Onset of Intervention for Learners in Autism-Specific Government-Funded Schools in South Africa

Abstract

Late identification of children with ASD remains a concern. Due to limited research in low and middle-income countries (LMICs) such as South Africa (SA), the early management of autism spectrum disorder (ASD) should be further explored. The aim was to describe the demographic characteristics and typical early management of learners attending the six autism-specific government-funded schools in SA. Participants included 234 (28.4% of total approached) caregivers of children with ASD enrolled at the only six autism-specific government-funded schools in SA. Data were collected from parent-completed questionnaires. The majority of caregivers became concerned about their child's development on average at 25.2 months, but only a few (3.8%) thought it was ASD. Late identification was significantly associated with the respondent, nationality, qualification of the father and qualification of the mother. It appears that late identification sets a trajectory of late intervention. Factors underlying the trajectory appear to be unfamiliarity with ASD, and limited services and schools for children with ASD.Public awareness should focus on early symptoms associated with ASD risk to expedite early intervention.

What barriers could impede access to mental health services for children and adolescents in Africa? A scoping review

“…While professional and traditional/alternative treatments are not necessarily mutually exclusive, stigma was found to be negatively associated with seeking professional help [25]. Importantly, parents, especially those experiencing stigma, report resorting to traditional services for the mental health challenges of their children [22].…”

“…Although mental health needs have been explored in several countries [20,21], there is a paucity of comprehensive reviews pertaining to the mental health needs of children and teenagers in African countries. Most research pertaining to mental health in Africa has focused on South Africa [22][23][24]. Expanding the search to include all countries in Africa could help paint a more accurate picture of mental health needs in an understudied context.…”

“…Compared to parents with more years of education, uneducated parents and parents with fewer years of education (having less than 9 years of schooling) were approximately five times more likely to prefer traditional treatment options [32]. Additionally, higher maternal education appeared to be associated with greater knowledge of child development [22]. As for careers, housewives and farmers were 1.5 times more likely to prefer traditional treatment compared to merchants and other professionals [32].…”

Mapping Research Evidence on Children Living With Autism Spectrum Disorders in Africa: a Scoping Review Protocol.

“…In Africa, literature on the prevalence of ASD is limited PJ De Vries [10] partly due to diagnostic challenges [11]. Nonetheless, a study suggested that most individuals with ASDs live in low-and-middle-income countries compared to high-income countries [10,12,13]. To this end, research evidence on ASDs is needed to inform policy as well as reveal literature gaps for future research to improve care rendered to children living with ASDs in Africa.…”

Reliability and Concurrent Validity of a Cultural Adaptation and Northern Sotho Translation of the M-CHAT-R/F

“…In a retrospective case study of an autism-specific school, the mean age of autism diagnosis of learners (n = 141) was 71.6 months from 1990 to 2014 (Van Biljon et al, 2015). Yet, in a prospective follow-up study, the mean age of diagnosis in the six autism-specific schools was much lower (46.6 months; Erasmus et al, 2019). The positive decline of 25 months in the age of autism diagnosis for school-going children in South Africa is encouraging, but identification and assessment efforts need to increase further to reap the benefits of early intervention as an accurate diagnosis of autism can already be made as early as 14 months of age (Pierce et al, 2019).…”