AUTISM: Community perception, implication for social development and learning in childhood

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AUTISM Community perception, implication for
social development and learning in childhood

• Muideen O. Bakare, M.B.B.S, FMCPsych, MNIM
• Senior Consultant Psychiatrist Head, Training
  Research
• Child Adolescent Unit, Federal Neuropsychiatric
  Hospital, Enugu, Enugu State, Nigeria
• Chairman, Childhood Neuropsychiatric Disorders
  Initiatives (CNDI)
• E-mail mobakare2000_at_yahoo.com
• Website - http//cndinitiatives.com/

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- Community Perception of Autism- Implication
for social development and learning in childhood
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Diagnostic ProfilingIs there Autism in Nigeria
/ Africa?

• - Some schools of thoughts, just as Sanua, (1984)
  opined still believes Autism is a disorder of
  children living in Western Industrialized
  Countries with high technological development and
  as a result, may be uncommon among African
  Children.
• - This is not true with our present level of
  knowledge on the subject today.

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Autism The Previous Diagnostic Profiling
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Autism is a Spectrum

• Perception and Understanding of Autism in Africa
  may be skewed towards very Severe Spectrum as
  reflected in available Case Reports and Case
  Series from African Sub-culture (Mankoski et al,
  2006, Bakare Munir, 2011a, 2011b).
• Milder Spectrum, previously referred to as
  Aspergers Syndrome may be construed as part of
  normal behavior in most African Sub-cultures.
• Evidence abound of extra-ordinary talents in
  children with Autism of milder spectrum.

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PLEASE, DONT TELL ME I AM NORMAL Faith Jegede
reflected on her two Brothers with Autism
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Community Perception Misdiagnosis Confusion
with other Early Onset Neurological Conditions

• Autism may be confused with some of the
  co-morbid disorders like Intellectual Disability
  and Epilepsy and early onset infectious
  neurological conditions.
• Research findings suggest that period of onset
  of ASD symptoms among African children coincide
  with the period of less than five years that is
  characterized by vulnerabilities of African
  children to physical illness and infectious
  diseases associated with neurological
  consequences (Mankoski et al, 2006).

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Cultural Background and Perception of Autism in
African Sub-Cultures

• - Are there Local Language Synonyms for Autism in
  most African Sub-cultures?
• - Knowledge and Perception on Clinical
  Presentation.
• - Knowledge and Perception on what are
  responsible Etiological Factors.
• - Perception about Prognosis and Community
  Inclusion.

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Local Language Synonyms for Autism in most
African Sub-cultures

• Hausa - ????
• Igbo - ????
• Yoruba - ????
• Ijaw - ????

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Knowledge and Perception on Clinical Presentation

• Research findings suggest that continuous
  education of healthcare workers and the general
  public in Africa is essential to raise the level
  of knowledge on clinical presentation and
  awareness about ASD which is presently low, as
  improved knowledge would help in early
  recognition and intervention for African children
  with ASD (Bakare Munir, 2011a, 2011b).

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Knowledge and Perception on what are responsible
Etiological Factors

• - Research finding observed that the etiological
  basis of ASD is still being explained by
  supernatural causes (Bakare et al, 2009b).
• - In Africa, witchcraft, demonic afflictions,
  evil spirits are common acceptable mode of
  explaining etiology of ASD and other.
• - Individuals with ASD and their families are
  often faced with rejection, negative and
  derogatory comments, further promoting stigma.
• - To avoid stigma, families tend to hide away the
  affected children from the society. This may lead
  to late presentation and diagnosis of the
  disorder among African children.

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Perception about Preventability, Prognosis and
Community Inclusion

• In a previous study in Nigeria among healthcare
  workers, a total of 54.5 of the healthcare
  workers were of the opinion that childhood autism
  is treatable and the rest thought otherwise,
  while 32.1 of the healthcare workers were of the
  opinion that childhood autism is preventable, the
  rest thought otherwise (Bakare et al. 2009).
• The healthcare workers that subscribed to the
  opinion that childhood autism is treatable cited
  special education and behavioral therapy among
  others as possible modalities of treatment
  (Bakare et al. 2009).

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Perception about Preventability, Prognosis and
Community Inclusion

• - The healthcare workers who were of the opinion
  that childhood autism is preventable cited
  avoiding maternal infection during pregnancy,
  avoiding birth injury, pleasing the ancestral
  spirit and avoiding sins, among others, as
  modalities of prevention (Bakare et al. 2009).
• - The above explanations among the healthcare
  workers are further reflection of community
  perception on Autism.
•  

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Implication for social development and learning
in childhood

• The above community perceptions in different
  dimension may reduce understanding of what Autism
  is.
• These perceptions can in turn promote stigma,
  resulting in community exclusion of affected
  children and adults, which often leads to little
  or no interventions (Bakare Munir, 2011c).

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Collective Vs Individual Approach to Learning

• Previous study had suggested that many of
  affected children do not have access to any form
  of education (Bakare Munir, 2011c).
• Lack of policy for widely available special
  education facilities within the normal mainstream
  schools in Nigeria and other African Countries
  may be as a result of negative community
  perception of Autism.
• Individual Approach to Learning is largely
  recommended for Children with Autism

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Summary Community Perception of Autism in Africa
as documented by VOA News
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References

• - Bakare, M.O, Munir, K.M (2011a). Autism
  Spectrum Disorders in Africa, A Comprehensive
  Book on Autism SpectrumDisorders, Mohammad-Reza
  Mohammadi (Ed.), Chapter 10 ISBN
  978-953-307-494-8, InTech, Available from
  http//www.intechopen.com/articles/show/title/auti
  sm-spectrum-disorders-in-africa. 
• - Bakare, M.O Munir, K.M (2011b) Autism
  spectrum disorders (ASD) in Africa a
  perspective Afr J Psychiatry 208-210. 
• - Bakare, M.O, Agomoh, A.O, Ebigbo, P.O, Eaton,
  J, Okonkwo, K.O, Onwukwe, J.U Onyeama, G.M
  (2009b) Etiological explanation, treat-ability
  and preventability of childhood autism a survey
  of Nigerian healthcare workers opinion Ann Gen
  Psychiatry 8 6.
• - Bakare, M.O Munir, K.M (2011c) Excess of
  non-verbal cases of autism spectrum disorders
  presenting to orthodox practice in Africa a
  trend possibly resulting from late diagnosis and
  intervention South African Journal of
  Psychiatry 17(4) 118 120.
• - Mankoski, R.E, Collins, M, Ndosi, N.K, Mgalla,
  E.H, Sarwatt, V.V, Folstein, S.E (2006)
  Etiologies of autism in a case-series from
  Tanzania J Autism Dev Disord 36(8) 1039
  1051.
• - Sanua, V.D (1984) Is infantile autism a
  universal phenomenon? An open question Int J Soc
  Psychiatry 30(3) 163 177.

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THANK YOU!