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. 2023 Oct 24;2023(10):CD014722. doi: 10.1002/14651858.CD014722.pub2

McConachie 2000.

Study characteristics
Methods Study design: RCT
Duration of study: from 1993‐1995 (recruitment) to 2000 (publication)
Country: Bangladesh
Income classification: low‐income country until 2014
Geographical scope: one special school is in central Dhaka; the other community school is near Dhamrai in a rural setting within 50 km.
Healthcare setting: clinics at 2 school bases of the Bangladesh Protibondhi Foundation
Participants 1. Age: children 1.5‐5 years; mothers from 24.1 (3.8) to 28.0 (5.3)
2. Gender: both
3. Socioeconomic background: not specified
4. Educational background: 18‐56% of mothers had no education
Inclusion criteria:
a. children between the ages of 1.5 and 5 years at presentation;
b. lived in Dhaka or within 15 km of
the rural base;
c. assessed by a neurodevelopmental paediatrician to have cerebral palsy;
d. mothers of children with cerebral palsy.
Exclusion criteria:
there were no exclusion criteria.
Note: at baseline, the intervention (1 and 2) and control group scores for Self‐Report Questionnaire (SRQ) were, respectively, 4.44 (3.12) for urban and 7.79 (5.77) for rural context; 4.45 (3.75) and 7.08 (4.93).
Stated purpose: to compare the efficacy of an outreach programme for young children with cerebral palsy with centre‐based and “minimal intervention” control groups
Interventions Name
Intervention 1: distance training
Intervention 2: mother‐child group
Title/name of PW and number: “therapist”
1. Selection: from special education teachers
2. Educational background: not specified
3. Training: additional in‐service training in physiotherapy or speech therapy
4. Supervision: not specified
5. Incentives/remuneration: not specified
Prevention type: selective—participants were included based upon the presence of a risk factor (mothers of children affected by developmental disability) and presented with some level of distress as indicated by the SRQ scores that were below the cut‐off for the measure.
Intervention details
Intervention 1: conducted both in rural and urban locations. Simple outreach way of giving advice to parents of children living far from the schools. Caregivers were given the pictorial manuals, which illustrate positions, activities, and simple home‐made aids adapted for children with impairments, based on well‐established sources, and different manuals cover motor skills, speech and language, and cognitive skills. The suggestions appropriate to the child’s stage of development are practised with parents in a 1‐ to 2‐hour session before they take the manual home. This is combined with monthly visits to “therapists”, for demonstrations and practicing of techniques.
Intervention 2: conducted in urban area only. The mother‐child group intervention was held in a part of the urban special school; it was offered daily, led by a “therapist” with extra training in physiotherapy, and involved both the children and their parents. It was thus a centre‐based, regular attendance intervention. Practice in daily living skills such as using a cup and developmental activities such as sorting by colour were included.
Control: enhanced usual care—conducted in rural area only. The parents and children in the health advice group were usually seen only at the beginning of the study and then not again until invited to attend the final assessment. The child’s health was discussed as part of the assessment, and then nutritional advice and vitamin supplements were given to the parents as appropriate (this also applied to the other intervention groups on the first assessment). The parents in the health advice group were not given detailed advice on the positioning or other techniques but were given a box of simple local toys and books for their children to play with at home (not given to parents in the other groups).
Outcomes Participants’outcomes of interest for this review
  1. Distress/PTSD symptoms – SRQ

  2. Social outcomes – Family Support Scale (FSS)


Carers’outcomes of interest for this review
Nil
Economic outcomes
Nil
Time points: baseline, post‐intervention
Note: data were not included in the meta‐analysis because they were not provided in the right format or were not available even after attempted author contact.
Notes Source of funding: not available
Notes on validation of instruments (screening and outcomes): the SRQ and FSS are validated and established.
Additional information: none
Handling the data: not available
Prospective trial registration number: not available