Experiences and Attitudes on Early Identification Practices of Autism: A Preliminary Survey of Pediatric Professionals in Ecuador

Abstract

Early identification of children with autism is necessary to support their social and communicative skills and cognitive, verbal, and adaptive development. Researchers have identified several barriers to early diagnosis. Data collected in low- and middle-income contexts—where the vast majority of children in the world live—is scarce. In Ecuador, as in many other countries, estimates are lower compared to the global prevalence. Health authorities estimate a prevalence of 0.28% (0.18%–0.41%) in children aged five years old or less. Based on the hypothesis that, as in many parts of the world, children in Ecuador are not routinely screened and that this situation may result from poor recognition of this condition, our objective was to identify potential obstacles to case identification in pediatric settings. Several barriers, consistent with those identified in other countries, were reported by 153 participants on a survey, including lack of time, lack of resources to refer, fear of unnecessarily alarming families, and lack of information to guide families with concerns. The vast majority of participants are aware of the need for a screening tool for autism detection but report a lack of knowledge of its formal application. Most of the barriers reported in this study could be overcome by educational programs tailored to professional needs in order to support the well-being of children with autism and their families.

Perception, Beliefs, and Causal Attribution of Autism Early Signs in Ecuadorian General Population

“…Universities offer postgraduate education in pediatrics; however, the specific pedo-psychiatric and neuro-pediatric fields rely on interns trained in other countries who return to work in Ecuador. In the pediatric sector, professionals may face many challenges in ASD case-identification and case-management, such as access to training and available resources to refer families ( Buffle et al, 2022 ). The public health system has two pediatric hospitals in two main cities, and several community centers around the county and units providing specific ASD services of identification and treatment are currently being developed.…”

Feasibility of an observational procedure to enhance early identification of autism spectrum disorder in paediatric settings: A mixed-methods study on an Ecuadorian sample

“…This procedure can play an important role in primary care routines. Combined with a short, validated and culturally adapted questionnaire, it can contribute to eliminating barriers to screening and identification that have previously been reported by Ecuadorian paediatricians ( Buffle & Gentaz, 2019 ; Buffle et al, 2022 ).…”

“…The participants also perceived ASD-specific questionnaires as ‘not useful if a child is showing a normal development’, ‘lack of reliability on parental responses’ and ‘non-comfortable’ or ‘difficult to find’ as the main drawbacks. A second study ( Buffle et al, 2022 ), conducted on 183 paediatric professionals, indicated a low number of cases of autism identified during participant’s professional life, with 62% of participants reporting not having identified ASD cases during their professional life. This study also identified several barriers consistent with those identified in other countries, including limited knowledge of screening formal application, lack of time, lack of resources to refer and information to provide families, and fear of unnecessarily alarming families ( Buffle et al, 2022 ).…”

Insights on dental care management and prevention in children with autism spectrum disorder (ASD). What is new?

“…However, diagnosing autism is particularly burdensome in early childhood due to the complexity of ASD development and etiopathogenesis, which compels physicians to endeavor novel diagnostic strategies ( 64 – 71 ). The topic of oral, dental, and periodontal health in the early pediatric life of ASD subjects is still missing from the correct management of these individuals by pediatricians and pediatric dentistry ( 72 , 73 ).…”