Outcome of Community-Based Early Intervention and Rehabilitation for Children with Cerebral Palsy in Rural Bangladesh: A Quasi-Experimental Study

Abstract

We evaluated the outcome of a community-based early intervention and habilitation for children with cerebral palsy (CP) in Bangladesh. Children registered on the Bangladesh CP Register (BCPR) were recruited in two groups for this study: Group A received a comprehensive six-month long community-based caregiver-led intervention program at the “Shishu Shorgo” (Bengali title, which translates to ‘Children’s Heaven’) Early Intervention and Rehabilitation Centres developed to support participants from the BCPR. Group B received standard care. A quasi-experimental study was conducted. Data were obtained at baseline, at the end of the program (i.e., 6 months), and at a 12-month follow-up. Outcome measures for children included gross motor functional measure (GMFM-66), Communication Function Classification System (CFCS), and Viking Speech Scale (VSS) and, for adult caregivers, the depression, anxiety, and stress scale (DASS 21). Between October 2016 and March 2017, 156 children with CP were recruited (77 in Group A and 79 in Group B). The total score of GMFM-66, CFCS level, and VSS level significantly improved statistically in Group A (p < 0.05 for all) and deteriorated in Group B (p < 0.001, p = 0.095, p = 0.232). The intervention showed promising outcomes particularly for children with CP under five years of age. There is a need for caregiver-led community-based programs for children with CP in LMICs.

Nutrition Interventions for Children with Cerebral Palsy in Low- and Middle-Income Countries: A Scoping Review

“…In such a context, community-based approaches are highly recommended and there is a lack of evidence on community-based nutrition interventions for children with CP in LMICs. Nevertheless, in one recent study from Bangladesh, community-based parent-led intervention was found to be highly successful in improving functional outcomes of children with CP [ 33 ]. Emphasis should be given to the capacity development of mid-level service providers on growth monitoring and promotion, early identification, different blanket interventions, and referral to prevent and treat malnutrition among children with CP in LMICs.…”

A Social Business Model of Early Intervention and Rehabilitation for People with Disability in Rural Bangladesh

“…As part of the trial, parents of children with disabilities were identified from local communities and trained on goal-directed training, motor and cognitive enrichment training (using learning toys), and parent educational modules [ 8 ]. Karim et al [ 9 ] examined the effects of a community-based early intervention and rehabilitation program for children with CP in rural Bangladesh. As part of the program, group therapy, community follow-up, and primary caregivers training are provided for 6 months free of cost [ 9 ].…”

“…Karim et al [ 9 ] examined the effects of a community-based early intervention and rehabilitation program for children with CP in rural Bangladesh. As part of the program, group therapy, community follow-up, and primary caregivers training are provided for 6 months free of cost [ 9 ]. The authors observed significant improvements in motor function and communication of children with CP who attended the early intervention program compared with their non-attendee peers [ 9 ].…”

“…As part of the program, group therapy, community follow-up, and primary caregivers training are provided for 6 months free of cost [ 9 ]. The authors observed significant improvements in motor function and communication of children with CP who attended the early intervention program compared with their non-attendee peers [ 9 ]. To assess the outcome of an integrated livelihood and CBR program, an RCT is being conducted among children with CP from ultra-poor families in rural Bangladesh [ 10 ].…”

Editorial: Early Detection and Early Intervention Strategies for Cerebral Palsy in Low and High Resource Settings

“…It highlighted the sustainability of such a model centre in these settings, which is critical for the long term success of such initiatives. Similarly, Karim et al showcased a quasi-experimental study of an early-intervention community centre in Bangladesh, with promising outcomes [ 7 ]. Finally, Al Imam et al assessed the predictors of rehabilitation service utilisation in the LMIC setting [ 8 ].…”