Development and Preliminary Findings of a Modified WHO Caregiver Skills Training Program for Children with Autism in...

Purpose: Most children with autism live in resource-limited settings with limited access to timely interventions. To address this gap, the World Health Organization developed Caregiver Skills Training (CST) to support caregivers and expand intervention access globally. This study examined the feasibility and preliminary outcomes of a modified CST in mainland China. Methods: Using the ecological validity model and qualitative interviews, the CST materials were culturally adapted and modified for the Chinese context. A pre- and post-test controlled trial was conducted with caregivers of children with autism aged 2-9 years, who were assigned to either the CST intervention group (N = 15) or a caregiver education control group (N = 15). Clinical outcomes for caregivers and children were evaluated at baseline and after a 10-week intervention period. Results: Cultural adaptation and modifications focused on language adjustments, localization of case examples and demonstrations, and optimization of teaching methods and training schedules. Supplementary within-group analyses indicated pre-post changes in caregiver knowledge and skills, parenting stress, and selected child outcomes, including speech/language/communication, sensory/cognitive awareness, and overall autism symptoms. However, most between-group differences were not statistically significant after baseline adjustment. Conclusions: The findings provide preliminary evidence for the feasibility of culturally adapted and modified CST in mainland China. Given the pilot nature of the study and the absence of statistically significant between-group effects for most outcomes, the outcome findings should be interpreted as exploratory and hypothesis-generating rather than evidence of efficacy. Further large-scale studies with greater statistical power and objective outcome measures are needed to evaluate effectiveness and implementation feasibility.