Outcomes of the World Health Organization's Caregiver Skills Training Program for Eritrean and Ethiopian parents of autistic children in the United States.

Researchers tested a parent training program called Caregiver Skills Training with 25 Ethiopian and Eritrean mothers of autistic children in the US. The program was delivered online by facilitators from the same cultural background. After completing the program, parents showed better knowledge and skills for supporting their children, felt more confident, and had less depression. Children also improved in communication and social skills.

The program looks promising but more research is needed to confirm these results.

This single-arm pilot study evaluated the World Health Organization's Caregiver Skills Training (CST) program with 25 Ethiopian and Eritrean immigrant mothers of autistic children aged 2-9 years in the US. CST was delivered remotely by culturally matched facilitators across five groups. The study found statistically significant improvements in multiple parent outcomes including knowledge, skills, self-efficacy, depression, and empowerment. Child outcomes also improved significantly in communication, sociability, and sensory/cognitive awareness.

However, no significant changes were observed in parental anxiety, stress, coping, or some empowerment and child outcome subscales. The authors conclude CST shows promise for this underserved population but emphasize the need for randomized controlled trials to confirm findings.

CST shows promise as a culturally responsive intervention for Ethiopian and Eritrean immigrant families with autistic children. Remote delivery by culturally matched facilitators may improve accessibility. However, clinicians should await stronger evidence from controlled trials before widespread implementation in this population.

Single-arm pilot design without control group limits causal inferences. Small sample size (n=25) reduces generalizability. Pre-post design cannot control for natural development or other factors. Results need confirmation through randomized controlled trials as acknowledged by authors.

Autism intervention research has not adequately addressed the needs of Black autistic children and their families, particularly those who are also immigrants to the United States. The World Health Organization designed Caregiver Skills Training (CST), a parent-mediated intervention intended to improve child social communication and behavior, to fill in the global gap of services for caregivers of young children with autism and other neurodevelopmental conditions. While CST has been implemented in Ethiopia, it has not been evaluated for Ethiopian and Eritrean immigrant families in the United States. This single-arm pilot study of CST investigated pre- and post-intervention changes in parent and child outcomes within a sample of 25 mothers of autistic children (ages 2-9 years) in Maryland, Washington, DC, and Virginia.

Eritrean and Ethiopian facilitators delivered CST remotely to five parent groups. We used Wilcoxon signed-rank tests and found statistically significant improvements in parents' knowledge, skills, self-efficacy, depression, and empowerment, as well as child communication, sociability, and sensory/cognitive awareness. There were no statistically significant changes in parents' anxiety, stress, and coping, nor some subscales of the empowerment and child outcome measures. We conclude CST is a promising intervention for Ethiopian and Eritrean immigrant families in the United States.

Randomized controlled trials are needed to confirm study findings.Lay abstractAutism intervention research has often not included Black autistic children and families, including those who are also immigrants to the United States. The World Health Organization designed Caregiver Skills Training (CST) because there are not enough services for caregivers of young children with autism and other neurodevelopmental conditions. CST is an intervention in which parents receive information on how to support their own and their children's needs in nine group and three individual sessions. While CST has been adapted and piloted in Ethiopia, it has not been evaluated for Ethiopian and Eritrean immigrant families in the United States.

In this study, five groups with a total of 25 mothers of autistic children (ages 2-9 years) all received CST from Eritrean and Ethiopian facilitators on Zoom. The participants completed surveys about themselves and their autistic children before and after they completed CST. We found that parents' knowledge, skills, self-efficacy, depression, and empowerment, as well as their children's communication, sociability, and sensory/cognitive awareness improved after they completed CST. We did not find changes in some areas we measured, such as parents' anxiety, stress, and coping.

We believe that CST might be a promising intervention for Ethiopian and Eritrean immigrant families in the United States. We recommend that more research should be done to confirm what we found in this study.