may be resistant to participating in evaluations, especially if they have had negative experiences with research or evaluation in the past.
• Resistance from staff. Some staff may resist the changes necessary to build a culturally competent system of care. They may feel that they are not being asked to do their jobs, or they may not believe that cultural competence is important.
• Changing biases: It can be difficult to change our own cultural biases given the long reinforcement history.
• Lack of leadership. Cultural competence requires leadership from the top down. If leaders are not committed to cultural competence, it will be difficult to achieve.
• Lack of trust. If there is no trust between staff and the community, it will be difficult to build a culturally competent system of care.

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Ethical Considerations When Developing a Culturally Competent System of Care

The table below presents some important ethical considerations when developing a culturally competent system of care. The table includes specific action steps to help you ensure you practice in an ethical way.

Ethical Concern	Description	Action Steps for Ethical Practice
Cultural Appropriation	The adoption or use of elements from another culture without understanding or respecting their cultural significance, potentially leading to misrepresentation or harm.	– Engage in ongoing education and training on cultural competence and sensitivity. – Consult with individuals from the specific culture or seek guidance from cultural experts to ensure appropriate use of cultural elements. – Regularly assess and reflect on personal biases and assumptions.
Stereotyping and Bias	Making generalizations or assumptions about individuals based on their cultural background, leading to unfair treatment or limited opportunities.	– Develop awareness of personal biases and actively challenge and address them. – Promote cultural humility by recognizing and valuing the diversity and individuality within cultural groups. – Utilize individualized assessment and treatment planning that considers the unique needs and strengths of each person.
Lack of Cultural Knowledge	Insufficient understanding of cultural norms, practices, and values, resulting in ineffective or inappropriate interventions.	– Conduct thorough cultural assessments to gather relevant information about an individual’s cultural background and experiences. – Seek consultation or collaboration with professionals from the specific culture to enhance understanding and inform treatment strategies. – Engage in continuous learning about various cultures and incorporate cultural knowledge into practice.
Language and Communication Barriers	Inability to effectively communicate and understand individuals from different linguistic backgrounds, hindering accurate assessment and treatment.	– Provide language access services, such as interpreters or translated materials, to ensure effective communication with individuals and their families. – Employ culturally sensitive and inclusive communication strategies, such as using visual supports or culturally appropriate communication styles. – Collaborate with bilingual or multilingual professionals when language barriers arise.
Power Imbalance	Power differentials between practitioners and individuals from marginalized cultural groups, leading to paternalistic or oppressive dynamics.	– Adopt a collaborative and partnership-based approach, valuing the input and perspectives of individuals and families from diverse cultural backgrounds. – Promote shared decision-making and empower individuals to actively participate in the treatment planning and decision-making process. – Continually reflect on and challenge power imbalances within the therapeutic relationship.
Cultural Insensitivity	Lack of consideration or respect for cultural practices, values, or traditions, resulting in unintentional harm or exclusion.	– Engage in cultural self-reflection to identify and address personal biases or assumptions that may hinder cultural sensitivity. – Seek input from individuals and families regarding their cultural practices and preferences, and integrate this information into treatment plans. – Regularly evaluate and adapt interventions to align with cultural beliefs and values.
Lack of Diversity in the Workforce	Limited representation of diverse cultural backgrounds within the field of applied behavior analysis (ABA), which may lead to inadequate cultural understanding and limited perspectives.	– Actively recruit and promote diversity within the ABA workforce to reflect the communities served. – Provide culturally responsive training and professional development opportunities for practitioners to enhance cultural competence. – Foster inclusive and welcoming environments that value and celebrate diversity.
Cultural Disrespect or Stigmatization	Disregard for or devaluation of cultural practices or beliefs, leading to marginalization, discrimination, or stigma.	– Foster a culture of respect and inclusivity within the ABA setting, promoting acceptance and celebration of diverse cultures. – Challenge and address any instances of cultural disrespect or stigmatization, providing education and awareness to staff and clients. – Collaborate with community organizations or cultural leaders to develop culturally appropriate resources and supports.
Lack of Community Collaboration	Failure to engage and collaborate with community stakeholders and cultural leaders, limiting the effectiveness and relevance of interventions.	– Establish partnerships with community organizations, cultural leaders, and advocacy groups to foster collaboration and gain insight into cultural perspectives and needs. – Involve families and individuals from diverse cultural backgrounds in the treatment planning process, ensuring their voices are heard and respected. – Seek community input and feedback to inform program development and implementation.
Inadequate Assessment Tools and Methods	The use of assessment tools and methods that lack cultural validity or fail to account for cultural variations, leading to inaccurate or incomplete understanding of individuals’ needs.	– Utilize culturally sensitive assessment tools or adapt existing tools to ensure cultural validity and relevance. – Consider the impact of cultural factors on assessment results, interpreting findings in a culturally informed manner. – Seek input from cultural consultants or experts when developing or selecting assessment tools.
Cultural Inclusivity in Treatment Materials	Lack of representation and diversity in treatment materials, which may exclude or marginalize individuals from specific cultural backgrounds.	– Create and utilize treatment materials that represent and reflect the diversity of the individuals and communities served. – Incorporate cultural elements, diverse characters, and examples that are relevant and relatable to individuals from various cultural backgrounds. – Regularly review and update treatment materials to ensure cultural inclusivity and accuracy.
Lack of Training and Education	Insufficient training and education on cultural competence within the field of ABA, resulting in inadequate knowledge and skills to provide culturally competent care.	– Incorporate cultural competence training as a core component of ABA education and professional development programs. – Provide ongoing training opportunities that enhance practitioners’ understanding of cultural diversity, cultural responsiveness, and effective cross-cultural communication. – Encourage practitioners to pursue additional coursework or certifications in cultural competence.
Inappropriate Application of ABA Techniques	The application of ABA techniques in a manner that is incongruent with cultural values, beliefs, or practices, potentially causing distress or harm.	– Engage in culturally sensitive treatment planning, tailoring interventions to align with individuals’ cultural values and preferences. – Regularly assess treatment progress and adapt interventions to ensure they are respectful, effective, and aligned with cultural norms. – Consult with individuals, families, or cultural experts to determine appropriate modifications or alternatives to ABA techniques when necessary.
Confidentiality and Privacy	Failure to respect and protect individuals’ cultural information, practices, or beliefs, resulting in breaches of confidentiality and privacy.	– Obtain informed consent that includes an explicit discussion of the importance of cultural confidentiality and privacy. – Develop policies and procedures that address cultural confidentiality and privacy, ensuring the secure handling of cultural information. – Regularly train staff on cultural confidentiality and privacy requirements, emphasizing the importance of maintaining trust and respect for cultural practices.
Lack of Cultural Validation and Empowerment	Neglecting to validate and empower individuals’ cultural identities and experiences, leading to feelings of exclusion or cultural erasure.	– Create an inclusive and validating environment that recognizes and values individuals’ cultural identities and experiences. – Foster open communication and actively listen to individuals’ perspectives, allowing space for cultural expression and input. – Promote self-advocacy and empower individuals to assert their cultural needs and preferences within the treatment process.
Intersectionality Consideration	Failure to recognize and address the intersection of multiple cultural identities, leading to overlooking unique needs and experiences.	– Take an intersectional approach to cultural assessment and treatment planning, considering the influence of multiple cultural identities on individuals’ experiences. – Incorporate intersectional perspectives into staff training and professional development. – Develop collaborative partnerships with organizations that specialize in intersectionality and advocate for inclusive care.

Please note that the action steps provided are general recommendations to ensure ethical practice when developing a culturally competent system of care in ABA. The specific actions may vary depending on the unique cultural context, needs of individuals, and local regulations.

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Research Related to Developing a Culturally Competent System of Care

Below is a table summarizing research articles related to collecting and analyzing ABC data. The table includes important action steps to help you put these ideas into practice.

Article Title	Summary	Action Steps for Application
Behavior analysts’ training and practices regarding cultural diversity: The case for culturally competent care	This article explores the importance of providing culturally competent care in ABA and highlights the need for behavior analysts to receive training and develop practices that embrace cultural diversity.	– ABA professionals should seek additional training on cultural competence to enhance their understanding of diverse cultural backgrounds. – Incorporate cultural competence components in ABA education programs to prepare future practitioners. – Regularly assess and reflect on cultural competence in ABA practices and seek feedback from clients and families to ensure sensitivity to cultural differences.
Future directions of training and fieldwork in diversity issues in applied behavior analysis	This article discusses future directions for diversity-related training in ABA, emphasizing the importance of addressing diversity issues in training and fieldwork settings.	– Develop comprehensive diversity training modules for ABA professionals, addressing cultural competence, social justice, and inclusion. – Encourage ongoing dialogues and discussions about diversity and cultural competence in ABA organizations, workshops, and conferences. – Implement mentorship programs that focus on diversity issues and provide support to trainees from diverse backgrounds.
Towards a culturally competent system of care: A monograph on effective services for minority children who are severely emotionally disturbed	This monograph examines the need for culturally competent services for minority children with emotional disturbances, emphasizing the importance of understanding cultural differences in providing effective care.	– Develop and implement culturally competent assessment tools and intervention strategies in ABA settings to better serve diverse populations. – Collaborate with culturally diverse community organizations and stakeholders to ensure culturally appropriate services are available. – Engage in ongoing self-assessment and training to enhance cultural competence among ABA professionals.
Black caregivers’ perspectives on racism in ASD services: Toward culturally responsive ABA practice	This article explores the perspectives of Black caregivers regarding racism in Autism Spectrum Disorder (ASD) services and suggests strategies for culturally responsive ABA practice. Black caregivers reported experiencing racism within ASD services, leading to concerns about disparities in access, quality, and cultural responsiveness.	– Conduct cultural humility training for ABA professionals – Incorporate culturally diverse literature and resources into ABA training programs – Collaborate with culturally diverse communities to identify and address barriers to access and engagement, – Implement culturally sensitive assessment and intervention strategies – Advocating for policies that promote diversity, equity, and inclusion in ASD services.
Delivering home-supported applied behavior analysis therapies to culturally and linguistically diverse families	This study explores the challenges and strategies for providing home-supported ABA therapies to culturally and linguistically diverse families.	– Develop culturally sensitive materials and resources to support ABA interventions that are respectful of diverse linguistic and cultural backgrounds. – Collaborate with interpreters or bilingual professionals when delivering ABA therapies to families with language barriers. – Provide training for ABA therapists on culturally responsive practices when working with diverse families.
Building a social justice framework for cultural and linguistic diversity in ABA	This article advocates for a social justice framework in ABA to address cultural and linguistic diversity, promoting equity and inclusion within the field.	– Integrate social justice principles into the curriculum of ABA education programs. – Advocate for policies within ABA organizations that prioritize cultural and linguistic diversity and promote equity in access to services. – Encourage research that addresses disparities in ABA service access and effectiveness for diverse populations.
The culture assimilator: An approach to cross-cultural training	This article introduces the concept of the culture assimilator, a method for cross-cultural training that helps individuals acquire cultural competence through exposure to cultural scenarios and discussions.	– Develop and incorporate culture assimilator exercises or similar approaches into ABA training programs to enhance cross-cultural competence. – Encourage ABA professionals to engage in discussions and reflections on cultural scenarios to develop a better understanding of diverse perspectives. – Utilize culture assimilator techniques in team meetings or case discussions to address cultural considerations in ABA practice.
Increasing cultural understanding and diversity in applied behavior analysis	This article highlights the importance of increasing cultural understanding and diversity in the field of ABA, emphasizing the need for cultural competence training for behavior analysts.	– Incorporate cultural competence training modules into ABA coursework and continuing education programs. – Encourage behavior analysts to seek diverse practicum experiences and work with culturally diverse populations. – Promote research and publication on culturally diverse topics within the field of ABA.
Multicultural alliance of behavior analysis standards for cultural competence in behavior analysis	This article presents a set of standards for cultural competence in behavior analysis, aiming to promote cultural sensitivity and diversity within the field.	– Familiarize oneself with the Multicultural Alliance of Behavior Analysis Standards for Cultural Competence and incorporate them into practice. – Regularly self-assess cultural competence using the provided standards to identify areas for improvement. – Engage in ongoing professional development to enhance cultural competence and stay updated on best practices.
Rethinking cultural competence	This article critically examines the concept of cultural competence and argues for a more comprehensive and dynamic approach that recognizes the complexity of culture and its impact on healthcare practices.	– Adopt a flexible and adaptable approach to cultural competence that acknowledges the fluidity and diversity of cultural identities. – Engage in self-reflection and self-awareness to recognize personal biases and assumptions that may influence interactions with culturally diverse clients. – Foster collaborative relationships with diverse communities and seek their input in shaping culturally competent ABA practices.
Cultural competence self-assessment questionnaire: A manual for users	This manual provides a self-assessment questionnaire for individuals to evaluate their own cultural competence, identifying areas of strength and areas that require further development.	– Utilize the cultural competence self-assessment questionnaire as a tool for self-reflection and identifying areas of growth in cultural competence. – Create a personal development plan based on the self-assessment results to target specific areas for improvement. – Seek feedback from colleagues, supervisors, and clients to gain additional insights into one’s cultural competence and make adjustments accordingly.
Refining the concept of cultural competence: building on decades of progress	This article discusses the concept of cultural competence and proposes refinements to the framework, emphasizing the need for ongoing development and adaptation in response to cultural changes.	– Stay updated on emerging research and literature regarding cultural competence to stay informed about evolving best practices. – Engage in ongoing professional development and training to expand knowledge and skills related to cultural competence. – Regularly evaluate and refine cultural competence practices to align with current understanding and respond to changing cultural contexts.
Building cultural competence: Innovative activities and models	This book provides innovative activities and models for building cultural competence, offering practical strategies and exercises to enhance understanding and effectiveness in multicultural environments.	– Explore the activities and models presented in the book to incorporate practical exercises and strategies into ABA training programs. – Adapt the suggested activities to fit the specific needs and context of ABA practice. – Encourage team-building activities that promote cultural understanding and collaboration among ABA professionals.
Cultural humility in the practice of applied behavior analysis	This article introduces the concept of cultural humility and its relevance to ABA practice, emphasizing the importance of recognizing and respecting diverse perspectives and continuously learning from others.	– Embrace a mindset of cultural humility by acknowledging the limits of one’s own knowledge and actively seeking to learn from diverse cultures and experiences. – Engage in reflective practice to evaluate one’s own biases and assumptions and adjust behavior accordingly. – Foster an open and respectful dialogue with clients, families, and colleagues to promote cultural humility within the ABA field.

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References and Related Reading

Beaulieu, L., Addington, J., & Almeida, D. (2019). Behavior analysts’ training and practices regarding cultural diversity: The case for culturally competent care. Behavior Analysis in Practice, 12, 557-575.

Čolić, M., Araiba, S., Lovelace, T. S., & Dababnah, S. (2022). Black caregivers’ perspectives on racism in ASD services: Toward culturally responsive ABA practice. Behavior Analysis in Practice, 15(4), 1032-1041.

Conners, B., Johnson, A., Duarte, J., Murriky, R., & Marks, K. (2019). Future directions of training and fieldwork in diversity issues in applied behavior analysis. Behavior Analysis in Practice, 12, 767-776.

Cross, T. L. (1989). Towards a culturally competent system of care: A monograph on effective services for minority children who are severely emotionally disturbed. Washington, DC: Georgetown University Child Development Center, CASSP Technical Assistance Center.

Cross, T., Bazron, B., Dennis, K., & Isaacs, M., (1989). Towards A Culturally Competent System of Care, Volume I. Washington, DC: Georgetown University Child Development Center, CASSP Technical Assistance Center.

Dennison, A., Lund, E. M., Brodhead, M. T., Mejia, L., Armenta, A., & Leal, J. (2019). Delivering home-supported applied behavior analysis therapies to culturally and linguistically diverse families. Behavior Analysis in Practice, 12, 887-898.

Deochand, N., & Costello, M. S. (2022). Building a social justice framework for cultural and linguistic diversity in ABA. Behavior Analysis in Practice, 15(3), 893-908.

Dictionary.com. (n.d.). Diversity. In Dictionary.com. Retrieved July 3, 2013, from https://www.dictionary.com/browse/diversity.

Fiedler, F. E., Mitchell, T., & Triandis, H. C. (1971). The culture assimilator: An approach to cross-cultural training. Journal of applied psychology, 55(2), 95.

Fong, E. H., Ficklin, S., & Lee, H. Y. (2017). Increasing cultural understanding and diversity in applied behavior analysis. Behavior Analysis: Research and Practice, 17(2), 103.

Fong, E. H., & Tanaka, S. (2013). Multicultural alliance of behavior analysis standards for cultural competence in behavior analysis. International Journal of Behavioral Consultation and Therapy, 8(2), 17.

Kirmayer, L. J. (2012). Rethinking cultural competence. Transcultural psychiatry, 49(2), 149-164.

Mason, J. L. (1995). Cultural competence self-assessment questionnaire: A manual for users. Portland, OR: Portland State University, Research and Training Center on Family Support and Children’s Mental Health.

Thackrah, R. D., & Thompson, S. C. (2013). Refining the concept of cultural competence: building on decades of progress. Medical Journal of Australia, 199(1), 35-38.

Trompenaars, F. (2012). Building cultural competence: Innovative activities and models. Stylus Publishing, LLC.

Wright, P. I. (2019). Cultural humility in the practice of applied behavior analysis. Behavior Analysis in Practice, 12(4), 805-809.