Capacitar world health organization caregivers skills training program for parents and caregivers of children with developmental disorders - CST caregivers skills training

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.