Non-specialist psychosocial interventions for children with autism spectrum disorders

December 17, 2013

Many children with intellectual disability or lower functioning autism spectrum disorders, particularly those in low and middle income countries, do not receive psychosocial treatment interventions for their condition. If non-specialists were able to deliver such care, more children may be able to receive treatment. In this week's PLOS Medicine, Brian Reichow (Yale Child Study Center, University of Connecticut Health Center, US) and colleagues from the World Health Organization conducted a systematic review of studies of non-specialist psychosocial interventions for children and adolescents with intellectual disability or lower functioning autism spectrum disorders. In a search of several international databases for studies published through June 2013, the authors found 34 articles describing 29 studies (including 15 randomized controlled trials) involving 1,305 participants that met their inclusion criteria. The studies evaluated behavior analytic techniques, cognitive rehabilitation, training, and support, and parent training interventions.

The authors found that for behavior analytic interventions, the best outcomes were shown for developmental and daily skills; , training, and support were found to be most effective for improving developmental outcomes; and parent training interventions to be most effective for improving developmental, behavioral, and family outcomes. The study limitations included that in research of this type it is difficult to mask individuals to the intervention, and therefore the studies are susceptible to performance bias, and the fact that few studies were conducted in low and .

The authors state, "Overall, the outcomes of the studies included in this review show that non-specialist providers can deliver effective treatments to children with intellectual disabilities or lower-functioning autism spectrum disorders… Our findings that psychosocial interventions can be effective when delivered by nonspecialist providers has much relevance for improving access to care for children and adolescents with intellectual disabilities or lower-functioning autism spectrum disorders who live in both [high income countries] and [low and middle income countries], but it is useful especially in low-resource settings."

In an accompanying Perspective, Mashudat Bello-Mojeed and Muideen Bakare (Federal Neuro-Psychiatric Hospital, Lagos, Nigeria) (uninvolved in the study) discuss the implications of the study for care of children with or lower functioning in . They state, "With under-five child mortality declining in resource-poor countries, an increasing number of children will live on to experience an increasing burden of neurodevelopmental disorders while the family shares a huge burden of caregiving… Interventions provided by non-specialist care providers could help alleviate the scarcity of specialist care by task shifting and potentially also help reduce the risk of burn-out among existing specialists." They conclude, "Ultimately, non-specialist psychosocial interventions for [neurodevelopmental disorders] will require advocacy and government support in [low and middle income countries], where mortality is given priority over morbidity and disability."

Explore further: Interventions by non-mental health specialists may improve perinatal mental health disorders

More information: Reichow B, Servili C, Yasamy MT, Barbui C, Saxena S (2013) Non-Specialist Psychosocial Interventions for Children and Adolescents with Intellectual Disability or Lower-Functioning Autism Spectrum Disorders: A Systematic Review. PLoS Med 10(12): e1001572. DOI: 10.1371/journal.pmed.1001572

Related Stories

Interventions by non-mental health specialists may improve perinatal mental health disorders

October 29, 2013
In middle-income countries such as China, interventions that have a psychological or social component (often referred to as psychosocial interventions) delivered by health workers who are not mental health specialists could ...

Non-specialist health workers play important role in improving mental health in developing countries

November 19, 2013
Non-specialist health workers are beneficial in providing treatment for people with mental, neurological and substance-abuse (MNS) problems in developing countries – where there is often a lack of mental health professionals ...

Identifying the signs of autism earlier

October 29, 2013
How early can you diagnose autism? The American Academy of Pediatrics (AAP) recommends screening children beginning at 18 months, but research suggests subtle warning signs may be apparent even earlier, according to Patricia ...

Up to 1 in 5 children in developing countries has a mental health problem, yet treatment is woefully inadequate

October 16, 2011
Mental health problems affect 10-20% of children and adolescents worldwide. Despite their relevance as a leading cause of health-related disability in this age group and their longlasting effects throughout life, the mental ...

A single spray of oxytocin improves brain function in children with autism

December 2, 2013
A single dose of the hormone oxytocin, delivered via nasal spray, has been shown to enhance brain activity while processing social information in children with autism spectrum disorders, Yale School of Medicine researchers ...

Huge hospital burden for kids with intellectual disability

March 1, 2013
New research from the Telethon Institute for Child Health Research has shown that children with an intellectual disability or autism are up to ten times more likely to be admitted to hospital than unaffected children.

Recommended for you

Late-breaking mutations may play an important role in autism

July 17, 2017
A study of nearly 6,000 families, combining three genetic sequencing technologies, finds that mutations that occur after conception play an important role in autism. A team led by investigators at Boston Children's Hospital ...

Females with autism show greater difficulty with day-to-day tasks than male counterparts

July 14, 2017
Women and girls with autism may face greater challenges with real world planning, organization and other daily living skills, according to a study published in the journal Autism Research.

Researchers investigate possible link between carnitine deficiency and autism

July 13, 2017
Researchers are always looking for new clues to the causes of autism, with special emphasis on prevention or treatment. At Baylor College of Medicine, Dr. Arthur Beaudet has been following clinical and genetic clues in patients ...

How children look at mom's face is influenced by genetic factors and altered in autism

July 12, 2017
New research has uncovered compelling evidence that genetics plays a major role in how children look at the world and whether they have a preference for gazing at people's eyes and faces or at objects.

Oxytocin improves social abilities in some kids with autism, study finds

July 10, 2017
Children with autism showed improved social behavior when treated with oxytocin, a hormone linked to social abilities, according to a new study by researchers at the Stanford University School of Medicine. Children with low ...

Possible early diagnosis of autism spectrum disorder

June 29, 2017
Measuring a set of proteins in the blood may enable earlier diagnosis of autism spectrum disorder (ASD), according to a study from the Peter O'Donnell Jr. Brain Institute at UT Southwestern Medical Center.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.