Whose evidence counts in evidence-based practice? The politics of cultural responsiveness in therapeutic programming for Autistic children and youth
Year: 2026
Type: article
Abstract: Therapeutic programming with Autistic children and youth in Canada responds to definitions of autism and operates as a culturally situated phenomenon. Cultural responsiveness was examined in relation to neurodiversity-affirming values, power dynamics, and intersectional family contexts. The purpose of this qualitative phenomenological study was to understand caregivers’ and therapeutic providers` lived experiences of therapeutic programming within culturally situated contexts and their recommendations for change. The study was theoretically informed by critical theory and guided by a social constructivist epistemology. Eight semi-structured interviews were conducted. Data were analyzed following Creswell and Poth’s phenomenological procedures, including in-vivo coding, analytic memoing, and iterative theme development. Trustworthiness was supported through member checking, bracketing, maintenance of an audit trail, inclusion of negative case analysis and rich, thick description. Five overarching themes were identified: (1) Evaluating neurodiversity-affirming practices; (2) Advocacy for Autistic identity and neurodiversity-affirming approaches within therapeutic programming and beyond; (3) Exploring power imbalances within therapeutic partnerships and the need to redistribute power among Autistic individuals, caregivers, and therapeutic providers; (4) Gaps in therapeutic providers’ preparedness and the need for training in culturally responsive practice; and (5) Redefining therapeutic programming through co-design, meaningful partnership and relational competencies such as provider self-reflection. Implications align with the priorities of the Framework for Autism in Canada, emphasizing therapeutic programming that responds to intersectional family realities, advances cultural responsiveness, and embeds neurodiversity-affirming principles within service design and delivery. Implications for future research and practice include using participatory approaches to develop environmental audit tools that identify and address culturally unresponsive elements of care. This work should be paired with system-level efforts such as training, cross-disciplinary collaboration, and reflective practice to further strengthen culturally responsive, neurodiversity-affirming care, and with co-design processes that center Autistic leadership while balancing diverse perspectives to drive meaningful change.
Source: Research in Neurodiversity
Authors: Kelly D’Souza, Tara Flanagan
Institution: McGill University
Language: English
Subfield: Cognitive Neuroscience
Field: Neuroscience
Domain: Life Sciences
Open Access status: hybrid
Estimated APC paid: $3,200
OpenAlex ID: W7215039293