Assessment of Children With Neurodevelopmental Disorder After Caregivers Skills Training

Objectives: The objective of this presentation is to assess the effectiveness of the Caregivers Skills Training (CST) program, a partnership with the World Health Organization, in reducing maladaptive symptoms in children with autism spectrum disorder (ASD). Methods: An open clinical trial was conducted with caregivers of children ages 2 to 9 years with neurodevelopmental disorders (NDs), residing in Curitiba, Brazil. Eleven professionals from both public health and public education, called facilitators, trained 5 groups of caregivers to perform the stimulation of children with NDs. The training was conducted online due to the COVID-19 pandemic and the tools used were: the Autism Treatment Evaluation Checklist (ATEC), Strength and Difficulties Questionnaire (SDQ), Clinical Global Impression-Improvement and -Severity (CGI-I and CGI-S), and measure of Target Behaviors. The paired Student's t test was performed to analyze the impact of the intervention through mean, median, and SD for the descriptive analysis. The analyses were performed at the 5% significance level with the aid of the Jamovi® software. Results: A total of 29 of the 37 families completed the training. The caregivers were mostly women (91.9%), the mean age was 35.2 years, and 61.1% were married or living with a partner;83.2% of the children were male, with a mean age of 5.22 years, and all were diagnosed with ASD, with mean age at diagnosis of 3.34 years. The total ATEC score showed an average decrease of 11.3 points (p < 0.01) in ASD symptoms, especially regarding communication and cognition, each presenting an average decrease of 2.3 points (p < 0.05). There was also a decrease in symptom severity in the CGI-S score (mean = 4.42 to 3.89;p < 0.01, and effect size = 0.86), and improvement in ASD symptoms in the CGI-I score, with an increase in the median from 1 to 2 and the doubling of the mean (0.789 for 1.526;p < 0.01). There was a 70% improvement in the target behaviors, with 40.4% presenting a significant improvement. There was no significant improvement in the SDQ score. Conclusions: The CST performed online by facilitators could be effective not only in reducing symptoms in children with ASD, but also in decreasing the severity of the illness. The training program could also be effective for the reduction of specific dysfunctional symptoms reported by family members, which are the target behaviors. ASD, PUP, PAT