Alpuche De Lille Maria Jose, Teixeira da Silva Renata, Smythe Tracey
London School of Hygiene & Tropical Medicine, London, UK.
Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Trop Med Int Health. 2025 Aug;30(8):763-781. doi: 10.1111/tmi.70000. Epub 2025 Jun 24.
To identify and evaluate the characteristics and reported effects of school-based mental health and psychosocial support interventions targeting children and adolescents with neurodevelopmental disorders (NDDs) in low- and middle-income countries, as well as those involving their parents, teachers or peers.
A systematic search of MEDLINE, EMBASE, ERIC, Global Health and PsycINFO was conducted in October 2024. Eligible studies included randomised controlled trials, quasi-experimental and qualitative research on school-based interventions in low- and middle-income countries for children and adolescents with NDDs (including attention deficit hyperactivity disorder [ADHD], autism, intellectual disabilities, epilepsy, cerebral palsy and foetal alcohol syndrome), as well as those involving their caregivers, teachers or peers. Only studies published in English, Spanish or Portuguese were included. A narrative synthesis was performed.
A total of 2158 titles were screened, with 29 studies from 13 countries included. Most studies used a quasi-experimental design (n = 19, 66%). Nearly half focused on children and adolescents with NDDs only (n = 14, 48%), with intellectual disabilities being the most targeted condition (n = 12, 34%), followed by autism (n = 8, 23%) and ADHD (n = 8, 23%). Intervention strategies included multimodal approaches (n = 6, 21%) and educational workshops (n = 6, 21%). Targeted outcomes were social skills (n = 7, 16%) and knowledge attitudes and practice (n = 5, 12%). Lifelong learning (n = 11, 33%) and educational system-strengthening interventions (n = 10, 31%) were the primary content areas. The majority of studies exhibited a moderate to high risk of bias.
Schools offer strategic platforms for delivering mental health and psychosocial support interventions to children and adolescents with NDDs in low- and middle-income countries, involving families, teachers and peers. While improvements in social skills and knowledge, attitudes and practices were reported, heterogeneity and methodological limitations constrain the generalisability of findings. Future research should address long-term impacts and expand to underrepresented conditions.
识别并评估低收入和中等收入国家针对患有神经发育障碍（NDDs）的儿童和青少年开展的校内心理健康及社会心理支持干预措施的特点和报告的效果，以及涉及这些儿童的父母、教师或同伴的干预措施的特点和效果。
2024年10月对MEDLINE、EMBASE、ERIC、Global Health和PsycINFO进行了系统检索。符合条件的研究包括针对低收入和中等收入国家患有NDDs（包括注意力缺陷多动障碍[ADHD]、自闭症、智力残疾、癫痫、脑瘫和胎儿酒精综合征）的儿童和青少年的校内干预措施的随机对照试验、准实验和定性研究，以及涉及这些儿童的照顾者、教师或同伴的研究。仅纳入以英文、西班牙文或葡萄牙文发表的研究。进行了叙述性综合分析。
共筛选了2158个标题，纳入了来自13个国家的29项研究。大多数研究采用准实验设计（n = 19，66%）。近一半的研究仅关注患有NDDs的儿童和青少年（n = 14，48%），其中智力残疾是最主要的目标疾病（n = 12，34%），其次是自闭症（n = 8，23%）和ADHD（n = 8，23%）。干预策略包括多模式方法（n = 6，21%）和教育工作坊（n = 6，21%）。目标结果包括社交技能（n = 7，16%）以及知识、态度和实践（n = 5，12%）。终身学习（n = 11，33%）和加强教育系统的干预措施（n = 10，31%）是主要内容领域。大多数研究显示出中度至高度的偏倚风险。
学校为低收入和中等收入国家患有NDDs的儿童和青少年提供了提供心理健康及社会心理支持干预措施的战略平台，涉及家庭、教师和同伴。虽然报告显示社交技能以及知识、态度和实践有所改善，但异质性和方法学局限性限制了研究结果的普遍性。未来的研究应关注长期影响，并扩展到代表性不足的疾病。
