School-based mental health and psychosocial support interventions for children and adolescents with developmental disabilities in low- and middle-income countries: A systematic review.

Abstract

Objectives: 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.

Methods: 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.

Results: 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.

Conclusions: 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.