title: Lessons learned while developing, adapting and implementing a pilot parent-mediated behavioural intervention for children with autism spectrum disorder in rural Bangladesh.
abstract: Low- and middle-income countries often have limited resources, underdeveloped health systems and scarce knowledge of autism spectrum disorder. The objectives of this preliminary study were to develop and adapt intervention materials and to train a native clinician to implement a community-based parent-mediated behavioural intervention in rural Gaibandha, Bangladesh. Intervention materials to support parents' use of behavioural strategies were developed and refined by US behavioural intervention experts and Bangladesh field experts. Study investigators trained a native child psychologist in developmental milestones and behavioural intervention techniques. The native clinician delivered a 1-day group education session attended by 10 families of children aged 7-9 years with autism spectrum disorder, followed by two one-on-one training sessions with each family to train and practice individualized strategies for targeted challenging behaviours. Preliminary qualitative results indicate the importance of materials that are culturally appropriate and at an adequate literacy level. All families expressed strong desires to have learned the behavioural strategies when their child was younger and vocalized their need for further support and tools to help their children. This study is a preliminary step to creating sustainable and low-cost autism spectrum disorder interventions in rural Bangladesh, and possibly for families in regions with similar cultural and socioeconomic status backgrounds.
authors.affiliation: 1 Johns Hopkins Bloomberg School of Public Health, USA.|2 University of Maryland School of Medicine, USA.
authors.forename: Jasmine M
authors.initials: JM
authors.lastname: Blake
authors.affiliation: 3 The University of North Carolina at Chapel Hill, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Rubenstein
authors.affiliation: 1 Johns Hopkins Bloomberg School of Public Health, USA.
authors.forename: Peng-Chou
authors.initials: PC
authors.lastname: Tsai
authors.affiliation: 4 Johns Hopkins University - Bangladesh, Bangladesh.
authors.forename: Hafizur
authors.initials: H
authors.lastname: Rahman
authors.affiliation: 5 San Diego State University, USA.|6 Child and Adolescent Services Research Center, USA.
authors.forename: Sarah R
authors.initials: SR
authors.lastname: Rieth
authors.affiliation: 1 Johns Hopkins Bloomberg School of Public Health, USA.|4 Johns Hopkins University - Bangladesh, Bangladesh.
authors.forename: Hasmot
authors.initials: H
authors.lastname: Ali
authors.affiliation: 1 Johns Hopkins Bloomberg School of Public Health, USA.
authors.forename: Li-Ching
authors.initials: LC
authors.lastname: Lee
mesh_terms: D000328:Adult; D000067877:Autism Spectrum Disorder / Q000523:psychology / Q000628:therapy*; D001459:Bangladesh; D001521:Behavior Therapy / Q000379:methods*; D002648:Child; D002652:Child Behavior / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D016487:Parenting / Q000523:psychology*; D010290:Parents; D010865:Pilot Projects; D015397:Program Evaluation / Q000379:methods*; D012424:Rural Population; D012923:Social Class
keywords: autism spectrum disorder; community-based intervention; international study; low- and middle-income countries; parent-mediated intervention