Mental health

Training parents to transform children’s lives

Childhood developmental disorders and disabilities are a growing challenge to healthcare systems around the globe: the majority of children with developmental disorders do not have access to care. While obtaining accurate prevalence estimates is a complex task, the global burden of disease for these conditions is thought to be significant and is predicted to gradually increase (Whiteford et al., 2013), as the population of children continues to rise.

Miguel Mendes

Caregiver skills training is being recommended for families of children with developmental delays by the WHO in the mhGAP Intervention Guide.

The World Health Organization’s (WHO) Global Strategy for Women’s, Children’s and Adolescents’ Health calls for the provision of nurturing care to all children. This means a stable, protective and emotionally supportive environment set up by parents and other caregivers that promotes the child’s good health and learning. Given the additional challenges that they experience, parents of children with developmental delays or disorders should be specifically supported in providing nurturing care within a ‘whole family’ approach.

The WHO Caregiver Skills Training programme

Based on the available evidence and experts’ and target users’ guidance, WHO, along with international partners, developed a novel, open-access programme for families of children with developmental delays or disorders, including autism, which could be implemented in low-resource settings by non-specialists. The programme uses a family-centred approach and is designed to be delivered by non specialists (nurses, community-based workers or peer caregivers) as part of a network of health and social services for children and families.

The WHO CST consists of nine group sessions and three individual home visits, focused on training the caregiver on how to use everyday play and home activities and routines as opportunities for learning and development. The sessions specifically address communication, engagement, daily living skills, challenging behaviour and caregiver coping strategies. Additional, booster modules on caregiver well-being and for minimally verbal children are available

Field testing and the way forward

The WHO CST programme is currently undergoing field testing in more than 30 countries in regions throughout the world, including high-, low- and middle-income countries. Two randomised controlled trials are underway in Pakistan and Italy, and future trials are planned in China, Ethiopia and Kenya. More than 300 professionals have been trained and more than 2550 families have received the intervention.

With previous research highlighting the effectiveness of caregiver-mediated interventions and preliminary evidence of good acceptability and feasibility of the WHO CST programme in communities worldwide, the programme is working towards the goal of closing the gap in access to care for children with developmental disorders and delays, ultimately aiming to help them reach their optimal developmental potential.

The WHO Caregiver Skills Training programme for families of children with developmental delays and disorders is available upon request.