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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

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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.

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Acknowledgments

The authors would like to gratefully acknowledge Azim Premji Philanthropy Institute (APPI), Autism Speaks, Andy Shih and Cecilia Montiel-Nava for supporting the adaptation, MT training and field-testing of the WHO-CST in India. We gratefully acknowledge the invaluable contribution of Gopika Kapoor, Aakankshi Jhaveri, Cristabelle Mascarenhas, Ojaswita Khaparde, Shilpa Taula & Praphul Sudarshan during adaptation and field-testing, Lakshmi Ananthanarayanan for conducting the FGDs, and all the families and children who participated.

Funding

This work was made possible due to a Corporate Social Responsibility (CSR) grant from Azim Premji Philanthropy Institute (APPI).

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Author notes

  1. Subharati Ghosh

    Present address: Research Insights and Innovation, Population Health and Safety, SEIU 775 Benefits Group, Seattle, USA

Authors and Affiliations

  1. Autism Intervention Services, Ummeed Child Development Center, Ground Floor, Mantri Pride, 1-B, 1/62 N.M. Joshi Marg, Subhash Nagar, Near Chinchpokli Station, Lower Parel, Mumbai, 400011, India

    Koyeli Sengupta, Disha Sanghvi, Sanchita Mahadik & Oshin Deshmukh

  2. Department of Psychiatry, T. N. Medical College & BYL Nair Ch. Hospital, Mumbai, India

    Henal Shah & Allauki Dani

  3. Division of Child and Youth Mental Health, Department of Psychiatry, University of Toronto, Toronto, Canada

    Laura Pacione

  4. Autism Speaks, 1060 State Rd, Princeton, NJ, USA

    Pamela Dixon

  5. Department of Psychology, University of Milan-Bicocca, Milan, Italy

    Erica Salomone

  6. Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland

    Laura Pacione, Erica Salomone & Chiara Servili

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WHO-CST team

Contributions

KS conceived, designed, supervised and drafted the manuscript of the study, part of the WHO CST initiative led by CS. LP, ES, SS, FB and CS contributed to the development of the CST program materials and field-testing materials. SG and HS contributed equally to study design, field-testing, data acquisition, analysis and interpretation, drafting and critical review of manuscript. PD contributed to data analysis and interpretation and critical review of the manuscript; DS, SM, AD and OD contributed to study execution, acquisition of data, and drafting of the manuscript.

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Correspondence to Koyeli Sengupta.

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Sengupta, K., Shah, H., Ghosh, S. et al. World Health Organisation-Caregiver Skills Training (WHO-CST) Program: Feasibility of Delivery by Non-Specialist Providers in Real-world Urban Settings in India. J Autism Dev Disord 53, 1444–1461 (2023). https://doi.org/10.1007/s10803-021-05367-0

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