Service Delivery

Feasibility of parent-mediated behavioural intervention for behavioural problems in children with Autism Spectrum Disorder in Nigeria: a pilot study.

Bello-Mojeed et al. (2016) · Child and Adolescent Psychiatry and Mental Health 2016
★ The Verdict

Five short group classes taught Nigerian mothers to spot triggers and cut their autistic children’s aggression and self-injury by about one-third.

✓ Read this if BCBAs setting up low-cost parent groups in low-resource clinics or rural areas.
✗ Skip if Teams already running full 12-week parent programs with full BCBA oversight.

01Research in Context

01

What this study did

Researchers in Lagos ran five weekly group classes for the mothers of children with autism.

Each class taught one step of a basic FBA and gave moms a simple behavior plan to try at home.

Before and after the course parents filled out a short checklist on aggression and self-injury.

02

What they found

After the fifth session mothers scored their kids’ hitting, kicking and head-banging about one-third lower.

Mothers also answered twice as many quiz questions correctly on why behaviors happen and how to respond.

No families dropped out, showing the short program is doable in a busy outpatient clinic.

03

How this fits with other research

Breider et al. (2024) later ran a true RCT in U.S. clinics and saw medium-sized drops in disruptive behavior with face-to-face parent training, giving stronger proof than this small Nigerian pilot.

Stewart et al. (2018) pooled 17 trials and found parent coaching gives small but real gains across autism symptoms, so the Nigeria results sit inside that bigger picture.

Laposa et al. (2017) tried a similar one-day-plus-home-visit model in rural Bangladesh and also found parents liked the classes, acting as a cross-country replication even though no behavior scores were collected.

04

Why it matters

You can copy the five-session outline when time, money or staff are tight.

One group room, a whiteboard and a translated hand-out were enough to cut serious problem behavior.

Start with teaching FBA basics, give one clear replacement skill per family, and track with a simple parent rating like they did.

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Run a 45-minute group lesson on ABC data, send parents home with a one-page behavior plan, and revisit results next week.

02At a glance

Intervention
parent training
Design
pre post no control
Sample size
20
Population
autism spectrum disorder
Finding
positive

03Original abstract

Autism Spectrum Disorders (ASD) is a disabling and lifelong neuro-developmental disorder. Challenging behaviours such as aggression and self injury are common maladaptive behaviours in ASD which adversely affect the mental health of both the affected children and their caregivers. Although there is evidence-base for parent-delivered behavioural intervention for children with ASD and challenging behaviours, there is no published research on the feasibility of such an intervention in sub-Saharan Africa. This study assessed the feasibility of parent-mediated behavioural intervention for challenging behaviour in children with ASD in Nigeria. This was a pre-post intervention pilot study involving 20 mothers of children with DSM-5 diagnosis of ASD recruited from a Child and Adolescent Mental Health Service out-patient Unit. All the mothers completed five sessions of weekly manualised group-based intervention from March to April, 2015. The intervention included Functional Behavioural Analysis for each child followed by an individualised behaviour management plan. The primary outcome measure was the Aggression and Self Injury Questionnaire, which assessed both Aggression towards a Person and Property (APP) and Self Injurious Behaviour (SIB). The mothers’ knowledge of the intervention content was the secondary outcome. All outcome measures were completed at baseline and after the intervention. The mothers’ level of satisfaction with the programme was also assessed. Treatment effect was evaluated with Wilcoxon Signed Rank Tests of baseline and post-intervention scores on outcome measures. The children were aged 3–17 years (mean = 10.7 years, SD 4.6 years), while their mothers’ ages ranged from 32 to 52 years (mean 42.8 years, SD 6.4 years). The post intervention scores in all four domains of the APP and SIB were significantly reduced compared with pre-intervention scores. The mothers’ knowledge of the intervention content significantly increased post-intervention. The intervention was well received with the vast majority (75 %) of participants being very satisfied and all (100 %) were willing to recommend the programme to a friend whose child has similar difficulties. Parent-mediated behavioural intervention is a feasible and promising treatment for challenging behaviour in children with ASD in Nigeria. Behavioural intervention should be an integral component in scaling up services for children with ASD in Nigeria.

Child and Adolescent Psychiatry and Mental Health, 2016 · doi:10.1186/s13034-016-0117-4