# Advancing Hózhó in Autism Assessment (AHAA) for Diné Families

> **NIH NIH R21** · NORTHERN ARIZONA UNIVERSITY · 2024 · $196,700

## Abstract

ABSTRACT
 Indigenous children, including those who identify as Diné (Navajo, meaning “The People”),
have inequitable access to autism spectrum disorder (ASD) diagnosis and treatment services.
ASD is a neurodevelopmental condition, which can be diagnosed in early childhood. The
objective of the Advancing Hózhó in Autism Assessment (AHAA) for Diné Families study is
to develop recommendations to ensure that ASD assessment practices and the context in which
assessments occur are culturally responsive. Assessment practices and contexts encompass
the assessment experience for Diné children and parents/guardians. This study is aligned with
the National Institute of Mental Health’s strategic plan to advance equity in ASD services and
outcomes, as well as the recommendation of the Lancet Commission on the future of care and
clinical research in autism to prioritize research strategies that have an emphasis on
“understanding what interventions work, for whom, when, how, and with what general
outcomes.”
 Our central hypothesis, substantiated through research examining practitioner confidence
and expertise in working with diverse children and families,6 is that a lack of culturally
responsive ASD assessment practices along with the contexts in which assessments occur for
Diné children and parents/guardians contributes to inaccurate ASD diagnosis and inequitable
ASD services access. Our long-term goal is to ensure that ASD services are culturally
responsive for Diné families and to reduce persistent ASD inequities for Indigenous
communities.
 Aim 1: Determine how ASD assessment practices and the assessment context align or
misalign with cultural beliefs, including Hózhó, among Diné families by conducting
interviews with 15 Diné parents/guardians of children ages 2-6 years who have experienced ASD
diagnosis in the last 12 months.
 Aim 2: Describe practitioner perspectives on how ASD assessments are conducted
with Diné families including cultural adaptations made or not made through interviews with
15 ASD practitioners and a survey of 55 ASD practitioners.
 Aim 3: Identify the cultural adaptations made by interdisciplinary ASD assessment
teams with Diné children and their participating parents/guardians through the observation
of 10 assessments with Diné children ages 2-6.

## Key facts

- **NIH application ID:** 10843678
- **Project number:** 1R21MH133405-01A1
- **Recipient organization:** NORTHERN ARIZONA UNIVERSITY
- **Principal Investigator:** Davis E Henderson
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $196,700
- **Award type:** 1
- **Project period:** 2024-08-01 → 2026-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10843678

## Citation

> US National Institutes of Health, RePORTER application 10843678, Advancing Hózhó in Autism Assessment (AHAA) for Diné Families (1R21MH133405-01A1). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10843678. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*