AUTISM AND CHILD DEVELOPMENTAL DISORDERS IN AFRICA
Autism in Africa is often compounded by severe stigma, a dire need for awareness and knowledge of intervention methods, a lack of resources and a lack of community support. Indeed this goes for other neurological disorders as well, with diagnostic distinctions not commonly made. The causes of autism spectrum disorders (ASD) and other developmental disabilities in Africa are often attributed to the supernatural. One survey done in Nigeria, for example, had 40% of nurses citing ancestral spirits, enemies, sin or the devil as the reasons for autism in Africa.(1)These attitudes mean that help for autism and developmental disorders in Africa is often first sought from traditional healers or religious leaders, rather than from a medical clinic or practising professional, increasing the incidence of late diagnoses.
In the US and other highly-resourced countries, autism is usually diagnosed between 18 months and 3 years, allowing children to get effective early intervention. By comparison, limited research shows the age of diagnosis of children in under-resourced countries to be between 6-8 years, with some children not even diagnosed until well into their teenage years(2). Without access to early interventions or speech therapy, children with developmental disabilities in developing countries are more likely to be nonverbal. Two of six studies on autism in Africa done in Nigeria, Tunisia, Kenya and Tanzania and published between 1982 and 2010, reported nonverbal rates among children with autism in Africa at an average of 61%, compared with around 25% in the U.S.(3)(4)
Parents with children with ASD in Africa often have no knowledge, no recourse, and no resources to help their child. With pressures and ostracism from families, churches and society at large, children with autism in Africa have been known to be locked away or hidden at home by their parents. These attitudes and challenges apply to developmental disabilities across the board. Indeed, with poor diagnoses, very little distinction is often made between autism and any other developmental or psychiatric impairment.
The good news is that awareness is definitely improving, particularly in the cities. Globally, mental health issues overall in Africa are starting to get more attention. In 2012, public health experts called on the United Nations General Assembly to host a special session on mental, neurological, and substance (MNS) use disorders,(5) and in 2013, the UN Secretary-General remarked that “international attention is essential to address stigma, lack of awareness and inadequate support structures" when it comes to global autism.They urged organizations and researchers to spend more time investigating autism and helping to treat it across the globe".(6)
CHIP International is one of the few international organizations beginning to take on this herculean challenge.
1. Simmons Foundation: Autism Research Initiative https://sfari.org/news-and-opinion/blog/2011/out-of-africa
2. December issue of the South African Journal of Psychiatry http://www.ncbi.nlm.nih.gov/pubmed/22229024
3. December issue of the South African Journal of Psychiatry http://www.ncbi.nlm.nih.gov/pubmed/22229024
4. Autism Speaks, October 07, 2009 https://www.autismspeaks.org/science-blog
5. UN Secretary-General's Message for 2013 http://www.un.org/en/events/autismday/2013/sgmessage.shtml