Group Programmes to Improve the Skills, Confidence and Wellbeing of Caregivers of Children with Neurodisability: a Systematic Review of Effects

Abstract Caregiver skills training programmes are well-researched in the fields of autism and intellectual disability, but children with motor disorders such as cerebral palsy remain underrepresented despite their high prevalence. These caregivers face unique challenges, and group programmes may provide family-centred care through information provision, problem-solving and peer support. Systematic searches of five databases (CINAHL, Medline, Embase, PsychINFO and ERIC) were conducted for interventional studies of group programmes aiming to improve the skills, confidence and wellbeing of caregivers of children with neurodisability focusing on motor disorders. Data were extracted on study and intervention characteristics and outcomes. Risk of bias was assessed, effect sizes calculated, and results summarised descriptively using forest plots. Of 6093 studies identified, 21 studies met inclusion criteria (nine randomised-controlled trials, two quasi-experimental and ten pre-post designs). Most reported on programmes developed in resource-constrained settings and addressed caregiver skills, coping strategies, or health-promoting behaviours. Outcomes were grouped according to caregiver wellbeing, caregiver skills and confidence, and social support and family functioning. Child outcomes were reported separately. Most caregiver outcomes showed positive effects, though most studies had high risk of bias due to self-reported outcomes and lack of blinding of intervention allocation and outcome measurement. Group-based training programmes show promise for improving caregiver skills and wellbeing. Clinicians and stakeholders in high-income countries may learn from these innovations in low-resource settings. Future research should strengthen protocol reporting, address attrition, control for confounding factors, and establish a core set of caregiver-reported outcomes to better capture programme impact. Systematic review registration: PROSPERO registration CRD42024595002.