World Health Organisation-Caregiver Skills Training (WHO-CST) Program: Feasibility of Delivery by Non-Specialist Providers in Real-world Urban Settings in India

Sengupta, Koyeli; Shah, Henal; Ghosh, Subharati; Sanghvi, Disha; Mahadik, Sanchita; Dani, Allauki; Deshmukh, Oshin; Pacione, Laura; Dixon, Pamela; Salomone, Erica; Servili, Chiara; team, Who-Cst

doi:10.1007/s10803-021-05367-0

Cited by 26 publications

(43 citation statements)

References 47 publications

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“…This is not surprising, as the program is specifically designed to improve the abovementioned domains of functioning; out of nine sessions, two sessions are dedicated to understanding and improvement of the child's communication, and two sessions for understanding and controlling the child's behavior. Research conducted on the CST program in other countries reports similar results (11,13,14). According to our previous research, the primary concern of parents in our country was related to the child's interaction and communication (3).…”

Section: Discussionsupporting

confidence: 67%

“…It provides parents with very high professional support, as well as with much needed emotional support. The research from other countries that implemented the CST reports similar results, especially in the LIMC (11,13,14).…”

Section: Discussionsupporting

confidence: 53%

“…The CST has shown to be a promising intervention in LIMC due to the fact that it doesn't require the involvement of specialists or other high profile experts (it can be even delivered by educated parents or volunteers), it doesn't require high material/financial resources or expensive equipment. The studies conducted in these countries indicate that CST could be the intervention which can be implemented, culturally adapted and sustainable for many LIMC (13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

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Positive Effects of the Caregiver Skill Training Program on Children With Developmental Disabilities: Experiences From Serbia

et al. 2022

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BackgroundIntervention programs for children with developmental disabilities increasingly target caregiver training to implement effective strategies for child development. Research conducted in different countries shows that the Caregiver Skills Training Program (CST) developed by the World Health Organization and Autism Speaks could also be a recommended intervention.MethodsThe pre-pilot phase included seven, and the pilot phase included 29 families of children with developmental disabilities trained to implement the intervention program. The caregivers were asked to complete the Autism Treatment Evaluation Checklist at the beginning and at the end of the program.ResultsIn the pre-pilot phase, the Wilcoxon signed-rank test determined a statistically significant improvement in Speech, Language and Communication (z = −2.99, p < 0.05) and Health/Physical/Behavior (z = −2.375, p < 0.05) after caregiver participation in the training program. In the pilot phase, the paired t-test also determined a statistically significant improvement in Speech, Language and Communication between the first (M = 24.52, SD = 5.57) and the second testing (M = 25.66, SD = 6.11), t(28) = −2.29, p < 0.05, as well as a significant improvement between the first (M = 36.62; SD = 7.15) and the second testing (M = 35.38; SD = 5.91), t(28) = 2.11, p < 0.05 in Health/Physical/Behavior. Eta squared values (0.16 and 0.14) indicate that the intervention effect was significant. No differences were determined in Sociability and Sensory/Cognitive Awareness between the first and the second testing.ConclusionThe initial results of the Caregiver Skills Training Program are encouraging. For this program to be recommended as an evidence-based intervention, further research should be conducted on larger samples, controlling possible intervening variables.

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Section: Discussionsupporting

confidence: 67%

Section: Discussionsupporting

confidence: 53%

Section: Introductionmentioning

confidence: 99%

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Positive Effects of the Caregiver Skill Training Program on Children With Developmental Disabilities: Experiences From Serbia

et al. 2022

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“…At the point of this scoping review, there were no published systematic evaluations of effectiveness using non-specialist providers. However, feasibility and acceptability studies have been conducted ( 49 , 50 ), and we have been informed of evaluations of non-specialist delivery under review. The intervention has been pre-piloted through specialist workers in Italy and is now being field tested, including with non-specialist providers, in more than 30 countries around the world ( 50 ).…”

Section: Discussionmentioning

confidence: 99%

Early Autism Intervention Components Deliverable by Non-specialists in Low- and Middle-Income Countries: A Scoping Review

et al. 2022

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IntroductionThe past decade has seen key advances in early intervention for autistic children in high-income countries, with most evidence based on specialist delivery of interventions. The care gap seen in low- and middle-income countries (LMIC) remains close to 100%. A key challenge in addressing this care gap concerns the paucity of specialists available to deliver services. Task-sharing provides an important potential solution; there is a need to identify interventions that are suitable for scaled-up delivery through task-sharing in low-resourced settings. We aimed to conduct a scoping review to identify studies which reported autism intervention delivered by non-specialists within LMIC and, using established frameworks, specify intervention components with evidence of successful non-specialist delivery.MethodsA scoping literature search, conducted within four databases, generated 2,535 articles. Duplicates were removed, followed by screening of titles and abstracts, with 10% double-rated for reliability. 50 full text articles were then screened independently by two raters. Articles were included if studies: (a) were conducted in LMIC; (b) included samples of autistic children (age < 10); (c) evaluated psycho-social interventions delivered by non-specialists; (d) reported child outcomes; and (e) were peer-reviewed full-texts in English. Two established frameworks – @Practicewise and NDBI-Fi framework - were then used to ascertain the commonly delivered components of these interventions.ResultsTwo studies met the inclusion criteria. Both studies evaluated parent-mediated interventions delivered by non-specialists in South Asia. Through the two frameworks, we identified elements and techniques that had been delivered successfully by non-specialists.ConclusionThere is evidence from two acceptability and feasibility trials that non-specialists can be trained to deliver some intervention elements and techniques within parent-mediated interventions, with good fidelity and acceptability and evidence of effectiveness. The review points up the lack of a widespread evidence base in this area and need for further research in low resourced settings, including well-powered trials and mechanistic analyses to identify active ingredients. A focus on the pre-requisites for non-specialist delivery is critical to reduce inequity and provide universal health coverage within resource-constrained health systems.

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“…Although the WHO CST program was designed for global use, the materials and delivery process should be adapted for each context and to suit local needs ( 29 , 30 ) to make the program relevant and feasible for implementation. The process of evaluating the feasibility and accessibility of the WHO CST consists of three stages: adaptation, prepilot and pilot stages ( 29 , 31 ). Ideally, the adaptations were made prior to and within the prepilot stage.…”

Section: Introductionmentioning

confidence: 99%

Promotion and implementation effectiveness of World Health Organization's Caregiver Skills Training program in Taiwan

et al. 2022

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The World Health Organization (WHO) developed the Caregiver Skills Training for Families of Children with Developmental Delays and Disabilities (CST) with support from Autism Speaks to address the resource gaps and worldwide needs for interventions for children with developmental disorders or delays, especially those with autism spectrum disorder (ASD), and their families. Evidence has indicated that parent-mediated interventions benefit both caregivers and children by strengthening caregivers' knowledge and confidence and children's social communication skills and behavioral regulation. The CST-Taiwan team began the prepilot field trial in 2017 and developed the project to serve families in various locations. This study (1) delineated the adaptations and promotion of CST-Taiwan; (2) determined the program's effectiveness in the promotional stage, in terms of caregiver and child outcomes, and (3) examined the maintenance of its effects. The materials, delivery, and facilitator training procedure of the original CST were adapted to Taiwan. The quantitative data indicated that CST-Taiwan is a promising program, it positively affected caregiver knowledge and confidence and reduced the severity of the children's autistic symptoms. The 3-month follow-up results suggested that the effects persisted. Thus, CST-Taiwan, and its promotional strategies are feasible and effective.

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World Health Organisation-Caregiver Skills Training (WHO-CST) Program: Feasibility of Delivery by Non-Specialist Providers in Real-world Urban Settings in India

Cited by 26 publications

References 47 publications

Positive Effects of the Caregiver Skill Training Program on Children With Developmental Disabilities: Experiences From Serbia

Positive Effects of the Caregiver Skill Training Program on Children With Developmental Disabilities: Experiences From Serbia

Early Autism Intervention Components Deliverable by Non-specialists in Low- and Middle-Income Countries: A Scoping Review

Promotion and implementation effectiveness of World Health Organization's Caregiver Skills Training program in Taiwan

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