| Child:
- Age between 2 and 9 years. This is the target age the WHO CST programme was developed for. The CST is unsuitable for children under 2 years as it presumes a higher level of developmental maturation, and is unsuitable after age 9 years because puberty and sexual maturation then become important issues.
- DSM-5 diagnosis of specific neurodevelopmental disorders associated with impairments in social and social communication domains, including
1. Autism Spectrum Disorder
2. Intellectual Disabilities (intellectual disability; global developmental delay; unspecified intellectual disability). In addition, also we will include children with conditions with a known
cause with intellectual disability as a consequence, e.g. Down’s syndrome, Prader Willi Syndrome and Foetal Alcohol Syndrome.
3. Communication disorders: Language disorder and Social Communication Disorder only (not including speech sound disorder, childhood onset fluency disorder or unspecified
communication disorder)
Caregiver:
- Having the long-term caring responsibility for a child aged 2-9 years with a DD, preferably as the primary caregiver
- Resident in the same household as the child and having sufficient contact time during the week with the child with DD (seeing the child at least 5 days a week on average) to carry out homework exercises
- Able to attend three individual home-based sessions and nine group sessions
- Intending to stay within the study area for the next 12 months
- Ability to speak Amharic/ Kiswahili/Kigiriama/English (as appropriate for the site)
- Caregiver is 18 years of age or older, or caregiver is younger than 18 years and the biological parent of the child with DD (and therefore considered emancipated youth)
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Child:
- Other neurodevelopmental disorders in the DSM-5 (ADHD, motor disorders, specific learning disorder) without the presence of autism, communication disorder, intellectual disability or global developmental delay will be excluded. The CST focuses on addressing delays and impairments in the social and communication domain; children with diagnoses in these other categories of neurodevelopmental disorders have needs that are not well aligned with the strategies offered in the programme.
- Children with epilepsy only without co-occurring neurodevelopmental disorder.
- Child with DD is in need of urgent medical attention (for condition other than DD);
- Severe malnutrition: assessed using Mid Upper Arm Circumference, with <115mm as cut-off following World Health Organization (WHO) guidance (children up to 5 years) or using body mass index (for children >5 years) with a clinical specialist confirming malnutrition is so severe the child is unlikely to directly benefit from CST;
- Child has co-occurring physical or sensory disabilities or health problems that mean the strategies taught in the CST are unsuitable, including:
o Severe to profound hearing loss, severe visual impairment or totally blind (mild/moderate impairments are permitted);
o Severe motor impairment: inability to sit independently; inability to move upper extremities independently.
Caregiver:
- Lives outside the delineated study cluster
- Family took part in the CST programme previously
- Caregiver is in need of urgent medical attention.
- Caregiver has sensory disabilities or intellectual disabilities that severely limit the caregiver’s ability to participate in the CST and/or to implement CST strategies with their child, including:
o Severe to profound hearing loss, severe visual impairment or totally blind;
o Having a difficulty to communicate because of impaired speech;
o Moderate, severe or profound intellectual disability
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Adolescent: 13 Year-18 Year,Adult: 19 Year-44 Year,Aged: 65+ Year(s),Child: 6 Year-12 Year,Middle Aged: 45 Year(s)-64 Year(s),Preschool Child: 2 Year-5 Year |
2 Year(s) |
9 Year(s) |
Both |