Makombe CBT, Shabalala N, Viljoen M, Seris N, De Vries PJ, Franz L. Sustainable implementation of early intervention for autism spectrum disorder through caregiver coaching: South African perspectives on barriers and facilitators. Pediatric medicine (Hong Kong, China). 2019 Aug;2(2). PMID: 31528856 [PubMed] PMCID: PMC6746419 NIHMSID: NIHMS1050045.
A lack of specialists, and insufficient infrastructure and funding to scale early interventions for autism spectrum disorder (ASD) characterize low-resource settings. Integration of early intervention methods that utilize non-specialists, and involve caregivers, into existing systems of care, offers the best hope to address such unmet needs. In South Africa, a caregiver coaching intervention, informed by principles of the Early Start Denver Model (ESDM) was adapted for delivery by non-specialist Early Childhood Development (ECD) practitioners. This study explored perceived barriers and facilitators to sustainable implementation of this approach.