A comparative feasibility study of two parent education and training programmes for autism spectrum disorder in a low-resource South African setting

Despite the clear need for post-diagnostic parent/carer education and training in autism spectrum disorder, the evidence base is small, particularly in low-resource settings. Furthermore, few studies have examined the feasibility of intervention implementation. Here, we performed a comparative feasibility study of two Parent Education and Training programmes in a low-resource South African setting. EarlyBird/EarlyBird Plus, a UK-developed programme was compared to Autism Cares, a locally developed programme. The aims were to (1) examine acceptability, adaptation and perform limited efficacy testing and (2) use a multi-stakeholder panel and new autism spectrum disorder Parent Education and Training evaluation framework checklist to compare the programmes. A mixed-method, quasi-experimental design collected pre, post and 3-month follow-up data. Measures included standardised and custom-designed quantitative and qualitative data. In total, 18 parents participated in the EarlyBird/EarlyBird Plus programmes and 11 in Autism Cares. Strong parental acceptability for both programmes was found and adaptation suggestions were provided. Limited efficacy testing showed positive changes for parental stress, knowledge of autism spectrum disorder and child changes. The multi-stakeholder panel rated EarlyBird/EarlyBird Plus superior for next-step research based on implementation feasibility. Our findings contribute to the limited evidence base for autism spectrum disorder Parent Education and Training in low-resource environments and underline the need for evidence base of programmes to include not only intervention outcomes but also procedural and implementation outcomes. Lay Abstract After a diagnosis of autism, it is an important first step to give families information about autism and skills to help them support their child. These interventions are called Parent Education and Training programmes. Little is known about these programmes or if they can make a difference to families, particularly in countries with few autism resources. In this study, we compared two Parent Education and Training programmes in South Africa. EarlyBird/EarlyBird Plus was developed in the United Kingdom, and Autism Cares in South Africa. We wanted to know if parents found the programmes useful, and if any changes were required. We collected information from parents through questionnaires and interviews before and after the group. We also asked a panel of experts (including parents) to compare the programmes. In total, 18 parents attended the EarlyBird/EarlyBird Plus group and 11 attended the Autism Cares group. Parents found both programmes helpful and made suggestions for improvements. Parents showed less stress, more knowledge of autism, and saw improvements in their children. The expert panel rated EarlyBird/EarlyBird Plus as better because it was more supportive of parents and was seen as easier to run in the country. Our study showed that Parent Education and Training programmes are important, but that researchers must study not only the outcomes but also the implementation needs of these programmes.