A systematic review of cultural adaptations in the global application of <scp>ABA</scp>‐based telehealth services

Sivaraman and team hunted for papers that shipped ABA telehealth to families outside the US. They found nine real-world reports from India, South Africa, Brazil, and similar places.

Each paper told how staff tweaked the program for local families. Tweaks meant translating handouts, picking trainers who spoke the home language, or swapping cartoon pictures for local ones.

Every study used at least one cultural fix. Most paired language translation with a culturally matched coach. None ran true experiments, so we cannot say if the fixes worked better than standard English telehealth.

The review simply proves: global teams are already adapting ABA telehealth, even without formal tests.

Ferguson et al. (2022) and Howard et al. (2023) show telehealth parent training can hit high fidelity and teach kids new skills. Those papers ran single-case designs, so they give the hard numbers the review lacks.

Rabin et al. (2018) adds a twist: they culturally adapted PEERS, but delivered it in person. Their RCT showed real social gains, hinting that cultural fixes plus face-to-face contact may outshine telehealth alone. The review does not contradict this; it just shows telehealth is catching up.

Ruppel et al. (2023) closes the loop: remote BST with Zoom feedback trained staff to run preference assessments at 90 % fidelity. That mirrors the coach-training step many global studies used, giving you a ready-made model to copy.

If you serve multilingual families, borrow the review's three common moves: translate key handouts, match the coach to the family's language, and swap visuals for local ones. You can test the package with the same remote feedback loop Ruppel showed works. Start small: one caregiver, one goal, one Zoom rehearsal plus follow-up feedback. Track fidelity for five sessions. If it holds, you have a culturally adapted telehealth program backed by both global practice and single-case evidence.