Implementing the WHO caregivers skills training program with caregivers of autistic children <i>via</i> telehealth in rural communities.
Telehealth WHO parent classes bring light child gains and high rural reach, but newer FCT and PRT telehealth models give faster, bigger behavior change.
01Research in Context
What this study did
The team ran the WHO Caregivers Skills Training program through Zoom for rural families. Nine group classes and four home visits were all online. Parents of autistic children joined from home computers.
No control group was used. Before-and-after scores showed if the program helped.
What they found
Kids made small gains in talking and acting less oddly. Parents felt more sure of themselves. The online setup worked—families stayed and liked it.
How this fits with other research
Lindgren et al. (2020) beat these results with a stronger design. Their telehealth FCT cut problem behavior by 98% in 12 weeks. The big drop makes the small WHO gains look tiny, but the studies tested different tools.
Bearss et al. (2018) did a simpler telehealth parent course and also saw feasibility first. Montiel-Nava adds a full manualized program to that line.
Cheong et al. (2026) later ran a Taiwan RCT of telehealth PRT. Medium-to-large child gains and lower parent stress top the small effects seen here. Their tighter method shows what stronger coaching can do.
Why it matters
If you serve rural families, WHO-CST online is ready to use and easy to scale. Expect modest child progress and a parent confidence boost. For faster, larger gains, swap in FCT or PRT telehealth models that now show stronger evidence. Start with WHO if you need a free, structured package; plan to layer in function-based coaching later.
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02At a glance
03Original abstract
For families with autistic children living in rural areas, limited access to services partly results from a shortage of providers and extensive travel time. Telehealth brings the possibility of implementing alternative delivery modalities of Parent Mediated Interventions (PMIs) with the potential to decrease barriers to accessing services. This study aimed to evaluate the feasibility and acceptability of implementing the World Health Organization-Caregivers Skills Training program (WHO-CST) via an online, synchronous group format in rural Missouri. We used a mixed methods design to collect qualitative and quantitative data from caregivers and program facilitators at baseline and the end of the program, following the last home visit. Caregivers of 14 autistic children (3–7 years), residents of rural Missouri, completed nine virtual sessions and four virtual home visits. Four main themes emerged from the focus groups: changes resulting from the WHO-CST, beneficial aspects of the program, advantages and disadvantages of the online format, and challenges to implementing the WHO-CST via telehealth. The most liked activity was the demonstration (36%), and the least liked was the practice with other caregivers. From baseline to week 12, communication skills improved in both frequency (p < 0.05) and impact (p < 0.01), while atypical behaviors decreased (p < 0.01). For caregivers' outcomes, only confidence in skills (p < 0.05) and parental sense of competence (p < 0.05) showed a positive change. Our results support the feasibility of implementing the WHO-CST program via telehealth in a US rural setting. Caregivers found strategies easy to follow, incorporated the program into their family routines, and valued the group meetings that allowed them to connect with other families. A PMI such as the WHO-CST, with cultural and linguistic adaptations and greater accessibility via telehealth-plays an essential role in closing the treatment gap and empowering caregivers of autistic children.
Frontiers in Psychiatry, 2022 · doi:10.3389/fpsyt.2022.909947