Neuropsychology as a field is undergoing critical review of its legacy of disregard of and disservice to historically oppressed groups. This is further accentuated by resistance to equitably upgrade practice models and expand the repertoire of neuropsychological services. Although widescale discussions about systemic racism and its impact have intensified, much is adult-population focused.  Comparatively, consideration of these issues in pediatric neuropsychology is scarce and practitioners working with young children and families are seeking guidance on how to creatively incorporate EDI in practice and education. The objective of this program evaluation was to leverage the I-InTERACT North (I-N) program, a neuropsychologically informed early parenting intervention designed with and for young children following early brain injury and their families, as an example of how EDI principles can be embedded both in clinical care but most importantly in the training of pediatric neuropsychologists.

Between 2019 and 2023, 258 families were referred to I-N from a large tertiary pediatric hospital and provincial neurodevelopmental network in Canada. Children’s diagnoses were transdiagnostic with common referrals regarding behaviour and emotion regulation. Primary medical diagnoses included hypoxic-ischemic encephalopathy, epilepsy, stroke, and neurodevelopmental conditions (i.e., ADHD/ASD).  In addition to behavioural  outcomes post-treatment (previously published), parent feedback was sought through questionnaires and focus groups about the extent to which the program considered their racial/cultural identities to guide treatment.

Concurrently, there were three training sessions involving 20 therapists, most were PhD neuropsychology students and neuropsychologists (65%). EDI content was included. Trainee feedback was gathered through surveys of training acceptability ratings, open-ended text boxes, and post-training interviews. Family and trainee feedback data were analyzed using quantitative descriptive analyses and thematic content analyses.

Reported family race included representation of racial/ethnic identity reflective of the Canadian population: Asian (10%),  Black (4%), White (77%), Hispanic (2%), and Indigenous (1%). Parents reported that the program and therapist adequately incorporated their family’s cultural or racial heritage to guide treatment. Focus groups identified future EDI opportunities for larger scale implementation including: hybrid in person/virtual formats, knowledge dissemination across rural and urban settings, translations of program materials, and expanding racial, cultural, and neurodiverse identity representation in program video content.

Trainee feedback regarding EDI-embedded training was positive. Trainees appreciated EDI discussion, self-reflection regarding positionality and implicit biases, differentiating cultural competence from cultural humility, and instruction on specific practices to be integrated into I-N promoting cultural humility. The following recommendations and training guidelines were generated: incorporate EDI principles throughout the program, create safe and inclusive spaces to foster trust with families, engage families in discussions of cultural considerations in parenting, provide opportunities for cultural consultation and mentorship, and promote trainee participation in ongoing EDI-informed learning.

We offer the I-N program, as one solution-focused example to aide future work towards services that can be more equitably developed, accessed, and delivered through an EDI-informed lens. Recommendations highlight how EDI-informed approaches may be integrated into training and how extending the menu of neuropsychological service options is integral in our work towards more equitable utility and relevance for all children and families.