Adaptation of Extension of Community Healthcare Outcomes Model to Support Children with Autism and Neurodevelopmental Disabilities
Dr. Sarah Dababnah
School of Social Work
An estimated 473 million children (nearly 1 in 5) live in countries affected by war, other conflict or disaster, often without access to medical care, quality education, proper nutrition, and protection (UNICEF, 2016). Africa and the Middle East are home to the majority of this global population. Children living through violent conflicts face a number of direct and indirect impacts on their wellbeing including, but not limited to, trauma exposure, adverse health risks (e.g., disease and malnutrition), loss of educational opportunities, and forced displacement (Kadir et al., 2018). Children with pre-existing disabilities face additional impacts such as missed opportunities for intervention and interruptions of traditional support systems and social capital. Although there are no known estimates of the global rates of autism or other neurodevelopmental disabilities (NDD) in humanitarian contexts, the United Nations (2023) estimates that persons with disabilities comprise 16% of the world population, with 80% living in the Global South. Although several initiatives have been developed to broadly address mental health needs in children living through humanitarian crises (e.g., World Health Organization, 2013), no interventions to date exist in supporting children with NDD in these contexts.
There are significant challenges in addressing the needs of individuals with NDD in the World Health Organization’s (WHO’s) Eastern Mediterranean Region (EMR). These challenges include limited access to evidence-based interventions, and disparities in healthcare, education, and employment opportunities. Moreover, the region faces additional difficulties to support these individuals and their families in the context of humanitarian emergencies, including persistent political conflict. Considering the ongoing humanitarian crises unfolding in the EMR, it is vital and timely to develop and evaluate a model that can help build capacity for providers to support children with NDD in humanitarian contexts.
This project aims to identify community needs and subsequently adapt and pilot the Extension of Community Healthcare Outcomes (ECHO) Autism model (https://projectecho.unm.edu/model/) to increase the ability of providers in humanitarian contexts to identify and support children with neurodevelopmental disabilities (NDD) such as autism. ECHO Autism is a tele-based training and mentoring model for building autism-related knowledge and competencies among non-specialized providers. We will build capacity to support early identification and intervention of NDD, working
closely with our key partners (including healthcare and humanitarian workers in Yemen, Sudan, Palestine, Lebanon, Syria, Libya, Jordan, Egypt, and Iraq) in alignment with broader humanitarian efforts such as mental health programming by adapting ECHO Autism and piloting ECHO Neurodevelopmental Disabilities in Humanitarian Contexts (ECHO-NDD/HC). Our specific aims are as follows:
Aim 1: Assess needs of key partners in the EMR working with children with NDD in humanitarian contexts.
Aim 2: Adapt the ECHO Autism model to address specific needs of providers working in the EMR with children with NDD in humanitarian contexts (ECHO-NDD/HC).
Aim 3: Pilot and assess the feasibility and acceptability of ECHO-NDD/HC in the EMR.