# Autism Caregiver Coaching in Africa

> **NIH NIH R01** · DUKE UNIVERSITY · 2022 · $630,651

## Abstract

ABSTRACT
 Globally there is a growing need to implement community-based services that support improvements in quality
of life of autistic people. Early autism intervention is critical because it can significantly improve both child and
family outcomes, but implementation gaps exist worldwide. These gaps are starkest in Africa, where by 2050,
iven the lack of specialists in Africa, task shifting early autism
intervention to non-specialists will be a key implementation strategy. Naturalistic Developmental Behavioral
Interventions (NDBI), are a class of early autism intervention approaches, that can be effectively delivered by
caregivers. Through a partnership between Duke University and the University of Cape Town, our team laid the
groundwork for an innovative and scalable coaching intervention for young autistic children . We systematically
adapted a caregiver coaching NDBI for the South African context in which coaching is effectively delivered by
non-specialist Early Childhood Development practitioners employed by the Education Department. In the
proposed study we will build on our foundational work by conducting a type 1 hybrid effectiveness implementation
trial of the coaching intervention, delivered by non-specialists, within an existing system of care in South Africa.
Our goal is to implement a feasible, scalable early autism intervention model in Africa by conducting research
with culturally and linguistically diverse participants in community-based settings, that is inclusive of diverse
stakeholder perspectives and incorporates task-shifting. In the proposed study, we will build on our current
relationships with families, practitioners, and policy makers by formalizing these relationships and including other
key stakeholder groups such as South African autistic self-advocates through a community-academic
partnership, a key bridging factor in the EPIS implementation framework. The proposed project has three main
objectives. First, to evaluate the real-world effectiveness of non-specialist delivered NDBI caregiver coaching for
improving patterns of caregiver-child interaction and child developmental outcomes, and assess the cost-
effectiveness of this approach. Second, to identify implementation determinants to inform scale-up. Third, to
expand African autism research capacity to enhance scalability. This project also offers a unique opportunity to
study variability in autism-related behaviors and phenomenology. We will therefore assess the degree to which
response to intervention is moderated by caregiver and dimensional child characteristics. In addition, using an
innovative digital assessment method, changes in dimensional quantitative measures of autism-related
behaviors will be examined. Finally, cross-cultural differences in dimensional autism-related behaviors will be
evaluated via comparison with existing quantitative phenotypic data gathered in U.S. studies. This study is timely
and innovative and will inform scale-up of autism ear...

## Key facts

- **NIH application ID:** 10538701
- **Project number:** 1R01MH127573-01A1
- **Recipient organization:** DUKE UNIVERSITY
- **Principal Investigator:** Lauren Franz
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $630,651
- **Award type:** 1
- **Project period:** 2022-08-17 → 2027-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10538701

## Citation

> US National Institutes of Health, RePORTER application 10538701, Autism Caregiver Coaching in Africa (1R01MH127573-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10538701. Licensed CC0.

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