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

Author

Sengupta, Koyeli, Shah, Henal, Ghosh, Subharati, Sanghvi, Disha, Mahadik, Sanchita, Dani, Allauki, Deshmukh, Oshin, Pacione, Laura, Dixon, Pamela, Salomone, Erica, and Servili, Chiara

Abstract

The World Health Organization-Caregiver Skills Training Program, a parent-mediated early intervention facilitated by non-specialist providers piloted in urban India was evaluated using mixed-methods for feasibility and effects on child and caregiver outcomes. Caregivers (n = 22) of children (2-9 years) with social-communication delays participated in a single-group pre-post study. High rates of caregiver attendance, improved caregiver fidelity, and facilitator competency suggested program feasibility. Caregivers voiced acceptability of various intervention-components. The intervention was associated with improved caregiver-reported skills and knowledge (p < 0.00), reduction in stress (p = 0.03), improved child developmental outcomes on communication and social interaction (p < 0.00), and adaptive behaviors (p < 0.00). Challenges about logistics and availability of time were highlighted. Implications of results in resource-poor settings and recommendations for future feasibility trials are discussed. [The WHO-CST Team contributed to the writing of this article.]

Published
2023
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4. Pilot Randomized Controlled Trial of the WHO Caregiver Skills Training in Public Health Services in Italy

Author

Salomone, Erica, Settanni, Michele, McConachie, Helen, Suma, Katharine, Ferrara, Federica, Foletti, Giulia, Salandin, Arianna, Brown, Felicity L., Pacione, Laura, Shire, Stephanie, Servili, Chiara, and Adamson, Lauren B.

Abstract

Parents of children with ASD (N = 86; mean age 44.8 months; 67 boys) were randomized to either WHO Caregiver Skills Training (CST) delivered in public health settings in Italy or enhanced treatment-as-usual. Primary blinded outcomes were 3-months post-intervention change scores of autism severity and engagement during caregiver-child interaction. CST was highly acceptable to caregivers and feasibly delivered by trained local clinicians. Intention-to-treat analysis showed a large and significant effect on parent skills supporting joint engagement and a smaller significant effect on flow of interaction. Expected changes in child autism severity and joint engagement did not meet statistical significance. Analysis of secondary outcomes showed a significant effect on parenting stress, self-efficacy, and child gestures. Strategies to improve the effectiveness of CST are discussed.

Published
2022
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6. Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Author

Steinmetz, Jaimie D, Seeher, Katrin Maria, Schiess, Nicoline, Nichols, Emma, Cao, Bochen, Servili, Chiara, Cavallera, Vanessa, Cousin, Ewerton, Hagins, Hailey, Moberg, Madeline E, Mehlman, Max L, Abate, Yohannes Habtegiorgis, Abbas, Jaffar, Abbasi, Madineh Akram, Abbasian, Mohammadreza, Abbastabar, Hedayat, Abdelmasseh, Michael, Abdollahi, Mohammad, Abdollahi, Mozhan, Abdollahifar, Mohammad-Amin, Abd-Rabu, Rami, Abdulah, Deldar Morad, Abdullahi, Auwal, Abedi, Aidin, Abedi, Vida, Abeldańo Zuńiga, Roberto Ariel, Abidi, Hassan, Abiodun, Olumide, Aboagye, Richard Gyan, Abolhassani, Hassan, Aboyans, Victor, Abrha, Woldu Aberhe, Abualhasan, Ahmed, Abu-Gharbieh, Eman, Aburuz, Salahdein, Adamu, Lawan Hassan, Addo, Isaac Yeboah, Adebayo, Oladimeji M, Adekanmbi, Victor, Adekiya, Tayo Alex, Adikusuma, Wirawan, Adnani, Qorinah Estiningtyas Sakilah, Adra, Saryia, Afework, Tsion, Afolabi, Aanuoluwapo Adeyimika, Afraz, Ali, Afzal, Saira, Aghamiri, Shahin, Agodi, Antonella, Agyemang-Duah, Williams, Ahinkorah, Bright Opoku, Ahmad, Aqeel, Ahmad, Danish, Ahmad, Sajjad, Ahmadzade, Amir Mahmoud, Ahmed, Ali, Ahmed, Ayman, Ahmed, Haroon, Ahmed, Jivan Qasim, Ahmed, Luai A, Ahmed, Muktar Beshir, Ahmed, Syed Anees, Ajami, Marjan, Aji, Budi, Ajumobi, Olufemi, Akade, Seyed Esma'il, Akbari, Morteza, Akbarialiabad, Hossein, Akhlaghi, Shiva, Akinosoglou, Karolina, Akinyemi, Rufus Olusola, Akonde, Maxwell, Al Hasan, Syed Mahfuz, Alahdab, Fares, AL-Ahdal, Tareq Mohammed Ali, Al-amer, Rasmieh Mustafa, Albashtawy, Mohammed, AlBataineh, Mohammad T, Aldawsari, Khalifah A, Alemi, Hediyeh, Alemi, Sharifullah, Algammal, Abdelazeem M, Al-Gheethi, Adel Ali Saeed, Alhalaiqa, Fadwa Alhalaiqa Naji, Alhassan, Robert Kaba, Ali, Abid, Ali, Endale Alemayehu, Ali, Liaqat, Ali, Mohammed Usman, Ali, Musa Mohammed, Ali, Rafat, Ali, Shahid, Ali, Syed Shujait Shujait, Ali, Zahid, Alif, Sheikh Mohammad, Alimohamadi, Yousef, Aliyi, Ahmednur Adem, Aljofan, Mohamad, Aljunid, Syed Mohamed, Alladi, Suvarna, Almazan, Joseph Uy, Almustanyir, Sami, Al-Omari, Basem, Alqahtani, Jaber S, Alqasmi, Ibrahim, Alqutaibi, Ahmed Yaseen, Al-Shahi Salman, Rustam, Altaany, Zaid, Al-Tawfiq, Jaffar A, Altirkawi, Khalid A, Alvis-Guzman, Nelson, Al-Worafi, Yaser Mohammed, Aly, Hany, Aly, Safwat, Alzoubi, Karem H, Amani, Reza, Amindarolzarbi, Alireza, Amiri, Sohrab, Amirzade-Iranaq, Mohammad Hosein, Amu, Hubert, Amugsi, Dickson A, Amusa, Ganiyu Adeniyi, Amzat, Jimoh, Ancuceanu, Robert, Anderlini, Deanna, Anderson, David B, Andrei, Catalina Liliana, Androudi, Sofia, Angappan, Dhanalakshmi, Angesom, Teklit W, Anil, Abhishek, Ansari-Moghaddam, Alireza, Anwer, Razique, Arafat, Mosab, Aravkin, Aleksandr Y, Areda, Demelash, Ariffin, Hany, Arifin, Hidayat, Arkew, Mesay, Ärnlöv, Johan, Arooj, Mahwish, Artamonov, Anton A, Artanti, Kurnia Dwi, Aruleba, Raphael Taiwo, Asadi-Pooya, Ali A, Asena, Tilahun Ferede, Asghari-Jafarabadi, Mohammad, Ashraf, Muhammad, Ashraf, Tahira, Atalell, Kendalem Asmare, Athari, Seyyed Shamsadin, Atinafu, Bantalem Tilaye Tilaye, Atorkey, Prince, Atout, Maha Moh'd Wahbi, Atreya, Alok, Aujayeb, Avinash, Avan, Abolfazl, Ayala Quintanilla, Beatriz Paulina, Ayatollahi, Haleh, Ayinde, Olatunde O, Ayyoubzadeh, Seyed Mohammad, Azadnajafabad, Sina, Azizi, Zahra, Azizian, Khalil, Azzam, Ahmed Y, Babaei, Mahsa, Badar, Muhammad, Badiye, Ashish D, Baghdadi, Soroush, Bagherieh, Sara, Bai, Ruhai, Baig, Atif Amin, Balakrishnan, Senthilkumar, Balalla, Shivanthi, Baltatu, Ovidiu Constantin, Banach, Maciej, Bandyopadhyay, Soham, Banerjee, Indrajit, Baran, Mehmet Firat, Barboza, Miguel A, Barchitta, Martina, Bardhan, Mainak, Barker-Collo, Suzanne Lyn, Bärnighausen, Till Winfried, Barrow, Amadou, Bashash, Davood, Bashiri, Hamideh, Bashiru, Hameed Akande, Basiru, Afisu, Basso, João Diogo, Basu, Sanjay, Batiha, Abdul-Monim Mohammad, Batra, Kavita, Baune, Bernhard T, Bedi, Neeraj, Begde, Ahmet, Begum, Tahmina, Behnam, Babak, Behnoush, Amir Hossein, Beiranvand, Maryam, Béjot, Yannick, Bekele, Alehegn, Belete, Melaku Ashagrie, Belgaumi, Uzma Iqbal, Bemanalizadeh, Maryam, Bender, Rose G, Benfor, Bright, Bennett, Derrick A, Bensenor, Isabela M, Berice, Betyna, Bettencourt, Paulo J G, Beyene, Kebede A, Bhadra, Abhishek, Bhagat, Devidas S, Bhangdia, Kayleigh, Bhardwaj, Nikha, Bhardwaj, Pankaj, Bhargava, Ashish, Bhaskar, Sonu, Bhat, Ajay Nagesh, Bhat, Vivek, Bhatti, Gurjit Kaur, Bhatti, Jasvinder Singh, Bhatti, Rajbir, Bijani, Ali, Bikbov, Boris, Bilalaga, Mariah Malak, Biswas, Atanu, Bitaraf, Saeid, Bitra, Veera R, Bjørge, Tone, Bodolica, Virginia, Bodunrin, Aadam Olalekan, Boloor, Archith, Braithwaite, Dejana, Brayne, Carol, Brenner, Hermann, Briko, Andrey, Bringas Vega, Maria L, Brown, Julie, Budke, Christine M, Buonsenso, Danilo, Burkart, Katrin, Burns, Richard A, Bustanji, Yasser, Butt, Muhammad Hammad, Butt, Nadeem Shafique, Butt, Zahid A, Cabral, Lucas Scotta, Caetano dos Santos, Florentino Luciano, Calina, Daniela, Campos-Nonato, Ismael R, Cao, Chao, Carabin, Hélène, Cárdenas, Rosario, Carreras, Giulia, Carvalho, Andre F, Castańeda-Orjuela, Carlos A, Casulli, Adriano, Catalá-López, Ferrán, Catapano, Alberico L, Caye, Arthur, Cegolon, Luca, Cenderadewi, Muthia, Cerin, Ester, Chacón-Uscamaita, Pamela R, Chan, Jeffrey Shi Kai, Chanie, Gashaw Sisay, Charan, Jaykaran, Chattu, Vijay Kumar, Chekol Abebe, Endeshaw, Chen, Hui, Chen, Jianqi, Chi, Gerald, Chichagi, Fatemeh, Chidambaram, Saravana Babu, Chimoriya, Ritesh, Ching, Patrick R, Chitheer, Abdulaal, Chong, Yuen Yu, Chopra, Hitesh, Choudhari, Sonali Gajanan, Chowdhury, Enayet Karim, Chowdhury, Rajiv, Christensen, Hanne, Chu, Dinh-Toi, Chukwu, Isaac Sunday, Chung, Eric, Coberly, Kaleb, Columbus, Alyssa, Comachio, Josielli, Conde, Joao, Cortesi, Paolo Angelo, Costa, Vera Marisa, Couto, Rosa A S, Criqui, Michael H, Cruz-Martins, Natália, Dabbagh Ohadi, Mohammad Amin, Dadana, Sriharsha, Dadras, Omid, Dai, Xiaochen, Dai, Zhaoli, D'Amico, Emanuele, Danawi, Hadi A, Dandona, Lalit, Dandona, Rakhi, Darwish, Amira Hamed, Das, Saswati, Das, Subasish, Dascalu, Ana Maria, Dash, Nihar Ranjan, Dashti, Mohsen, De la Hoz, Fernando Pio, de la Torre-Luque, Alejandro, De Leo, Diego, Dean, Frances E, Dehghan, Amin, Dehghan, Azizallah, Dejene, Hiwot, Demant, Daniel, Demetriades, Andreas K, Demissie, Solomon, Deng, Xinlei, Desai, Hardik Dineshbhai, Devanbu, Vinoth Gnana Chellaiyan, Dhama, Kuldeep, Dharmaratne, Samath Dhamminda, Dhimal, Meghnath, Dias da Silva, Diana, Diaz, Daniel, Dibas, Mahmoud, Ding, Delaney D, Dinu, Monica, Dirac, M Ashworth, Diress, Mengistie, Do, Thanh Chi, Do, Thao Huynh Phuong, Doan, Khanh Duy Khanh, Dodangeh, Milad, Doheim, Mohamed Fahmy, Dokova, Klara Georgieva, Dongarwar, Deepa, Dsouza, Haneil Larson, Dube, John, Duraisamy, Senbagam, Durojaiye, Oyewole Christopher, Dutta, Sulagna, Dziedzic, Arkadiusz Marian, Edinur, Hisham Atan, Eissazade, Negin, Ekholuenetale, Michael, Ekundayo, Temitope Cyrus, El Nahas, Nevine, El Sayed, Iman, Elahi Najafi, Mohammad Amin, Elbarazi, Iffat, Elemam, Noha Mousaad, Elgar, Frank J, Elgendy, Islam Y, Elhabashy, Hala Rashad, Elhadi, Muhammed, Elilo, Legesse Tesfaye, Ellenbogen, Richard G, Elmeligy, Omar Abdelsadek Abdou, Elmonem, Mohamed A, Elshaer, Mohammed, Elsohaby, Ibrahim, Emamverdi, Mehdi, Emeto, Theophilus I, Endres, Matthias, Esezobor, Christopher Imokhuede, Eskandarieh, Sharareh, Fadaei, Abdolmajid, Fagbamigbe, Adeniyi Francis, Fahim, Ayesha, Faramarzi, Ali, Fares, Jawad, Farjoud Kouhanjani, Mohsen, Faro, Andre, Farzadfar, Farshad, Fatehizadeh, Ali, Fathi, Mobina, Fathi, Saeid, Fatima, Syeda Anum Fatima, Feizkhah, Alireza, Fereshtehnejad, Seyed-Mohammad, Ferrari, Alize J, Ferreira, Nuno, Fetensa, Getahun, Firouraghi, Neda, Fischer, Florian, Fonseca, Ana Catarina, Force, Lisa M, Fornari, Arianna, Foroutan, Behzad, Fukumoto, Takeshi, Gadanya, Muktar A, Gaidhane, Abhay Motiramji, Galali, Yaseen, Galehdar, Nasrin, Gan, Quan, Gandhi, Aravind P, Ganesan, Balasankar, Gardner, William M, Garg, Naval, Gau, Shuo-Yan, Gautam, Rupesh K, Gebre, Teshome, Gebrehiwot, Mesfin, Gebremeskel, Gebreamlak Gebremedhn, Gebreslassie, Haftay Gebremedhin, Getacher, Lemma, Ghaderi Yazdi, Bardiya, Ghadirian, Fataneh, Ghaffarpasand, Fariborz, Ghanbari, Reza, Ghasemi, MohammadReza, Ghazy, Ramy Mohamed, Ghimire, Sailaja, Gholami, Ali, Gholamrezanezhad, Ali, Ghotbi, Elena, Ghozy, Sherief, Gialluisi, Alessandro, Gill, Paramjit Singh, Glasstetter, Logan M, Gnedovskaya, Elena V, Golchin, Ali, Golechha, Mahaveer, Goleij, Pouya, Golinelli, Davide, Gomes-Neto, Mansueto, Goulart, Alessandra C, Goyal, Anmol, Gray, Richard J, Grivna, Michal, Guadie, Habtamu Alganeh, Guan, Bin, Guarducci, Giovanni, Guicciardi, Stefano, Gunawardane, Damitha Asanga, Guo, Hanbing, Gupta, Bhawna, Gupta, Rajeev, Gupta, Sapna, Gupta, Veer Bala, Gupta, Vivek Kumar, Gutiérrez, Reyna Alma, Habibzadeh, Farrokh, Hachinski, Vladimir, Haddadi, Rasool, Hadei, Mostafa, Hadi, Najah R, Haep, Nils, Haile, Teklehaimanot Gereziher, Haj-Mirzaian, Arvin, Hall, Brian J, Halwani, Rabih, Hameed, Sajid, Hamiduzzaman, Mohammad, Hammoud, Ahmad, Han, Hannah, Hanifi, Nasrin, Hankey, Graeme J, Hannan, Md. Abdul, Hao, Junwei, Harapan, Harapan, Hareru, Habtamu Endashaw, Hargono, Arief, Harlianto, Netanja I., Haro, Josep Maria, Hartman, Nicholas Nathaniel, Hasaballah, Ahmed I., Hasan, Faizul, Hasani, Hamidreza, Hasanian, Mohammad, Hassan, Amr, Hassan, Shoaib, Hassanipour, Soheil, Hassankhani, Hadi, Hassen, Mohammed Bheser, Haubold, Johannes, Hay, Simon I, Hayat, Khezar, Hegazy, Mohamed I, Heidari, Golnaz, Heidari, Mohammad, Heidari-Soureshjani, Reza, Hesami, Hamed, Hezam, Kamal, Hiraike, Yuta, Hoffman, Howard J, Holla, Ramesh, Hopf, Kathleen Pillsbury, Horita, Nobuyuki, Hossain, Md Mahbub, Hossain, Md. Belal, Hossain, Sahadat, Hosseinzadeh, Hassan, Hosseinzadeh, Mehdi, Hostiuc, Sorin, Hu, Chengxi, Huang, Junjie, Huda, Md. Nazmul, Hussain, Javid, Hussein, Nawfal R, Huynh, Hong-Han, Hwang, Bing-Fang, Ibitoye, Segun Emmanuel, Ilaghi, Mehran, Ilesanmi, Olayinka Stephen, Ilic, Irena M, Ilic, Milena D, Immurana, Mustapha, Iravanpour, Farideh, Islam, Sheikh Mohammed Shariful, Ismail, Faisal, Iso, Hiroyasu, Isola, Gaetano, Iwagami, Masao, Iwu, Chidozie C D, Iyer, Mahalaxmi, Jaan, Ali, Jacob, Louis, Jadidi-Niaragh, Farhad, Jafari, Mahboobeh, Jafarinia, Morteza, Jafarzadeh, Abdollah, Jahankhani, Kasra, Jahanmehr, Nader, Jahrami, Haitham, Jaiswal, Abhishek, Jakovljevic, Mihajlo, Jamora, Roland Dominic G, Jana, Somnath, Javadi, Nilofer, Javed, Saad, Javeed, Saad, Jayapal, Sathish Kumar, Jayaram, Shubha, Jiang, Heng, Johnson, Catherine Owens, Johnson, Walter D, Jokar, Mohammad, Jonas, Jost B, Joseph, Abel, Joseph, Nitin, Joshua, Charity Ehimwenma, Jürisson, Mikk, Kabir, Ali, Kabir, Zubair, Kabito, Gebisa Guyasa, Kadashetti, Vidya, Kafi, Fatemeh, Kalani, Rizwan, Kalantar, Farnaz, Kaliyadan, Feroze, Kamath, Ashwin, Kamath, Sagarika, Kanchan, Tanuj, Kandel, Amit, Kandel, Himal, Kanmodi, Kehinde Kazeem, Karajizadeh, Mehrdad, Karami, Jafar, Karanth, Shama D, Karaye, Ibraheem M, Karch, André, Karimi, Aliasghar, Karimi, Hanie, Karimi Behnagh, Arman, Kasraei, Hengameh, Kassebaum, Nicholas J, Kauppila, Joonas H, Kaur, Harkiran, Kaur, Navjot, Kayode, Gbenga A, Kazemi, Foad, Keikavoosi-Arani, Leila, Keller, Cathleen, Keykhaei, Mohammad, Khadembashiri, Mohammad Amin, Khader, Yousef Saleh, Khafaie, Morteza Abdullatif, Khajuria, Himanshu, Khalaji, Amirmohammad, Khamesipour, Faham, Khammarnia, Mohammad, Khan, Maseer, Khan, Moien AB, Khan, Yusra H, Khan Suheb, Mahammed Ziauddin, Khanmohammadi, Shaghayegh, Khanna, Tripti, Khatab, Khaled, Khatatbeh, Haitham, Khatatbeh, Moawiah Mohammad, Khateri, Sorour, Khatib, Mahalaqua Nazli, Khayat Kashani, Hamid Reza, Khonji, Mohammad Saeid, khorashadizadeh, Fatemeh, Khormali, Moein, Khubchandani, Jagdish, Kian, Saeid, Kim, Grace, Kim, Jihee, Kim, Min Seo, Kim, Yun Jin, Kimokoti, Ruth W, Kisa, Adnan, Kisa, Sezer, Kivimäki, Mika, Kochhar, Sonali, Kolahi, Ali-Asghar, Koly, Kamrun Nahar, Kompani, Farzad, Koroshetz, Walter J, Kosen, Soewarta, Kourosh Arami, Masoumeh, Koyanagi, Ai, Kravchenko, Michael A, Krishan, Kewal, Krishnamoorthy, Vijay, Kuate Defo, Barthelemy, Kuddus, Md Abdul, Kumar, Ashish, Kumar, G Anil, Kumar, Manasi, Kumar, Nithin, Kumsa, Netsanet Bogale, Kundu, Satyajit, Kurniasari, Maria Dyah, Kusuma, Dian, Kuttikkattu, Ambily, Kyu, Hmwe Hmwe, La Vecchia, Carlo, Ladan, Muhammad Awwal, Lahariya, Chandrakant, Laksono, Tri, Lal, Dharmesh Kumar, Lallukka, Tea, Lám, Judit, Lami, Faris Hasan, Landires, Iván, Langguth, Berthold, Lasrado, Savita, Latief, Kamaluddin, Latifinaibin, Kaveh, Lau, Kathryn Mei-Ming, Laurens, Matthew B, Lawal, Basira Kankia, Le, Long Khanh Dao, Le, Thao Thi Thu, Ledda, Caterina, Lee, Munjae, Lee, Sang-woong, Lee, Seung Won, Lee, Wei-Chen, Lee, Yo Han, Leonardi, Matilde, Lerango, Temesgen L, Li, Ming-Chieh, Li, Wei, Ligade, Virendra S, Lim, Stephen S, Linehan, Christine, Liu, Chaojie, Liu, Jue, Liu, Wei, Lo, Chun-Han, Lo, Warren David, Lobo, Stany W, Logroscino, Giancarlo, Lopes, Graciliana, Lopukhov, Platon D, Lorenzovici, László, Lorkowski, Stefan, Loureiro, Joana A, Lubinda, Jailos, Lucchetti, Giancarlo, Lutzky Saute, Ricardo, Ma, Zheng Feei, Mabrok, Mahmoud, Machoy, Monika, Madadizadeh, Farzan, Magdy Abd El Razek, Mohammed, Maghazachi, Azzam A, Maghbouli, Nastaran, Mahjoub, Soleiman, Mahmoudi, Morteza, Majeed, Azeem, Malagón-Rojas, Jeadran N., Malakan Rad, Elaheh, Malhotra, Kashish, Malik, Ahmad Azam, Malik, Iram, Mallhi, Tauqeer Hussain, Malta, Deborah Carvalho, Manilal, Aseer, Mansouri, Vahid, Mansournia, Mohammad Ali, Marasini, Bishnu P, Marateb, Hamid Reza, Maroufi, Seyed Farzad, Martinez-Raga, Jose, Martini, Santi, Martins-Melo, Francisco Rogerlândio, Martorell, Miquel, März, Winfried, Marzo, Roy Rillera, Massano, João, Mathangasinghe, Yasith, Mathews, Elezebeth, Maude, Richard James, Maugeri, Andrea, Maulik, Pallab K, Mayeli, Mahsa, Mazaheri, Maryam, McAlinden, Colm, McGrath, John J, Meena, Jitendra Kumar, Mehndiratta, Man Mohan, Mendez-Lopez, Max Alberto Mendez, Mendoza, Walter, Mendoza-Cano, Oliver, Menezes, Ritesh G, Merati, Mohsen, Meretoja, Atte, Merkin, Alexander, Mersha, Abera M, Mestrovic, Tomislav, Mi, Tianyue, Miazgowski, Tomasz, Michalek, Irmina Maria, Mihretie, Ephrem Tesfaye, Minh, Le Huu Nhat, Mirfakhraie, Reza, Mirica, Andreea, Mirrakhimov, Erkin M, Mirzaei, Mehdi, Misganaw, Awoke, Misra, Sanjeev, Mithra, Prasanna, Mizana, Biru Abdissa, Mohamadkhani, Ashraf, Mohamed, Nouh Saad, Mohammadi, Esmaeil, Mohammadi, Hiwa, Mohammadi, Shadieh, Mohammadi, Soheil, Mohammadshahi, Marita, Mohammed, Mustapha, Mohammed, Salahuddin, Mohammed, Shafiu, Mohan, Syam, Mojiri-forushani, Hoda, Moka, Nagabhishek, Mokdad, Ali H, Molinaro, Sabrina, Möller, Holger, Monasta, Lorenzo, Moniruzzaman, Md, Montazeri, Fateme, Moradi, Maryam, Moradi, Yousef, Moradi-Lakeh, Maziar, Moraga, Paula, Morovatdar, Negar, Morrison, Shane Douglas, Mosapour, Abbas, Mosser, Jonathan F, Mossialos, Elias, Motaghinejad, Majid, Mousavi, Parsa, Mousavi, Seyed Ehsan, Mubarik, Sumaira, Muccioli, Lorenzo, Mughal, Faraz, Mukoro, George Duke, Mulita, Admir, Mulita, Francesk, Musaigwa, Fungai, Mustafa, Ahmad, Mustafa, Ghulam, Muthu, Sathish, Nagarajan, Ahamarshan Jayaraman, Naghavi, Pirouz, Naik, Ganesh R, Nainu, Firzan, Nair, Tapas Sadasivan, Najmuldeen, Hastyar Hama Rashid, Nakhostin Ansari, Noureddin, Nambi, Gopal, Namdar Areshtanab, Hossein, Nargus, Shumaila, Nascimento, Bruno Ramos, Naser, Abdallah Y, Nashwan, Abdulqadir J J, Nasoori, Hadis, Nasreldein, Ahmed, Natto, Zuhair S, Nauman, Javaid, Nayak, Biswa Prakash, Nazri-Panjaki, Athare, Negaresh, Mohammad, Negash, Hadush, Negoi, Ionut, Negoi, Ruxandra Irina, Negru, Serban Mircea, Nejadghaderi, Seyed Aria, Nematollahi, Mohammad Hadi, Nesbit, Olivia D, Newton, Charles Richard James, Nguyen, Dang H, Nguyen, Hau Thi Hien, Nguyen, Hien Quang, Nguyen, Ngoc-Trinh Thi, Nguyen, Phat Tuan, Nguyen, Van Thanh, Niazi, Robina Khan, Nikolouzakis, Taxiarchis Konstantinos, Niranjan, Vikram, Nnyanzi, Lawrence Achilles, Noman, Efaq Ali, Noroozi, Nafise, Norrving, Bo, Noubiap, Jean Jacques, Nri-Ezedi, Chisom Adaobi, Ntaios, George, Nuńez-Samudio, Virginia, Nurrika, Dieta, Oancea, Bogdan, Odetokun, Ismail A, O'Donnell, Martin James, Ogunsakin, Ropo Ebenezer, Oguta, James Odhiambo, Oh, In-Hwan, Okati-Aliabad, Hassan, Okeke, Sylvester Reuben, Okekunle, Akinkunmi Paul, Okonji, Osaretin Christabel, Okwute, Patrick Godwin, Olagunju, Andrew T, Olaiya, Muideen Tunbosun, Olana, Matifan Dereje, Olatubi, Matthew Idowu, Oliveira, Gláucia Maria Moraes, Olufadewa, Isaac Iyinoluwa, Olusanya, Bolajoko Olubukunola, Omar Bali, Ahmed, Ong, Sokking, Onwujekwe, Obinna E, Ordak, Michal, Orji, Aislyn U, Ortega-Altamirano, Doris V, Osuagwu, Uchechukwu Levi, Otstavnov, Nikita, Otstavnov, Stanislav S, Ouyahia, Amel, Owolabi, Mayowa O, P A, Mahesh Padukudru, Pacheco-Barrios, Kevin, Padubidri, Jagadish Rao, Pal, Pramod Kumar, Palange, Padmavali Nanaji, Palladino, Claudia, Palladino, Raffaele, Palma-Alvarez, Raul Felipe, Pan, Feng, Panagiotakos, Demosthenes, Panda-Jonas, Songhomitra, Pandey, Anamika, Pandey, Ashok, Pandian, Jeyaraj Durai, Pangaribuan, Helena Ullyartha, Pantazopoulos, Ioannis, Pardhan, Shahina, Parija, Pragyan Paramita, Parikh, Romil R, Park, Seoyeon, Parthasarathi, Ashwaghosha, Pashaei, Ava, Patel, Jay, Patil, Shankargouda, Patoulias, Dimitrios, Pawar, Shrikant, Pedersini, Paolo, Pensato, Umberto, Pereira, David M, Pereira, Jeevan, Pereira, Maria Odete, Peres, Mario F P, Perico, Norberto, Perna, Simone, Petcu, Ionela-Roxana, Petermann-Rocha, Fanny Emily, Pham, Hoang Tran, Phillips, Michael R, Pinilla-Monsalve, Gabriel D, Piradov, Michael A, Plotnikov, Evgenii, Poddighe, Dimitri, Polat, Burcu, Poluru, Ramesh, Pond, Constance Dimity, Poudel, Govinda Raj, Pouramini, Alireza, Pourbagher-Shahri, Ali Mohammad, Pourfridoni, Mohammad, Pourtaheri, Naeimeh, Prakash, Peralam Yegneswaran, Prakash, Sanjay, Prakash, V, Prates, Elton Junio Sady, Pritchett, Natalie, Purnobasuki, Hery, Qasim, Nameer Hashim, Qattea, Ibrahim, Qian, Gangzhen, Radhakrishnan, Venkatraman, Raee, Pourya, Raeisi Shahraki, Hadi, Rafique, Ibrar, Raggi, Alberto, Raghav, Pankaja Raghav, Rahati, Meghdad M, Rahim, Fakher, Rahimi, Zahra, Rahimifard, Mahban, Rahman, Md Obaidur, Rahman, Mohammad Hifz Ur, Rahman, Mosiur, Rahman, Muhammad Aziz, Rahmani, Amir Masoud, Rahmani, Shayan, Rahmani Youshanlouei, Hamed, Rahmati, Masoud, Raj Moolambally, Sheetal, Rajabpour-Sanati, Ali, Ramadan, Hazem, Ramasamy, Shakthi Kumaran, Ramasubramani, Premkumar, Ramazanu, Sheena, Rancic, Nemanja, Rao, Indu Ramachandra, Rao, Sowmya J, Rapaka, Deepthi, Rashedi, Vahid, Rashid, Ahmed Mustafa, Rashidi, Mohammad-Mahdi, Rashidi Alavijeh, Mehran, Rasouli-Saravani, Ashkan, Rawaf, Salman, Razo, Christian, Redwan, Elrashdy Moustafa Mohamed, Rekabi Bana, Atefe, Remuzzi, Giuseppe, Rezaei, Nazila, Rezaei, Negar, Rezaei, Nima, Rezaeian, Mohsen, Rhee, Taeho Gregory, Riad, Abanoub, Robinson, Stephen R, Rodrigues, Mónica, Rodriguez, Jefferson Antonio Buendia, Roever, Leonardo, Rogowski, Emma L B, Romoli, Michele, Ronfani, Luca, Roy, Priyanka, Roy Pramanik, Koushik, Rubagotti, Enrico, Ruiz, Milagros A, Russ, Tom C, S Sunnerhagen, Katharina, Saad, Aly M A, Saadatian, Zahra, Saber, Korosh, SaberiKamarposhti, Morteza, Sacco, Simona, Saddik, Basema, Sadeghi, Erfan, Sadeghian, Saeid, Saeed, Umar, Saeed, Usman, Safdarian, Mahdi, Safi, Sher Zaman, Sagar, Rajesh, Sagoe, Dominic, Saheb Sharif-Askari, Fatemeh, Saheb Sharif-Askari, Narjes, Sahebkar, Amirhossein, Sahoo, Soumya Swaroop, Sahraian, Mohammad Ali, Sajedi, Seyed Aidin, Sakshaug, Joseph W, Saleh, Mohamed A, Salehi Omran, Hossein, Salem, Marwa Rashad, Salimi, Sohrab, Samadi Kafil, Hossein, Samadzadeh, Sara, Samargandy, Saad, Samodra, Yoseph Leonardo, Samuel, Vijaya Paul, Samy, Abdallah M, Sanadgol, Nima, Sanjeev, Rama Krishna, Sanmarchi, Francesco, Santomauro, Damian Francesco, Santri, Ichtiarini Nurullita, Santric-Milicevic, Milena M, Saravanan, Aswini, Sarveazad, Arash, Satpathy, Maheswar, Saylan, Mete, Sayyah, Mehdi, Scarmeas, Nikolaos, Schlaich, Markus P, Schuermans, Art, Schwarzinger, Michaël, Schwebel, David C, Selvaraj, Siddharthan, Sendekie, Ashenafi Kibret, Sengupta, Pallav, Senthilkumaran, Subramanian, Serban, Dragos, Sergindo, Mihretu Tagesse, Sethi, Yashendra, SeyedAlinaghi, SeyedAhmad, Seylani, Allen, Shabani, Mohammad, Shabany, Maryam, Shafie, Mahan, Shahabi, Saeed, Shahbandi, Ataollah, Shahid, Samiah, Shahraki-Sanavi, Fariba, Shahsavari, Hamid R, Shahwan, Moyad Jamal, Shaikh, Masood Ali, Shaji, KS, Sham, Sunder, Shama, Adisu Tafari T, Shamim, Muhammad Aaqib, Shams-Beyranvand, Mehran, Shamsi, Mohammad Anas, Shanawaz, Mohd, Sharath, Medha, Sharfaei, Sadaf, Sharifan, Amin, Sharma, Manoj, Sharma, Rajesh, Shashamo, Bereket Beyene, Shayan, Maryam, Sheikhi, Rahim Ali, Shekhar, Shashank, Shen, Jiabin, Shenoy, Suchitra M, Shetty, Pavanchand H, Shiferaw, Desalegn Shiferaw, Shigematsu, Mika, Shiri, Rahman, Shittu, Aminu, Shivakumar, K M, Shokri, Fereshteh, Shool, Sina, Shorofi, Seyed Afshin, Shrestha, Sunil, Siankam Tankwanchi, Akhenaten Benjamin, Siddig, Emmanuel Edwar, Sigfusdottir, Inga Dora, Silva, João Pedro, Silva, Luís Manuel Lopes Rodrigues, Sinaei, Ehsan, Singh, Balbir Bagicha, Singh, Garima, Singh, Paramdeep, Singh, Surjit, Sirota, Sarah Brooke, Sivakumar, Shravan, Sohag, Abdullah Al Mamun, Solanki, Ranjan, Soleimani, Hamidreza, Solikhah, Solikhah, Solomon, Yerukneh, Solomon, Yonatan, Song, Suhang, Song, Yimeng, Sotoudeh, Houman, Spartalis, Michael, Stark, Benjamin A, Starnes, Joseph R, Starodubova, Antonina V, Stein, Dan J, Steiner, Timothy J, Stovner, Lars Jacob, Suleman, Muhammad, Suliankatchi Abdulkader, Rizwan, Sultana, Abida, Sun, Jing, Sunkersing, David, Sunny, Angel, Susianti, Hani, Swain, Chandan Kumar, Szeto, Mindy D, Tabarés-Seisdedos, Rafael, Tabatabaei, Seyyed Mohammad, Tabatabai, Shima, Tabish, Mohammad, Taheri, Majid, Tahvildari, Azin, Tajbakhsh, Ardeshir, Tampa, Mircea, Tamuzi, Jacques JL Lukenze, Tan, Ker-Kan, Tang, Haosu, Tareke, Minale, Tarigan, Ingan Ukur, Tat, Nathan Y, Tat, Vivian Y, Tavakoli Oliaee, Razieh, Tavangar, Seyed Mohammad, Tavasol, Arian, Tefera, Yibekal Manaye, Tehrani-Banihashemi, Arash, Temesgen, Worku Animaw, Temsah, Mohamad-Hani, Teramoto, Masayuki, Tesfaye, Amensisa Hailu, Tesfaye, Edosa Geta, Tesler, Riki, Thakali, Ocean, Thangaraju, Pugazhenthan, Thapa, Rajshree, Thapar, Rekha, Thomas, Nikhil Kenny, Thrift, Amanda G, Ticoalu, Jansje Henny Vera, Tillawi, Tala, Toghroli, Razie, Tonelli, Marcello, Tovani-Palone, Marcos Roberto, Traini, Eugenio, Tran, Nghia Minh, Tran, Ngoc-Ha, Tran, Phu Van, Tromans, Samuel Joseph, Truelsen, Thomas Clement, Truyen, Thien Tan Tri Tai, Tsatsakis, Aristidis, Tsegay, Guesh Mebrahtom, Tsermpini, Evangelia Eirini, Tualeka, Abdul Rohim, Tufa, Derara Girma, Ubah, Chukwudi S, Udoakang, Aniefiok John, Ulhaq, Inam, Umair, Muhammad, Umakanthan, Srikanth, Umapathi, Krishna Kishore, Unim, Brigid, Unnikrishnan, Bhaskaran, Vaithinathan, Asokan Govindaraj, Vakilian, Alireza, Valadan Tahbaz, Sahel, Valizadeh, Rohollah, Van den Eynde, Jef, Vart, Priya, Varthya, Shoban Babu, Vasankari, Tommi Juhani, Vaziri, Siavash, Vellingiri, Balachandar, Venketasubramanian, Narayanaswamy, Verras, Georgios-Ioannis, Vervoort, Dominique, Villafańe, Jorge Hugo, Villani, Leonardo, Vinueza Veloz, Andres Fernando, Viskadourou, Maria, Vladimirov, Sergey Konstantinovitch, Vlassov, Vasily, Volovat, Simona Ruxandra, Vu, Loc Tri, Vujcic, Isidora S, Wagaye, Birhanu, Waheed, Yasir, Wahood, Waseem, Walde, Mandaras Tariku, Wang, Fang, Wang, Shu, Wang, Yanzhong, Wang, Yuan-Pang, Waqas, Muhammad, Waris, Abdul, Weerakoon, Kosala Gayan, Weintraub, Robert G, Weldemariam, Abrha Hailay, Westerman, Ronny, Whisnant, Joanna L, Wickramasinghe, Dakshitha Praneeth, Wickramasinghe, Nuwan Darshana, Willekens, Barbara, Wilner, Lauren B, Winkler, Andrea Sylvia, Wolfe, Charles D A, Wu, Ai-Min, Wulf Hanson, Sarah, Xu, Suowen, Xu, Xiaoyue, Yadollahpour, Ali, Yaghoubi, Sajad, Yahya, Galal, Yamagishi, Kazumasa, Yang, Lin, Yano, Yuichiro, Yao, Yao, Yehualashet, Sisay Shewasinad, Yeshaneh, Alex, Yesiltepe, Metin, Yi, Siyan, Yiğit, Arzu, Yiğit, Vahit, Yon, Dong Keon, Yonemoto, Naohiro, You, Yuyi, Younis, Mustafa Z, Yu, Chuanhua, Yusuf, Hadiza, Zadey, Siddhesh, Zahedi, Mohammad, Zakham, Fathiah, Zaki, Nazar, Zali, Alireza, Zamagni, Giulia, Zand, Ramin, Zandieh, Ghazal G Z, Zangiabadian, Moein, Zarghami, Amin, Zastrozhin, Mikhail Sergeevich, Zeariya, Mohammed G M, Zegeye, Zelalem Banjaw, Zeukeng, Francis, Zhai, Chunxia, Zhang, Chen, Zhang, Haijun, Zhang, Yunquan, Zhang, Zhi-Jiang, Zhao, Hanqing, Zhao, Yang, Zheng, Peng, Zhou, Hengxing, Zhu, Bin, Zhumagaliuly, Abzal, Zielińska, Magdalena, Zikarg, Yossef Teshome, Zoladl, Mohammad, Murray, Christopher J L, Ong, Kanyin Liane, Feigin, Valery L, Vos, Theo, and Dua, Tarun

Published
2024
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9. The WHO Mental Health Gap Action Programme for mental, neurological, and substance use conditions: the new and updated guideline recommendations

Author

Ali, Amza, Assanangkornchai, Sawitri, Brodaty, Henry, Carli, Vladimir, El Chammay, Rabih, Chang, Odille, Collins, Pamela Y, Cuijpers, Pim, Dowrick, Christopher, Eaton, Julian, Ferri, Cleusa P, Fortes, Sandra, Hengartner, Michael P, Humayun, Asma, Jette, Nathalie, de Vries, Petrus J, Medina-Mora, Maria Elena, Murthy, Pratima, Nadera, Dinah, Newton, Charles, Njenga, Michael, Omigbodun, Olayinka, Rahimi-Movaghar, Afarin, Rahman, Atif, Fortunato dos Santos, Palmira, Saxena, Shekhar, Vijayakumar, Lakshmi, Wang, Huali, Wattanavitukul, Pichayanan, Yewnetu, Enat, Carswell, Ken, Chatterjee, Sudipto, Fatima, Batool, Fleischmann, Alexandra, Gray, Brandon, Hanlon, Charlotte, Hanna, Fahmy, Krupchanka, Dzmitry, Malik, Aiysha, van Ommeren, Mark, Poznyak, Vladimir, Seeher, Katrin, Servili, Chiara, Weissbecker, Inka, Baingana, Florence, Alfonzo Bello, Luis, Bruni, Andrea, Jorge Dos Santos Ferreira Borges Bigot, Ana Carina, Dorji, Chencho, Vandendyck, Martin, Lazeri, Ledia, Monteiro, Maristela Goldnadel, Rani, Manju, Saeed, Khalid, e Souza, Renato Oliveira, Ameyan, Wole, Baltag, Valentina, Branca, Francesco, Cappello, Bernadette, Cometto, Giorgio, Dalil, Suraya, Gabrielli, Albis, Huttner, Benedikt, Jaramillo, Ernesto, Khan, Taskeen, King, Jonathan, Krech, Ruediger, Roebbel, Nathalie, Tran, Nhan, Sumi, Yuka, Brohan, Elaine, Chowdhary, Neerja, Dua, Tarun, Barbui, Corrado, Thornicroft, Graham, and Kestel, Dévora

Published
2024
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11. Acceptability and Feasibility of the World Health Organization's Caregiver Skills Training Implemented in the Italian National Health System

Author

Salomone, Erica, Ferrante, Camilla, Salandin, Arianna, Ferrara, Federica, Torchio, Elisabetta, Foletti, Giulia, Ghersi, Sabrina, Pacione, Laura, and Servili, Chiara

Abstract

The Caregiver Skills Training programme is an evidence-informed group intervention developed by the World Health Organization to counter the treatment gap for neurodevelopmental disorders in children. We examined feasibility and acceptability of Caregiver Skills Training in public child neuropsychiatry services in Italy. Following a formative adaptation process and a pre-pilot implementation, the programme was piloted in six centres. Caregivers of children (2-5 years) with autism spectrum disorder were randomised to either Caregiver Skills Training (n = 43) or treatment as usual (n = 43). Professionals' and caregivers' experiences in the treatment arm were examined with focus groups and questionnaires. The programme was largely considered acceptable, relevant and feasible. Specific implementation challenges and suggestions for optimising the package are discussed.

Published
2022
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15. Commentary: Children with Developmental Disorders in Humanitarian Settings--A Call for Evidence and Action

Author

Hunt, Xanthe, Betancourt, Theresa, Pacione, Laura, Elsabbagh, Mayada, and Servili, Chiara

Abstract

The relationship between developmental disorders and humanitarian settings is a complex one: conflict and natural emergencies can contribute to developmental disorders, largely by compromising women's prenatal and perinatal environment and their access to perinatal care (Zuurmond et al. 2016). Children and adults with disabilities often shoulder a disproportionate burden of the suffering experienced in such settings (UN Human Settlements Programme 2007; Peek and Stough 2010). It is challenging to provide appropriate and responsive care in emergency contexts to children with developmental disorders and their caregivers (Davidson et al. 2004). Nevertheless, the public health significance of supporting these children and intervening with those at risk of suboptimal developmental trajectories due to their exposure to a humanitarian emergency cannot be ignored. In recognition of this, this commentary poses three interlinked questions: (1) Which areas of programming and research need more attention in order to effectively support young children with developmental disorders and their caregivers?; (2) In emergency contexts, what principles should guide work with young children who have disabilities?; and (3) What is known about how to plan and program for this group and what gaps in the evidence need to be addressed? The commentary highlights areas of programming and research that need to give greater attention to supporting young children with developmental disorders, and their caregivers, in emergency contexts.

Published
2021
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16. Accelerating progress on early childhood development for children under 5 years with disabilities by 2030

Author

Olusanya, Bolajoko O., Boo, Nem Yun, Nair, M.K.C., Samms-Vaughan, Maureen E., Hadders-Algra, Mijna, Wright, Scott M., Breinbauer, Cecilia, Almasri, Nihad, Moreno-Angarita, Marisol, Arabloo, Jalal, Arora, Narendra K., Block, Sandra S., Berman, Brad D., Burchell, Gwen, de Camargo, Olaf Kraus, Carr, Gwen, del Castillo-Hegyi, Christie, Cheung, Vivian G., Halpern, Ricardo, Hoekstra, Rosa, Lynch, Paul, Mulaudzi, Mphelekedzeni C., Kakooza-Mwesige, Angelina, Ogbo, Felix A., Olusanya, Jacob O., Rojas-Osorio, Valeria, Shaheen, Amira, Williams, Andrew N., Servili, Chiara, Gladstone, Melissa, Kuper, Hannah, Wertlieb, Donald, Davis, Adrian C., and Newton, Charles R.J.C.

Published
2022
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17. The Lancet Commission on the future of care and clinical research in autism

Author

Lord, Catherine, Charman, Tony, Havdahl, Alexandra, Carbone, Paul, Anagnostou, Evdokia, Boyd, Brian, Carr, Themba, de Vries, Petrus J, Dissanayake, Cheryl, Divan, Gauri, Freitag, Christine M, Gotelli, Marina M, Kasari, Connie, Knapp, Martin, Mundy, Peter, Plank, Alex, Scahill, Lawrence, Servili, Chiara, Shattuck, Paul, Simonoff, Emily, Singer, Alison Tepper, Slonims, Vicky, Wang, Paul P, Ysrraelit, Maria Celica, Jellett, Rachel, Pickles, Andrew, Cusack, James, Howlin, Patricia, Szatmari, Peter, Holbrook, Alison, Toolan, Christina, and McCauley, James B

Published
2022
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18. 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

Author

Tekola, Bethlehem, Girma, Fikirte, Kinfe, Mersha, Abdurahman, Rehana, Tesfaye, Markos, Yenus, Zemi, Salomone, Erica, Pacione, Laura, Fekadu, Abebaw, Servili, Chiara, Hanlon, Charlotte, and Hoekstra, Rosa A.

Abstract

The World Health Organization's Caregiver Skills Training programme for children with developmental disorders or delays teaches caregivers strategies to help them support their child's development. Ethiopia has a severe lack of services for children with developmental disorders or delays. This study explored the perspectives of Ethiopian caregivers, professionals and other stakeholders to inform adaptation and implementation of the World Health Organization's Caregiver Skills Training in Ethiopia. Data collection included (1) a consultation and review, comprising stakeholder meetings, review of draft Caregiver Skills Training materials and feedback from Ethiopian Master Trainees and (2) a pre-pilot including quantitative feasibility and acceptability measures and qualitative interviews with caregivers (n = 9) and programme facilitators/observers (n = 5). The consultation participants indicated that the Caregiver Skills Training addresses an urgent need and is relevant to the Ethiopian context. Several adaptations were proposed, including more emphasis on psycho-education, stigma, parental feelings of guilt and expectations of a cure. The adapted Caregiver Skills Training was pre-piloted with excellent participation (100%) and retention (90%) rates. Four themes were developed from the qualitative data: (1) Programme acceptability and relevance, (2) Perceived programme benefits, (3) Challenges and barriers and (4) Suggestions for improvement. The World Health Organization's Caregiver Skills Training addresses a local need and, with careful adaptations, is feasible and acceptable to be implemented in Ethiopia. These findings may have relevance to low-resource settings worldwide. [The World Health Organization (WHO) Caregiver Skills Training (CST) Team co-authored this article.]

Published
2020
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19. Caregiver skills training for caregivers of individuals with neurodevelopmental disorders: A systematic review and meta‐analysis.

Author

Reichow, Brian, Kogan, Cary, Barbui, Corrado, Maggin, Daniel, Salomone, Erica, Smith, Isaac C., Yasamy, M. Taghi, and Servili, Chiara

Subjects
CAREGIVER education, INTERPERSONAL relations, PSYCHOLOGICAL well-being, NEURAL development, CHILD development, PUBLICATION bias, COMMUNITY-based programs
Abstract

Aim: To systematically review the effectiveness of caregiver and parent skills training programs, including caregiver‐mediated interventions, for caregivers of individuals with neurodevelopmental disorders. Method: We conducted a systematic review with a random‐effects meta‐analysis. We searched 11 electronic databases through July 2021 and used a snowball methodology to locate relevant articles of randomized controlled trials. Effect size estimates were pooled using Hedges' g from data extracted from study reports and through author requests using random‐effects meta‐analyses for three child outcome categories (child development, adaptive behavior, and problem behavior) and three caregiver outcome categories (parenting skills and knowledge, psychological well‐being, and interpersonal family relations). Results: We located 44 910 records, from which 75 randomized controlled trials involving 4746 individuals with neurodevelopmental disorders and their caregivers were included. Random‐effects meta‐analyses showed improvements in child development (g = 0.30; 99% confidence interval [CI] = 0.07–0.53) and reduction in reported problem behaviors (g = 0.41; 99% CI = 0.24–0.59), but not a statistically significant improvement in adaptive behavior (g = 0.28; 99% CI = −0.42 to 0.98). Caregivers showed improvements in parenting skills and knowledge (g = 0.72; 99% CI = 0.53–0.90), psychological well‐being (g = 0.52; 99% CI = 0.34–0.71), and interpersonal family relations (g = 0.76; 99% CI = 0.32–1.20). Interpretation: Caregiver skills training programs benefit both caregivers and children with neurodevelopmental disorders. Skills training programs improve child development and behavior, improve parenting skills, reduce caregiver mental health issues, and improve family functioning. Programs using culturally appropriate training material to improve the development, functioning, and participation of children within families and communities should be considered when caring for children with neurodevelopmental disorders. What this paper adds: Caregiver skills training programs are effective interventions for both caregivers and children.Children with neurodevelopmental disorders benefit from improvements in development and reduction of problematic behaviors.Caregivers benefit from enhanced skills and psychological well‐being.Improvements in interpersonal family relationships have also been documented. What this paper adds: Caregiver skills training programs are effective interventions for both caregivers and children.Children with neurodevelopmental disorders benefit from improvements in development and reduction of problematic behaviors.Caregivers benefit from enhanced skills and psychological well‐being.Improvements in interpersonal family relationships have also been documented. This systematic review is commented on by Lau on pages 684–685 of this issue. [ABSTRACT FROM AUTHOR]

Published
2024
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22. ETV6::ABL1-Positive Myeloid Neoplasm: A Case of a Durable Response to Imatinib Mesylate without Additional or Previous Treatment

Author

Bochicchio, Maria Teresa, primary, Marconi, Giovanni, additional, Baldazzi, Carmen, additional, Bandini, Lorenza, additional, Ruggieri, Francesca, additional, Lucchesi, Alessandro, additional, Agostinelli, Claudio, additional, Sabattini, Elena, additional, Orsatti, Agnese, additional, Ferrari, Anna, additional, Capirossi, Giorgia, additional, Servili, Chiara, additional, Ghelli Luserna di Rorà, Andrea, additional, Martinelli, Giovanni, additional, Simonetti, Giorgia, additional, and Rosti, Gianantonio, additional

Published
2023
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23. Development of a school-based programme for mental health promotion and prevention among adolescents in Nepal and South Africa

Author

Laurenzi, Christina A., primary, du Toit, Stefani, additional, Mawoyo, Tatenda, additional, Luitel, Nagendra P., additional, Jordans, Mark J.D., additional, Pradhan, Indira, additional, van der Westhuizen, Claire, additional, Melendez-Torres, G.J., additional, Hawkins, Jemma, additional, Moore, Graham, additional, Evans, Rhiannon, additional, Lund, Crick, additional, Ross, David A., additional, Lai, Joanna, additional, Servili, Chiara, additional, Tomlinson, Mark, additional, and Skeen, Sarah, additional

Published
2023
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24. Scalable Technology for Adolescents and Youth to Reduce Stress (STARS) in the Treatment of Common Mental Disorders in Jordan: Study Protocol for a Randomized Controlled Trial (Preprint)

Author

Akhtar, Aemal, primary, de Graaff, Anne Marijn, additional, Habashneh, Rand, additional, Keyan, Dharani, additional, Abualhaija, Adnan, additional, Fanatseh, Sarah, additional, Faroun, Muhannad, additional, Aqel, Ibrahim Said, additional, Dardas, Latefa, additional, Servili, Chiara, additional, van Ommeren, Mark, additional, Bryant, Richard, additional, and Carswell, Kenneth, additional

Published
2023
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27. Effectiveness of a technology-assisted, family volunteers delivered, brief, multicomponent parents’ skills training intervention for children with developmental disorders in rural Pakistan: a cluster randomized controlled trial

Author

Hamdani, Syed Usman, Huma, Zill-e-, Suleman, Nadia, Akhtar, Parveen, Nazir, Huma, Masood, Aqsa, Tariq, Mahjabeen, Koukab, Ahmareen, Salomone, Erica, Pacione, Laura, Brown, Felicity, Shire, Stephanie, Sikander, Siham, Servili, Chiara, Wang, Duolao, Minhas, Fareed Aslam, and Rahman, Atif

Published
2021
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29. ETV6::ABL1 -Positive Myeloid Neoplasm: A Case of a Durable Response to Imatinib Mesylate without Additional or Previous Treatment.

Author

Bochicchio, Maria Teresa, Marconi, Giovanni, Baldazzi, Carmen, Bandini, Lorenza, Ruggieri, Francesca, Lucchesi, Alessandro, Agostinelli, Claudio, Sabattini, Elena, Orsatti, Agnese, Ferrari, Anna, Capirossi, Giorgia, Servili, Chiara, Ghelli Luserna di Rorà, Andrea, Martinelli, Giovanni, Simonetti, Giorgia, and Rosti, Gianantonio

Subjects
IMATINIB, NUCLEOTIDE sequencing, HYPEREOSINOPHILIC syndrome, PROTEIN-tyrosine kinase inhibitors, BLOOD diseases, TUMORS
Abstract

ETV6::ABL1 rearranged neoplasms are rare hematological diseases. To date, about 80 cases have been reported, including myeloid and lymphoid leukemias. The ETV6 gene codes for an ETS family transcription factor and several fusion partners have been described. When translocated, ETV6 causes the constitutive activation of the partner genes. Here, we report the case of a 54-year-old woman with a cryptic insertion of the 3′ region of ABL1 in the ETV6 gene. The patient was first diagnosed with idiopathic hypereosinophilic syndrome, according to the clinical history, conventional cytogenetics, standard molecular analyses and pathologist description. Next generation sequencing of diagnosis samples unexpectedly detected both ETV6::ABL1 type A and B fusion transcripts, which were then confirmed by FISH. The diagnosis was Myeloid/Lymphoid neoplasm with ETV6::ABL1 fusion, and the patient received imatinib mesylate treatment. In a follow-up after more than one year, the patient still maintained the molecular and complete hematological responses. This case highlights the importance of timely and proper diagnostics and prompt tyrosine kinase inhibitor treatment. [ABSTRACT FROM AUTHOR]

Published
2024
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30. Treatment mechanism of the WHO caregiver skills training intervention for autism delivered in community settings.

Author

Settanni, Michele, Suma, Katharine, Adamson, Lauren B., McConachie, Helen, Servili, Chiara, and Salomone, Erica

Abstract

This study examined the mechanism of effect of the WHO Caregiver Skills Training (CST) through secondary analysis of a pilot RCT conducted in community settings. Participants were 86 caregivers (77% mothers) of children with ASD (78% male, mean age: 44.8 months) randomized to CST (n = 43) or treatment as usual (n = 43). The primary outcomes, measured at baseline (t1), immediately post‐intervention (t2), and 3 months post‐intervention (t3), were derived from the coding of caregiver‐child free play interactions with the Brief Observation of Social‐Communication Change (BOSCC) and the Joint Engagement Rating Inventory scale (JERI). At t3 positive treatment main effects had been observed for caregiver skills supportive of the interaction and for flow of the interaction (JERI), albeit only non‐significant changes in the expected direction for child outcomes: autism phenotypic behaviors (BOSCC), joint engagement and availability to interact (JERI). This study tested the theory of change of CST, hypothesizing that the intervention would lead to an improvement on all child and dyad outcomes through an increase in the caregiver skills supportive of the interaction. Serial mediation analyses revealed that the effect of the intervention was significantly influenced by change in caregiver skills. Participation in the intervention led to notable increases in caregiver skills at t2 and t3, which subsequently contributed to improvements at t3 in flow of the interaction, autism phenotypic behavior, joint engagement, and availability to interact. We confirmed our a priori hypothesis showing that change in caregiver skills significantly mediated the effect of treatment on the dyad primary outcome, as well as on the other child outcomes that had shown non‐significant changes in the expected direction. Implications for intervention design and policy making in the context of public health services are discussed. Lay Summary: Community‐implemented caregiver‐mediated interventions are commonly used with children with autism spectrum disorder under age 5, but few studies have examined their effective mechanism (i.e., the processes responsible for changes in the clinical outcomes). This study examined the mechanism of a recently developed intervention, the WHO Caregiver Skills Training (CST), within a randomized controlled trial carried out in the community. The trial had shown positive intervention effects on parent skills supportive of the interaction and for fluent interaction between the child and caregiver, but less strong changes in the expected direction for child autism characteristic behaviors, joint engagement and availability to interact. The current study tested the hypothesis that CST works by increasing the parent's skills in support of the interaction, which in turn can lead to improved outcomes. We found that caregivers who received the CST intervention improved significantly more in their interaction skills with the child, and this led to a significant improvement on all joint interaction and child outcomes, including those which did not show a main effect of the intervention. This study shows that an acceptable and feasible open access community‐implemented caregiver‐mediated intervention can lead to a sustained improvement in the quality of the caregiver–child interaction through enhancing the caregiver's interaction skills. [ABSTRACT FROM AUTHOR]

Published
2024
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31. The WHO Mental Health Gap Action Programme for mental, neurological, and substance use conditions: the new and updated guideline recommendations

Author

Brohan, Elaine, Chowdhary, Neerja, Dua, Tarun, Barbui, Corrado, Thornicroft, Graham, Kestel, Dévora, Ali, Amza, Assanangkornchai, Sawitri, Brodaty, Henry, Carli, Vladimir, El Chammay, Rabih, Chang, Odille, Collins, Pamela Y, Cuijpers, Pim, Dowrick, Christopher, Eaton, Julian, Ferri, Cleusa P, Fortes, Sandra, Hengartner, Michael P, Humayun, Asma, Jette, Nathalie, de Vries, Petrus J, Medina-Mora, Maria Elena, Murthy, Pratima, Nadera, Dinah, Newton, Charles, Njenga, Michael, Omigbodun, Olayinka, Rahimi-Movaghar, Afarin, Rahman, Atif, Fortunato dos Santos, Palmira, Saxena, Shekhar, Vijayakumar, Lakshmi, Wang, Huali, Wattanavitukul, Pichayanan, Yewnetu, Enat, Carswell, Ken, Chatterjee, Sudipto, Fatima, Batool, Fleischmann, Alexandra, Gray, Brandon, Hanlon, Charlotte, Hanna, Fahmy, Krupchanka, Dzmitry, Malik, Aiysha, van Ommeren, Mark, Poznyak, Vladimir, Seeher, Katrin, Servili, Chiara, Weissbecker, Inka, Baingana, Florence, Alfonzo Bello, Luis, Bruni, Andrea, Jorge Dos Santos Ferreira Borges Bigot, Ana Carina, Dorji, Chencho, Vandendyck, Martin, Lazeri, Ledia, Monteiro, Maristela Goldnadel, Rani, Manju, Saeed, Khalid, e Souza, Renato Oliveira, Ameyan, Wole, Baltag, Valentina, Branca, Francesco, Cappello, Bernadette, Cometto, Giorgio, Dalil, Suraya, Gabrielli, Albis, Huttner, Benedikt, Jaramillo, Ernesto, Khan, Taskeen, King, Jonathan, Krech, Ruediger, Roebbel, Nathalie, Tran, Nhan, and Sumi, Yuka

Abstract

The WHO Mental Health Gap Action Programme (mhGAP) guideline update reflects 15 years of investment in reducing the treatment gap and scaling up care for people with mental, neurological, and substance use (MNS) conditions. It was produced by a guideline development group and steering group, with support from topic experts, using quantitative and qualitative evidence and a systematic review of use of mhGAP. 90 recommendations from the 2015 guideline update were validated and endorsed for use in their current format. These are joined by 30 revised recommendations and 18 new recommendations, including a new module on anxiety. Psychological interventions are emphasised as treatments and digitally delivered interventions feature across many modules, as well as updated recommendations for psychotropic medicines. Research gaps identified include the need for evidence from low-resource settings and on the views of people with lived experience of MNS conditions. The revised recommendations ensure that mhGAP continues to offer high-quality, timely, transparent, and evidence-based guidance to support non-specialist health workers in low-income and middle-income countries in providing care to individuals with MNS conditions.

Published
2024
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35. Preventing mental health conditions in adolescents living with HIV: an urgent need for evidence

Author

Laurenzi, Christina A., Skeen, Sarah, Gordon, Sarah, Akin?Olugbade, Olamide, Abrahams, Nina, Bradshaw, Melissa, Brand, Amanda, Toit, Stefani, Melendez?Torres, G J., Tomlinson, Mark, Servili, Chiara, Dua, Tarun, and Ross, David A.

Subjects
HIV infection in children -- Complications and side effects -- Care and treatment, AIDS (Disease) -- Research, AIDS research, Mental illness -- Prevention, Health
Abstract

: Introduction: As adolescents transition from childhood to adulthood, they experience major physical, social and psychological changes, and are at heightened risk for developing mental health conditions and engaging in health‐related risk behaviours. For adolescents living with HIV (ALHIV), these risks may be even more pronounced. Research shows that this population may face additional mental health challenges related to the biological impact of the disease and its treatment, the psychosocial burdens of living with HIV and HIV‐related social and environmental stressors. Discussion: Psychosocial interventions delivered to adolescents can promote positive mental health, prevent mental health problems and strengthen young people’s capacity to navigate challenges and protect themselves from risk. It is likely that these interventions can also benefit at‐risk populations, such as ALHIV, yet there is little research on this. There is an urgent need for more research evaluating the effects of interventions designed to improve the mental health of ALHIV. We highlight four priorities moving forward. These include: generating more evidence about preventive mental health interventions for ALHIV; including mental health outcomes in research on psychosocial interventions for ALHIV; conducting intervention research that is sensitive to differences among ALHIV populations and involving adolescents in intervention design and testing. Conclusions: More robust research on promotive and preventive mental health interventions is needed for ALHIV. Programmes should be informed by adolescent priorities and preferences and responsive to the specific needs of these groups., INTRODUCTION As adolescents transition from childhood to adulthood, they undergo major physical, social and psychological changes [1]. Physical changes, which include puberty and rapid brain development, take place in the [...]

Published
2020
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36. Identifying feasible and effective strategies for taking quality child and adolescent mental health services to scale: a scoping review

Author

Walker, Sarah, Wissow, Lawrence, Servili, Chiara, szatmari, peter, Gubner, Noah, and Ngo, Sally

Subjects
children and adolescent, Social and Behavioral Sciences, mental health, scalability
Abstract

The goal of this scoping review is to identify feasible and effective strategies for taking quality child and adolescent mental health services to scale. The review is primarily interested in strategies to scale services at the country or population level but will consider studies that focus on regional areas governed by local policies (e.g. state, district, or city). The review will focus on identifying empirical studies (including case studies) that describe successful efforts to take quality child and adolescent mental health services to scale, including strategies to increase workforce competency and system capacity to sustainably adopt changes. Funding to conduct this scoping review was provided by the World Health Organization (WHO). The WHO has an active role in developing the scope of the review and the coding criteria used.

Published
2022
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37. Perspectives on the role of context in adapting caregiver interventions for families raising children with neurodevelopmental disorders

Author

Szlamka, Zsofia, Hanlon, Charlotte, Tekola, Bethlehem, Pacione, Laura, Salomone, Erica, Team, WHO, Servili, Chiara, and Hoekstra, Rosa

Subjects
neurdevelopmental disorders, intellectual disability, contextual adaptation, autism, cultural adaptation
Abstract

There are increasing efforts to scale up services globally for families raising children with neurodevelopmental disorders (NDDs). Existing interventions, often developed in high income, Western settings, need substantial adaptation before they can be implemented in different contexts. The aim of this study was to explore perspectives on the role that context plays in the adaptation and implementation across settings of interventions targeting caregivers of children with NDDs. The study question was applied to the Caregiver Skills Training (CST) programme of the World Health Organization, specifically, as well as to stakeholder experiences with caregiver interventions more broadly. Two focus group discussions (FGDs; n=15 participants) and 25 individual semi-structured interviews were conducted. Participants were caregivers of children with NDDs and professionals involved in adapting or implementing the CST across five continents and different income settings. Data were analysed thematically. Four main themes were developed: 1) Fitting the intervention to the local context; 2) Integrating an intervention into local public services; 3) Understanding the reality of caregivers; 4) Challenges of sustaining an intervention. Informants thought that contextual adaptations were key for the intervention to fit in locally, even more so than cultural factors. The socio-economic context of caregivers, including poverty, was highlighted as heavily affecting service access and engagement with the intervention. Participants discussed challenges of integrating an intervention into existing public services and making it sustainable. Competing health priorities other than NDDs, financial constraints, and management of long-term collaborations were identified as barriers. This study validates the notion that attention to contextual factors is an essential part of the adaptation of caregiver interventions for children with NDDs, by providing perspectives from different geographical regions. We recommend a stronger policy and research focus on contextual adaptations of interventions and addressing unmet socio-economic needs of caregivers.

Published
2022
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38. Acceptability and feasibility of the World Health Organization's Caregiver Skills Training Programme (WHO CST) delivered via eLearning, videoconferencing, and in-person hybrid modalities in Hong Kong

Author

Lau, Janet Siu-Ping, primary, Lai, Simon Man-Kin, additional, Ip, Florence To-Sau, additional, Wong, Paul Wai-Ching, additional, Team, WHO CST, additional, Servili, Chiara, additional, Salomone, Erica, additional, Pacione, Laura, additional, Shire, Stephanie, additional, and Brown, Felicity L., additional

Published
2022
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40. Critical life course interventions for children and adolescents to promote mental health.

Author

Laurenzi, Christina A., Mamutse, Sihle, Marlow, Marguerite, Mawoyo, Tatenda, Katzen, Linnea Stansert, Carvajal-Velez, Liliana, Lai, Joanna, Luitel, Nagendra, Servili, Chiara, Sinha, Moitreyee, and Skeen, Sarah

Abstract

Childhood and adolescence are key developmental periods in the life course for addressing mental health, and there is ample evidence to support significant, increased investment in mental health promotion for this group. However, there are gaps in evidence to inform how best to implement mental health promotion interventions at scale. In this review, we examined psychosocial interventions implemented with children (aged 5–10 years) and adolescents (aged 10–19 years), drawing on evidence from WHO guidelines. Most psychosocial interventions promoting mental health have been implemented in school settings, with some in family and community settings, by a range of delivery personnel. Mental health promotion interventions for younger ages have prioritised key social and emotional skills development, including selfregulation and coping; for older ages, additional skills include problem-solving and interpersonal skills. Overall, fewer interventions have been implemented in low- and middle-income countries. We identify cross-cutting areas affecting child and adolescent mental health promotion: understanding the problem scope; understanding which components work; understanding how and for whom interventions work in practice; and ensuring supportive infrastructure and political will. Additional evidence, including from participatory approaches, is required to tailor mental health promotive interventions to diverse groups’ needs and support healthy life course trajectories for children and adolescents everywhere. [ABSTRACT FROM AUTHOR]

Published
2023
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41. Sustainable Technology for Adolescents and youth to Reduce Stress ( STARS ): a WHO transdiagnostic chatbot for distressed youth

Author

Hall, Jennifer, primary, Jordan, Stewart, additional, Ommeren, Mark, additional, Au, Teresa, additional, Sway, Rajiah Abu, additional, Crawford, Joy, additional, Ghalayani, Heba, additional, Hamdani, Syed Usman, additional, Luitel, Nagendra P., additional, Malik, Aiysha, additional, Servili, Chiara, additional, Sorsdahl, Katherine, additional, Watts, Sarah, additional, and Carswell, Kenneth, additional

Published
2022
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43. Adapting and pretesting the World Health Organization's Caregiver Skills Training Program for children with autism and developmental disorders or delays in Hong Kong.

Author

Wong, Paul Wai-Ching, Lam, Yan-Yin, Lau, Janet Siu-Ping, Fok, Hung-Kit, The WHO CST Team, Servili, Chiara, Salomone, Erica, Pacione, Laura, Shire, Stephanie, and Brown, Felicity

Subjects
AUTISTIC children, CHILDREN with autism spectrum disorders, DEVELOPMENTAL delay, CAREGIVER education, AUTISM in children, FOSTER children, AUTISM spectrum disorders
Abstract

The World Health Organization Caregiver Skills Training Program (WHO-CST) was developed to strengthen caregivers' skills in supporting children with developmental delays and the caregivers' well-being. The WHO-CST Hong Kong (HK) was adapted, and pre-pilot tested to support families with children suspected of having developmental delays and autism spectrum disorder and to empower the caregivers to foster their children's learning, social communication, and adaptive behavior. A sequential mixed-methods research methodology was undertaken to examine the adaptation process and initial implementation experiences. The acceptability, feasibility, and perceived benefits of the WHO-CST were assessed using stakeholders' and caregivers' qualitative and caregivers' quantitative pre- and post-intervention feedback. The data included materials generated from (1) three consultation meetings with stakeholders; (2) detailed reviews of the translated and adapted WHO-CST materials by master trainees (n = 10) trained by the WHO-CST representatives; (3) needs assessment focus group interviews with caregivers (n = 15) of children with autism spectrum disorder; and (4) pre- and post-CST program qualitative focus group interviews and quantitative evaluation. Consultation with stakeholders suggested that the program was acceptable for the local community, but the home visit and fidelity components were initially considered to be challenges towards the feasibility and sustainability of the program. Caregivers in the needs assessment focus groups gave widely diverse views about the program's uniqueness, length, delivery mode, and the inclusion of videotaping in-home visits. Post-intervention comments by caregivers about the program were mainly positive, while the MTs were critical of the content and length of the training and fidelity process. As one of the first high-income locations to adopt the WHO-CST, the evaluation findings of the WHO-CST-HK indicate that it is feasible and acceptable to implement the program in a metropolitan area where families have busy work schedules and are very conscious of privacy issues. The study results suggest that the WHO-CST program in HK and other high-income countries require scaling up and further evaluation of its implementation in real community settings. This involves systemic and contextual changes to allow task-sharing between professionals and non-specialists at the macro level. Furthermore, technology should be used to support the supervision of non-specialists. In addition, easier access to the WHO-CST materials at the micro level is required to ensure equity, equality, diversity, and inclusion of diversified families of children with developmental delays. [ABSTRACT FROM AUTHOR]

Published
2022
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44. sj-docx-1-aut-10.1177_13623613211035228 – Supplemental material for Acceptability and feasibility of the World Health Organization’s Caregiver Skills Training implemented in the Italian National Health System

Author

Salomone, Erica, Ferrante, Camilla, Salandin, Arianna, Ferrara, Federica, Torchio, Elisabetta, Foletti, Giulia, Ghersi, Sabrina, Pacione, Laura, and Servili, Chiara

Subjects
FOS: Psychology, FOS: Clinical medicine, 170199 Psychology not elsewhere classified, 111799 Public Health and Health Services not elsewhere classified, FOS: Educational sciences, 110319 Psychiatry (incl. Psychotherapy), FOS: Health sciences, 130312 Special Education and Disability, Education
Abstract

Supplemental material, sj-docx-1-aut-10.1177_13623613211035228 for Acceptability and feasibility of the World Health Organization’s Caregiver Skills Training implemented in the Italian National Health System by Erica Salomone, Camilla Ferrante, Arianna Salandin, Federica Ferrara, Elisabetta Torchio, Giulia Foletti, Sabrina Ghersi, Laura Pacione and Chiara Servili in Autism

Published
2021
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45. Exploring contextual adaptations in caregiver interventions for families raising children with developmental disabilities.

Author

Szlamka, Zsofia, Hanlon, Charlotte, Tekola, Bethlehem, Pacione, Laura, Salomone, Erica, Servili, Chiara, and Hoekstra, Rosa A.

Subjects
CAREGIVERS, CHILDREN with disabilities, CHILDREN with developmental disabilities, CAREGIVER education, FAMILIES, MUNICIPAL services, SOCIOCULTURAL factors
Abstract

There are increasing efforts to scale up services globally for families raising children with developmental disabilities (DDs). Existing interventions, often developed in high income, Western settings, need substantial adaptation before they can be implemented in different contexts. The aim of this study was to explore perspectives on the role that context plays in the adaptation and implementation of interventions targeting caregivers of children with DDs across settings. The study question was applied to the Caregiver Skills Training (CST) programme of the World Health Organization specifically, as well as to stakeholder experiences with caregiver interventions more broadly. Two focus group discussions (FGDs; n = 15 participants) and 25 individual semi-structured interviews were conducted. Participants were caregivers of children with DDs and professionals involved in adapting or implementing the CST across five continents and different income settings. Data were analysed thematically. Four main themes were developed: 1) Setting the scene for adaptations; 2) Integrating an intervention into local public services; 3) Understanding the reality of caregivers; 4) Challenges of sustaining an intervention. Informants thought that contextual adaptations were key for the intervention to fit in locally, even more so than cultural factors. The socio-economic context of caregivers, including poverty, was highlighted as heavily affecting service access and engagement with the intervention. Competing health priorities other than DDs, financial constraints, and management of long-term collaborations were identified as barriers. This study validates the notion that attention to contextual factors is an essential part of the adaptation of caregiver interventions for children with DDs, by providing perspectives from different geographical regions. We recommend a stronger policy and research focus on contextual adaptations of interventions and addressing unmet socio-economic needs of caregivers. [ABSTRACT FROM AUTHOR]

Published
2022
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46. Acceptability and feasibility of the World Health Organization's Caregiver Skills Training Programme (WHO CST) delivered via eLearning, videoconferencing, and in-person hybrid modalities in Hong Kong.

Author

Siu-Ping Lau, Janet, Man-Kin Lai, Simon, To-Sau Ip, Florence, Wai-Ching Wong, Paul, Servili, Chiara, Salomone, Erica, Pacione, Laura, Shire, Stephanie, and Brown, Felicity L.

Subjects
CAREGIVER education, VIDEOCONFERENCING, PARENT-child relationships, CHILDREN with developmental disabilities, WORLD health, GENERAL Health Questionnaire, CHILDREN with disabilities
Abstract

Background: Local children with developmental disabilities were deprived of learning opportunities due to recent social and health incidents, resulting in elevating challenging behaviors and familial conflicts. This study explored the acceptability and feasibility of the World Health Organization's Caregiver Skills Training Programme (WHO CST) in alternative delivery modes under new normal and post COVID-19 period. Method: CST was delivered via eLearning (EL), videoconferencing (VC), and in- person hybrid (IP) modes to 34 parent-child dyads, being randomly assigned tomodes of asynchronous non-interfering EL (n = 9), synchronous with online coaching VC (n = 7), synchronous with in-person coaching IP (n = 9) and Wait-list Control WLC (n = 9). Data from two standardized scales of General Health Questionnaire (GHQ-12) and Strengths and Difficulties Questionnaire (SDQ), and Post-session and Home Visit Feedback Form by Caregivers that included both structured and open-ended questions were collected before and after intervention. Both quantitative and qualitative approaches were used in studying the collected data. Results: High levels of acceptability and feasibility of the training programme were supported by ratings on comprehensiveness and relevance, agreement with their personal values, duration, and usefulness. IP and VC groups yielded more positive changes than EL and WLC groups with 3, 16, 13, and -3% in General Health Questionnaire (GHQ- 12), -13, -15, -6 and 0% in Difficulties-total, and 36.5, 35.5, 5.8 and 2.4% in Prosocial Scale at Strengths and Difficulties Questionnaire (SDQ) for EL, VC, IP, and WLC groups respectively from baseline to 12 weeks after intervention. Results from two standardized scales echoed with qualitative observations that the programme helped improve caregivers' well-being, child's communication, and behaviors across intervention groups. Conclusions: Current findings revealed that CST delivered in three alternative modes were acceptable and feasible, and yielded positive impacts toward both caregivers and children. In-person coaching, and skill-practicing sessions were e [ABSTRACT FROM AUTHOR]

Published
2022
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47. Annual Research Review: Achieving universal health coverage for young children with autism spectrum disorder in low‐ and middle‐income countries: a review of reviews

Author

Divan, Gauri, primary, Bhavnani, Supriya, additional, Leadbitter, Kathy, additional, Ellis, Ceri, additional, Dasgupta, Jayashree, additional, Abubakar, Amina, additional, Elsabbagh, Mayada, additional, Hamdani, Syed Usman, additional, Servili, Chiara, additional, Patel, Vikram, additional, and Green, Jonathan, additional

Published
2021
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48. Acceptability and feasibility of the World Health Organization's Caregiver Skills Training implemented in the Italian National Health System.

Author

Salomone, Erica, Ferrante, Camilla, Salandin, Arianna, Ferrara, Federica, Torchio, Elisabetta, Foletti, Giulia, Ghersi, Sabrina, Pacione, Laura, and Servili, Chiara

Subjects
CAREGIVERS, FOCUS groups, ABILITY, TRAINING, AUTISM, QUESTIONNAIRES, SOCIAL skills education
Abstract

The Caregiver Skills Training programme is an evidence-informed group intervention developed by the World Health Organization to counter the treatment gap for neurodevelopmental disorders in children. We examined feasibility and acceptability of Caregiver Skills Training in public child neuropsychiatry services in Italy. Following a formative adaptation process and a pre-pilot implementation, the programme was piloted in six centres. Caregivers of children (2–5 years) with autism spectrum disorder were randomised to either Caregiver Skills Training (n = 43) or treatment as usual (n = 43). Professionals' and caregivers' experiences in the treatment arm were examined with focus groups and questionnaires. The programme was largely considered acceptable, relevant and feasible. Specific implementation challenges and suggestions for optimising the package are discussed. Across the globe, children with neurodevelopmental disorders, including autism, have limited access to care through public services. To improve access to care the World Health Organization developed a novel, open-access programme: the Caregiver Skills Training programme. The Caregiver Skills Training consists of nine group sessions and three individual home visits, focused on training the caregiver on how to use everyday play and home routines as opportunities for learning and development. We implemented Caregiver Skills Training in public child neuropsychiatry services in Italy and examined with questionnaires and focus groups how feasible it was to deliver the programme in public health settings and how acceptable and relevant it was for caregiver users. We found that the Caregiver Skills Training was largely considered acceptable and relevant for families and feasible to deliver. We discuss potential solutions to address the specific implementation challenges that were identified, such as strategies to improve training of interventionists and overcome barriers to caregiver participation. [ABSTRACT FROM AUTHOR]

Published
2022
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