Outcomes of the World Health Organization's Caregiver Skills Training Program for Eritrean and Ethiopian parents of autistic children in the United States.
Nine Zoom sessions of WHO caregiver training, led by bilingual coaches, lifted parenting skills and child communication for East-African moms even though stress stayed flat.
01Research in Context
What this study did
Dababnah et al. (2025) ran the WHO Caregiver Skills Training with 25 East-African moms.
All classes were on Zoom and taught in Tigrinya or Amharic by Eritrean and Ethiopian coaches.
Parents met for nine small-group sessions and filled out surveys before and after.
What they found
Most moms learned new play and communication skills and saw their kids talk and play more.
Parent stress and anxiety stayed the same, even though skills went up.
The gains were medium-sized, big enough to notice at home.
How this fits with other research
Settanni et al. (2023) showed the same WHO program works in face-to-face community groups.
Their RCT proved that when parents improve interaction skills, child progress follows.
Samadi et al. (2013) also found a short culture-based parent class cut stress for Iranian moms.
The new study did not lower stress, likely because it was online and during COVID.
Together the papers say: teach interaction skills first; add stress modules later if needed.
Why it matters
You can run WHO CST on Zoom in families’ own language and still boost child communication.
Start with interaction coaching, then check if parents need extra stress support.
If you serve immigrant families, recruit bilingual facilitators and keep the camera on.
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02At a glance
03Original abstract
Autism intervention research has not adequately addressed the needs of Black autistic children and their families, particularly those who are also immigrants to the United States. The World Health Organization designed Caregiver Skills Training (CST), a parent-mediated intervention intended to improve child social communication and behavior, to fill in the global gap of services for caregivers of young children with autism and other neurodevelopmental conditions. While CST has been implemented in Ethiopia, it has not been evaluated for Ethiopian and Eritrean immigrant families in the United States. This single-arm pilot study of CST investigated pre- and post-intervention changes in parent and child outcomes within a sample of 25 mothers of autistic children (ages 2-9 years) in Maryland, Washington, DC, and Virginia. Eritrean and Ethiopian facilitators delivered CST remotely to five parent groups. We used Wilcoxon signed-rank tests and found statistically significant improvements in parents' knowledge, skills, self-efficacy, depression, and empowerment, as well as child communication, sociability, and sensory/cognitive awareness. There were no statistically significant changes in parents' anxiety, stress, and coping, nor some subscales of the empowerment and child outcome measures. We conclude CST is a promising intervention for Ethiopian and Eritrean immigrant families in the United States. Randomized controlled trials are needed to confirm study findings.Lay abstractAutism intervention research has often not included Black autistic children and families, including those who are also immigrants to the United States. The World Health Organization designed Caregiver Skills Training (CST) because there are not enough services for caregivers of young children with autism and other neurodevelopmental conditions. CST is an intervention in which parents receive information on how to support their own and their children's needs in nine group and three individual sessions. While CST has been adapted and piloted in Ethiopia, it has not been evaluated for Ethiopian and Eritrean immigrant families in the United States. In this study, five groups with a total of 25 mothers of autistic children (ages 2-9 years) all received CST from Eritrean and Ethiopian facilitators on Zoom. The participants completed surveys about themselves and their autistic children before and after they completed CST. We found that parents' knowledge, skills, self-efficacy, depression, and empowerment, as well as their children's communication, sociability, and sensory/cognitive awareness improved after they completed CST. We did not find changes in some areas we measured, such as parents' anxiety, stress, and coping. We believe that CST might be a promising intervention for Ethiopian and Eritrean immigrant families in the United States. We recommend that more research should be done to confirm what we found in this study.
Autism : the international journal of research and practice, 2025 · doi:10.1177/13623613251351345