Parenteral interventions to support families of children with neurodisability in low resource settings

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There are few services to support children with neurological disabilities and their families in resource poor settings, such as those found in sub-Saharan Africa. The parents and carers report that the two main features that impair their child's and family's quality of life are difficulties with their child's behaviour and communicating with the child. Recent reviews of the literature have supported that parent interventions may be the most acceptable and feasible way to improve communication and behaviour. In particular, the Stepping Stones parenting programme, which has been developed for parents of children with disabilities was suggested as an appropriate intervention, since it does not require specialised therapists, does not involve hours of therapy and empowers the parents and carers. This programme has been used in over 23 countries, shown to be effective in improving behaviour and communication in children with disabilities; but has not been tested in low-resource settings. The World Health Organization has also recognised these interventions, and promotes them through the mental health treatment gap interventions for children with developmental disorders. In addition the WHO has developed a a parent based intervention i.e. Parent Skills Training to improve communication and behaviour, but this intervention has not been tested in the field. The objectives of this grant are to examine the cultural acceptability and feasibility of administering two interventions i.e. Stepping Stones Programme and Patent Skills Training delivered through parents or carers to improve the communication, behaviour and quality of life of children with neurological disabilities. In particular we will identify the barriers to the administration of a parent intervention. In addition we will examine the reliability, validity and responsiveness of tools to measure behaviour, communication, parenting, stress and quality of life in these settings. This data of this project will be used to develop an intervention to be tested in a randomised control trial. Testing the interventions are likely to provide some support to the children with disabilities and their families. The data will also be fed back to non-government organisations, the Ministrys of Health, Education and Social Services who support children with disabilities in Kenya.