Suchergebnisse

Background  Although interventions for children with pervasive developmental disorders (PDD) have been the focus of research effort and evidence reviews in many Western countries, this evidence has not been assessed in the context of low‐ and middle‐income (LAMI) countries especially in terms of the fit with different cultures and resources.Method  As a part of the WHO MH‐GAP project, we carried out a systematic review of published literature relating to interventions for PDD in LAMI countries. Given the small amount of direct evidence found, we supplemented the review with findings from existing relevant evidence reviews to draw practical recommendations.Results  We found only four controlled studies evaluating an intervention for children with PDD in a LAMI country. These studies all evaluated different interventions. A systematic search of controlled studies of evidence‐based parenting training interventions (Incredible Years and Triple P) in non‐LAMI countries identified two studies both indicating successful outcomes.Conclusions  The evidence base for interventions for PDDs in LAMI countries is sparse, and to inform practical and future research recommendations, it is important to consider potentially deliverable behavioural parent training interventions. Such interventions need to be explored in LAMI countries when delivered in primary and secondary healthcare contexts.

Background  Community‐based rehabilitation (CBR) is being implemented in more than 90 countries. Concerns have been voiced about the adequacy of the evidence base regarding the efficacy, effectiveness and efficiency of CBR. This review summarizes evidence on the efficacy of CBR for children with intellectual disabilities.Materials and method  Electronic literature database searches were conducted to identify articles in the English language published since 1980 relating to the efficacy of CBR for children with intellectual disabilities. Requests for information were also sent to membership of International Association for the Scientific Study of Intellectual Disabilities and relevant organizations in selected low‐ and middle‐income countries.Results  Thirteen studies were identified for inclusion in the review. The quality of evidence for the efficacy of CBR for children with intellectual disabilities was 'very low'.Conclusion  Improving the evidence base will require greater investment in evaluation and addressing the marginalization of people with intellectual disabilities in CBR.

Background  In low‐ and middle‐income (LAMI) countries, there is a lack of well‐trained therapists to provide specialist interventions for children with intellectual disabilities and their families. We sought to identify strategies deliverable by families or non‐specialist workers.Materials and Methods  After searches of appropriate scientific databases, we applied GRADE methodology to rate the quality of evidence for these interventions.Results  We identified small‐scale interventions trialled in LAMI countries with limited evidence of effectiveness in supporting development, adaptive behaviour and/or community participation. In high‐income countries, the Stepping Stones Triple P program for adaptive behaviour and the Portage program for child development have the most extensive evidence base and may be applicable in LAMI countries.Conclusions  There is reason to hope that, when combined with community development strategies, the welfare of children with intellectual disabilities in LAMI countries can be advanced within those countries' economic means.