Parent-mediated intervention training for caregivers of children with developmental differences in Zambia

Lower- and middle-income countries (LAMICs) are under-resourced and have limited intervention services for children with developmental differences and their families. A logical method to address service gaps within resource-scarce contexts is to train caregivers as interventionists, specifically using empirically-supported parent-mediated Naturalistic Developmental Behavioral Interventions (P-M NDBIs; Kasari et al., 2010; Ingersoll & Wainer, 2013). The study implemented the first P-M NDBI in Zambia and aimed to train caregivers and improve children’s social-communication skills. The current study utilized a mixed-methods, pre-post design and implemented Project ImPACT (Ingersoll & Dvortcsak, 2010, 2019). Participants included 19 Zambian caregivers of children (n = 20) with developmental differences including autism spectrum condition, Down syndrome, and cerebral palsy. Findings indicated that children’s language skills and pretend play skills significantly improved from pre- to post-assessment, and caregivers most frequently used intervention strategies for modeling communication and prompting communication. The success and feasibility of implementing Project ImPACT in Zambia, and recommendations for culturally adapting and implementing P-M NDBIs in LAMICs, were discussed. •Sparse early intervention services make parent-mediated interventions optimal.•First parent-mediated intervention (PMI) successfully conducted in Zambia.•Zambian children and caregivers were positively changed by a PMI.•Existing parent-mediated interventions can be successful in lower-income contexts.