Adapting and pre-testing the World Health Organization's Caregiver Skills Training programme for autism and other developmental disorders in a very low-resource setting: Findings from Ethiopia.
Bethlehem Tekola, Fikirte Girma, Mersha Kinfe and 9 others
PMID 31094208WHAT IT FOUND
Caregivers in Ethiopia found the adapted WHO autism training acceptable and useful, with all nine who started finishing the course.
They reported improved skills and reduced stress, but the study was not designed to prove the treatment works.
Key findings
01All ten invited caregivers consented to join, and nine of the ten engaged with the programme and completed it.
02Caregivers described practical changes, such as children dressing themselves or asking for items by name, and parents using less physical punishment.
03Sessions took around three hours instead of the planned two to two and a half, and childcare was a major barrier until provided at the site.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study was a pre-pilot, not a controlled trial, so it cannot determine if the programme actually improved child outcomes compared to no treatment. It was conducted in an urban clinic with specialist facilitators, so results may not apply to rural settings or non-specialist delivery. The small sample size (9 participants) limits generalisability. Social desirability bias is possible, as participants had no other services available and may have felt pressured to evaluate the programme positively.
Declared interests
Funded by Autism Speaks and UK government bodies (MRC, DFID, Wellcome Trust, NIHR). Autism Speaks staff were involved in the training of the Master Trainers.
The easy way to misread this
Do not interpret the caregivers' reports of their children talking or dressing themselves as proof that the training caused these changes. This was a small pre-pilot with no control group, so natural development or other factors cannot be ruled out. The findings only support the programme's acceptability and feasibility.