Capacitar, World Health Organization caregivers training program for parents of children with autism in Brazil

Not Applicable

• Conditions: Autistic Spectrum Disorder; F03.625

• Registration Number: RBR-8mxj56m
• Lead Sponsor: niversidade Federal do Paraná

Brief Summary

The prevalence of neurodevelopmental disorders (ND), in particular Autism Spectrum Disorder (ASD) have increased, impacting on the health of not only individuals, but also of family and society. Early treatment of this condition, despite being efficient, is hardly accessible. Because of that, the World Health Organization (WHO) developed the Caregivers Skills Training (CST) program, which prepares health professionals to prepares health workers to carry out this parental training. This research is part of the CST Brazil pilot project, when training is carried out by the facilitator, and aims to assess the effectiveness of the CST program in reducing autism and maladaptive symptoms in children with ASD, in addition to analyzing the profile of symptoms that modify after training and characterize the studied sample regarding adaptive symptoms. This is an open clinical trial, with caregivers of children (2-9 years) with ND, residing in Curitiba. Five groups of caregivers (n=37) were trained by 11 professionals from the public health and education to perform the stimulation of children with ND. The training was conducted online due to the COVID-19 pandemic and the tools used were the Autism Treatment Evaluation Checklist (ATEC), Global Clinical Impression Scale, severity and improvement (CGI-S/ CGI-I), Target Behavior Measures and Pre- and post-intervention Strengths and Difficulties Questionnaire (SDQ) and Vineland Adaptive Scale 3. 28 of the 37 families completed the training. As a result, we observed an improvement in autism symptoms, with an average decrease of 11.3 points (p<0.01) in total ATEC. A decrease in the severity of symptoms was also observed by CGI-S (MD 4.42 to 3.89, p< 0.01) and improvement of the condition by CGI-I. There wasa 70% improvement in target behaviors, with 40.4% presenting a significant improvement. Participating children had adaptive capacity below the population average, especially communication skills. The symptoms with the most expressive improvement after training were communication and sensory cognitive symptoms. There was no significant improvement in the SDQ score. We conclude that CST is effective in decreasing autism symptoms in children with ASD and decreasing the severity of the illness. The program is also effective for the reduction of specific dysfunctional symptoms reported by family members, which are the target behaviors.

Detailed Description

Not available

Study Timeline

• Results First Posted: 1900-01-01
• Study Completion: 2020-12-18
• Study Start: 2023-07-31
• Last Update Posted: 22 August 2023

Recruitment & Eligibility

• Status: Recruitment completed
• Sex: Not specified
• Target Recruitment: Not specified

Inclusion Criteria

Caregivers of children between 2 and 9 years old, diagnosed with neurodevelopmental disorder or autism, who had been referred for treatment at a specialized municipal outpatient clinic and whose caregiver had time to participate in the intervention for 9 weeks

Exclusion Criteria

Those who did not show interest in participating in the program, who did not feel comfortable to carry out the training in the online modality in the second stage of the intervention, or who did not have access to the internet. Excluded those who did not remain after session 1.

Study & Design

• Study Type: Intervention
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Expected outcome 1: expected decrease in autism symptoms in children whose family members participated in the training, verified by the autism treatment evaluation checklist scale;Outcome found 1: decrease of 14,91% of autism symptoms with a reduction of 11.3 points on the autism treatment evaluation checklist scale;Expected outcome 2: decrease in disease severity according to the clinical global impression scale;Outcome found 2: 12% reduction in mean disease severity;Expected outcome 3: improvement of specific behaviors reported by each caregiver and that were worked on in individual sessions, the so-called target behaviors.;outcome found 3: There was improvement in 70% of target behaviors, with 40.4% significantly improving

Secondary Outcome Measures

Name	Time	Method
Expected outcome 4: Improved abilities and reduced difficulties through lower scores in strengths and difficulties questionnaire is expected;Outcome found 4: No significant improvement in abilities or difficulties was found by strengths and difficulties questionnaire;Expected outcome 5: Analysis of the adaptive behaviors presented by the studied population through the Vineland 3 scale.;Outcome found 5: Participating children had below-average adaptive capacity population, in particular the ability to communicate.;Expected outcome 6: evaluate which classes of symptoms responded most to the intervention based on the analysis of the sub-items of the autism treatment evaluation checklist scale;Outcome found 6: symptoms related to communication decreased by 16.4%, sensory-cognitive symptoms decreased by 15.44%. Socialization and behavioral symptoms had no statistically significant reduction.