Interventions provided by parents for children with intellectual disabilities in low and middle income countries.

BACKGROUND: In low- and middle-income (LAMI) countries, there is a lack of well-trained therapists to provide specialist interventions for children with intellectual disabilities and their families. We sought to identify strategies deliverable by families or non-specialist workers. MATERIALS AND METHODS: After searches of appropriate scientific databases, we applied GRADE methodology to rate the quality of evidence for these interventions. RESULTS: We identified small-scale interventions trialled in LAMI countries with limited evidence of effectiveness in supporting development, adaptive behaviour and/or community participation. In high-income countries, the Stepping Stones Triple P program for adaptive behaviour and the Portage program for child development have the most extensive evidence base and may be applicable in LAMI countries. CONCLUSIONS: There is reason to hope that, when combined with community development strategies, the welfare of children with intellectual disabilities in LAMI countries can be advanced within those countries' economic means.

How much does intellectual disability really cost? First estimates for Australia.

BACKGROUND: Given the paucity of relevant data, this study estimates the cost of intellectual disability (ID) to families and the government in Australia. METHOD: Family costs were collected via the Client Service Receipt Inventory, recording information relating to service use and personal expense as a consequence of ID. Government expenditure on the provision of support and services was estimated using top-down costing. RESULTS: A total of 109 parents participated. The cost of ID in Australia is high, especially for families. Total economic costs of ID are close to $14,720 billion annually. Opportunity cost of lost time provided 85% of family expense. A comparison of family expense and social welfare benefits received suggests that families suffer considerable loss. This may impact on families' physical and emotional wellbeing. CONCLUSIONS: Monitoring of changes in expenditure is required. Policies should ensure that money devoted to ID is allocated in a rational, equitable, and cost-effective manner.