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Adams SN. The Unmasking of Autism in South Africa and Nigeria. Neuropsychiatr Dis Treat 2024; 20:947-955. [PMID: 38737770 PMCID: PMC11088825 DOI: 10.2147/ndt.s461650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 05/02/2024] [Indexed: 05/14/2024] Open
Abstract
This review is of interest to researchers, policymakers, and healthcare professionals working in the field of autism in Africa. The review aims to describe autism in sub-Saharan Africa, focusing on South Africa and Nigeria regarding prevalence, incidence, identification, treatment, and attitudes towards autistic children. There are several challenges, such as lack of awareness, limited access to professional support and diagnostic tools, and cultural considerations in establishing the autism prevalence in the African region compared to other parts of the world. Additionally, South Africans and Nigerians exhibit diverse perspectives and attitudes that significantly influence the provision of treatment, including stigma and misconceptions held by healthcare professionals themselves. As a result, it is difficult to determine prevalence in South Africa and Nigeria. However, research has indicated that autism prevalence is rising globally, and in these contexts. Rising prevalence highlights the need to increase access to services, rehabilitation, and provide support to families of children with autism. Furthermore, research has emphasized the inequitable support and access available to families living in low-and high-income households and the need to provide contextually relevant and responsive interventions, education and training, research and policy in these countries.
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Affiliation(s)
- Skye Nandi Adams
- Department of Speech Pathology and Audiology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa
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2
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Lee JD, Kang VY, Terol AK, Joo S. Examining the Efficacy of Culturally Responsive Interventions for Autistic Children and Their Families: A Meta-Analysis. J Autism Dev Disord 2024:10.1007/s10803-023-06212-2. [PMID: 38246962 PMCID: PMC11260274 DOI: 10.1007/s10803-023-06212-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2023] [Indexed: 01/23/2024]
Abstract
Culturally responsive interventions for autistic children and their families have been developed and implemented to address issues related to limited representation, inequities, and disparities in access to care of minoritized families in research. Currently available reviews are relatively limited in scope or do not synthesize interventions specifically. Therefore, we conducted a meta-analysis to synthesize autism intervention literature that specifically targeted autistic individuals and their family members from minoritized backgrounds, such as immigrant families. We used four databases to identify studies that used culturally responsive interventions with minoritized autistic children and their families. An article was included if it included empirical intervention data using an experimental design. A total of 354 studies were initially screened, and 24 studies were included. Effect sizes of these studies were extracted across two levels (i.e., child and family levels). Data from group design studies were extracted manually, and data from single-case design studies were extracted using a web-based tool. We used design-comparable standardized effect sizes to compare across both designs. The analysis revealed a large, positive, and significant overall effect size across culturally responsive interventions. Specifically, social-communication and mental health outcomes yielded significant effects at the child level. Additionally, parents' mental health and fidelity of strategy implementation also yielded significant results. Our results suggest that culturally responsive interventions yield comparable outcomes to unadapted, original interventions. Future research should examine the distinction between the effect of cultural adaptation and the efficacy of the intervention itself.
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Affiliation(s)
- James D Lee
- Department of Psychiatry and Behavioral Sciences, University of Washington, 6901 Sand Point Ave NE, Seattle, WA, 98115, USA.
| | - Veronica Y Kang
- Department of Counseling, Higher Education, and Special Education, University of Maryland, College Park, USA
| | - Adriana Kaori Terol
- Department of Special Education, University of Illinois Urbana-Champaign, Champaign, USA
| | - Sean Joo
- Department of Educational Psychology, University of Kansas, Lawrence, USA
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3
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Asiimwe R, Dwanyen L, Subramaniam S, Kasujja R, Blow AJ. Training of interventionists and cultural adaptation procedures: A systematic review of culturally adapted evidence-based parenting programs in Africa. FAMILY PROCESS 2023; 62:160-181. [PMID: 35570371 DOI: 10.1111/famp.12780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 03/15/2022] [Accepted: 03/21/2022] [Indexed: 06/15/2023]
Abstract
There has been an increase in the implementation of evidence-based parenting programs from high-income countries to several African countries. In this review, we systematically evaluated intervention studies of culturally adapted parenting programs in nine African countries with the objective of examining the quality of training for interventionists and cultural adaptation procedures. A total of 18 studies, obtained from an electronic search of 6 databases, met the inclusion criteria and were evaluated following PRISMA guidelines. The Ecological Validity Model was adopted to organize data on cultural adaptation procedures. Sixteen of the 18 studies reported information regarding the clinical training of interventionists and the cultural adaptations undertaken. Live and interactive workshops were the most common format used to train interventionists in the focal intervention. Overall, cultural adaptations in most studies included translation of intervention protocols into the local language. However, studies varied in the way cultural adaptation procedures were reported with some studies failing to report on cultural adaptation procedures. Concurring with previous literature, attending to issues of culture, power, privilege, access, sustainability, and other relevant concepts to increase the cultural relevance is highly encouraged in parent intervention studies in Africa. This review provides a baseline upon which future training and adaptation procedures can be built.
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Affiliation(s)
- Ronald Asiimwe
- Department of Human Development and Family Studies, Michigan State University, East Lansing, Michigan, USA
| | - Lekie Dwanyen
- Department of Human Development and Family Studies, Michigan State University, East Lansing, Michigan, USA
| | - Saila Subramaniam
- Department of Human Development and Family Studies, Michigan State University, East Lansing, Michigan, USA
| | - Rosco Kasujja
- Department of Mental Health, School of Psychology, Makerere University, Kampala, Uganda
| | - Adrian J Blow
- Department of Human Development and Family Studies, Michigan State University, East Lansing, Michigan, USA
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4
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Pervin M, Ahmed HU, Hagmayer Y. Effectiveness of interventions for children and adolescents with autism spectrum disorder in high-income vs. lower middle-income countries: An overview of systematic reviews and research papers from LMIC. Front Psychiatry 2022; 13:834783. [PMID: 35990045 PMCID: PMC9386527 DOI: 10.3389/fpsyt.2022.834783] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 07/11/2022] [Indexed: 12/21/2022] Open
Abstract
Background There is a multitude of systematic reviews of interventions for children and adolescents with autism spectrum disorder (ASD). However, most reviews seem to be based on research conducted in High-Income Countries (HIC). Thus, summary findings may not directly apply to Lower Middle-Income Countries (LMIC). Therefore, we conducted a Meta-Review analyzing systematic reviews on the effectiveness of interventions for target outcomes in children and adolescents with ASD to find out whether there are differences in effectiveness between HIC and LMIC and which interventions can be considered evidence-based in LMIC. Methods Electronic databases (PsycINFO, PubMed, Cochrane database of systematic reviews) were searched for reviews on interventions for ASD in children and adolescents from January 2011 through December 2021, which included studies not coming from HIC. Systematic reviews with qualitative and quantitative syntheses of findings were included. Two investigators independently assessed studies against predetermined inclusion/exclusion criteria and extracted relevant data including quality and evidence assessments. Evidence for different types of interventions in HIC vs. LMIC was planned to be compared, but none of the reviews assessed potential differences. Therefore, a narrative review of the studies from LMIC was conducted including an assessment of quality and evidence. Results Thirty-five reviews fulfilled the inclusion criteria. Eleven considered findings from HIC and LMIC. Sixty-nine percent included studies with various research designs; 63% provided a qualitative synthesis of findings; 77% percent assessed the quality of studies; 43% systematically assessed the level of evidence across studies. No review compared evidence from HIC and LMIC. A review of the studies from LMIC found some promising results, but the evidence was not sufficient due to a small number of studies, sometimes poor quality, and small sample sizes. Conclusion Systematic reviews on interventions for children and adolescents with ASD did not look for potential differences in the effectiveness of interventions in HIC and LMIC. Overall, there is very little evidence from LMIC. None of the interventions can be considered evidence-based in LMIC. Hence, additional research and mutually agreed methodological standards are needed to provide a more secure basis for evidence-based treatments in LMIC trying to establish evidence-based practices.
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Affiliation(s)
- Maleka Pervin
- Institute of Psychology, Georg August University of Goettingen, Göttingen, Germany
- Department of Psychology, University of Dhaka, Dhaka, Bangladesh
| | - Helal Uddin Ahmed
- Department of Child Adolescent and Family Psychiatry, National Institute of Mental Health, Dhaka, Bangladesh
| | - York Hagmayer
- Institute of Psychology, Georg August University of Goettingen, Göttingen, Germany
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Kakooza-Mwesige A, Bakare M, Gaddour N, Juneja M. The need to improve autism services in lower-resource settings. Lancet 2022; 399:217-220. [PMID: 34883050 DOI: 10.1016/s0140-6736(21)02658-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 11/15/2021] [Indexed: 01/14/2023]
Affiliation(s)
- Angelina Kakooza-Mwesige
- Department of Paediatrics and Child Health, School of Medicine, Makerere University College of Health Sciences, PO Box 7072, Kampala, Uganda.
| | - Muideen Bakare
- Childhood Neuropsychiatric Disorders Initiatives, Enugu and Federal Neuropsychiatric Hospital, Enugu State, Nigeria
| | - Naoufel Gaddour
- University of Monastir, CHU Fattouma Bourguiba, Monastir, Tunisia
| | - Monica Juneja
- Department of Paediatrics and Child Development Centre, Centre of Excellence-Early Intervention Centre, Maulana Azad Medical College, New Delhi, India
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Lord C, Charman T, Havdahl A, Carbone P, Anagnostou E, Boyd B, Carr T, de Vries PJ, Dissanayake C, Divan G, Freitag CM, Gotelli MM, Kasari C, Knapp M, Mundy P, Plank A, Scahill L, Servili C, Shattuck P, Simonoff E, Singer AT, Slonims V, Wang PP, Ysrraelit MC, Jellett R, Pickles A, Cusack J, Howlin P, Szatmari P, Holbrook A, Toolan C, McCauley JB. The Lancet Commission on the future of care and clinical research in autism. Lancet 2022; 399:271-334. [PMID: 34883054 DOI: 10.1016/s0140-6736(21)01541-5] [Citation(s) in RCA: 258] [Impact Index Per Article: 129.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 06/22/2021] [Accepted: 06/24/2021] [Indexed: 12/13/2022]
Affiliation(s)
| | - Tony Charman
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Alexandra Havdahl
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway; Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway; Department of Psychology, University of Oslo, Oslo, Norway
| | - Paul Carbone
- Department of Pediatrics at University of Utah, Salt Lake City, UT, USA
| | - Evdokia Anagnostou
- Holland Bloorview Kids Rehabilitation Hospital, Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | | | - Themba Carr
- Rady Children's Hospital San Diego, Encinitas, CA, USA
| | - Petrus J de Vries
- Division of Child & Adolescent Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Cheryl Dissanayake
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, VIC, Australia
| | | | | | | | | | | | - Peter Mundy
- University of California, Davis, Davis, CA, USA
| | | | | | - Chiara Servili
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | | | - Emily Simonoff
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | - Vicky Slonims
- Evelina Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Paul P Wang
- Simons Foundation Autism Research Initiative, Simons Foundation, New York, NY, USA; Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA
| | | | - Rachel Jellett
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, VIC, Australia
| | - Andrew Pickles
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | - Patricia Howlin
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Peter Szatmari
- Holland Bloorview Kids Rehabilitation Hospital, Department of Pediatrics, University of Toronto, Toronto, ON, Canada
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Egbegi DR, Bella-Awusah T, Omigbodun O, Ani C. A controlled trial of Cognitive Behavioural Therapy-based strategies for insomnia among in-school adolescents in southern Nigeria. Child Adolesc Psychiatry Ment Health 2021; 15:52. [PMID: 34563220 PMCID: PMC8465787 DOI: 10.1186/s13034-021-00406-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 09/16/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Sleep difficulties are highly prevalent among adolescents, and are associated with significant impairments. The effectiveness and acceptability of Cognitive Behavioural Therapy-based (CBT-based) treatment for insomnia in adolescents is established for High Income Countries, but unknown for African settings. Thus, the aim of this study was to assess the effect of CBT-based intervention among in-school adolescents with sleep difficulties in Southern Nigeria. METHODS This was a pilot controlled trial involving 50 adolescents with highest ranked scores on the Insomnia Severity Index (ISI) recruited from four schools (two government and two privately owned). Balloting was used to assign two schools (public and private) with 25 participants to the intervention group, and the other two schools (public and private) with 25 participants as waiting-list controls. The two groups were dyad-matched for baseline ISI scores, gender, and type of school to reduce baseline differences. The treatment group received weekly group-based manualised CBT-based intervention over 5 weeks. Primary outcome was ISI score at 6th week. Secondary outcomes were sleep onset latency (SOL), Total sleep duration (TSD), depressive symptoms, sleep hygiene, and knowledge about sleep. RESULTS Participants were aged 13-17 years (M = 14.9, SD = 1.16) and consisted of 18 males and 32 females. Controlling for baseline scores, the intervention group showed significantly lower post-intervention insomnia scores compared with the control group {F (1, 34) = 1.10, p = 0.0001, (ηp2 = 0.59}, shorter SOL {F (1, 33) = 1.41, p = 0.0001, ηp2 = 0.39}, longer TSD {F (1, 33) = 1.03, p = 0.0001, ηp2 = 0.47}, lower depressive symptoms {F (1, 31) = 1.32, p = 0.002 (ηp2 = 0.34}, higher knowledge of sleep {F (1, 34) = 1.02, p = 0.001, ηp2 = 0.36}, but no significant change in sleep hygiene {F (1, 32) = 1.08, p = 0.08, ηp2 = 0.15}. All participants in the intervention group rated the programme as good or excellent. CONCLUSION This pilot CBT-based intervention for adolescents with insomnia was feasible, well received and showed promising efficacy in this setting. Larger controlled trials are recommended to establish the generalisability of these findings in this region. Trial registration Pan African Clinical Trial Registry (Registration Number PACTR202001710494962).
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Affiliation(s)
- Diseyei R. Egbegi
- grid.9582.60000 0004 1794 5983Centre for Child and Adolescent Mental Health, University of Ibadan, Ibadan, Nigeria
| | - Tolulope Bella-Awusah
- grid.9582.60000 0004 1794 5983Centre for Child and Adolescent Mental Health, University of Ibadan, Ibadan, Nigeria ,grid.9582.60000 0004 1794 5983Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Olayinka Omigbodun
- grid.9582.60000 0004 1794 5983Centre for Child and Adolescent Mental Health, University of Ibadan, Ibadan, Nigeria ,grid.9582.60000 0004 1794 5983Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Cornelius Ani
- Division of Psychiatry, Imperial College London, Hammersmith Hospital Campus, 2nd Floor Commonwealth Building, Du Cane Road, London, W12 0NN, UK. .,Surrey and Borders Partnership, NHS Foundation Trust, Leatherhead, Surrey, UK.
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Wei Q, Machalicek W, Zhu J. Treatment Acceptability for Interventions Addressing Challenging Behavior Among Chinese Caregivers of Children with Autism Spectrum Disorder. J Autism Dev Disord 2021; 53:1483-1494. [PMID: 34287734 DOI: 10.1007/s10803-021-05196-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2021] [Indexed: 11/29/2022]
Abstract
The present study evaluated treatment acceptability for behavioral interventions addressing challenging behaviors with Chinese caregivers of children with autism spectrum disorder. Factors influencing treatment acceptability (i.e., severity of challenging behavior and Chinese child-rearing values) were investigated. Caregivers of children aged 2-12 years (N = 216) participated in this survey study. Results suggest that caregivers found positive strategies including noncontingent reinforcement and positive reinforcement the most acceptable; punishment-based strategies were rated as the least acceptable. Furthermore, positive punishment was perceived as more acceptable for severe challenging behavior. Caregivers who endorsed training were more likely to find positive strategies acceptable, whereas those who endorsed shaming were more likely to rate punishment-based strategies as more acceptable. Implications for future research and culturally competent behavioral treatments in Chinese context are provided.
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Affiliation(s)
- Qi Wei
- Department of Special Education and Clinical Sciences, University of Oregon, HEDCO Education Building, Eugene, OR, 97403, USA.
| | - Wendy Machalicek
- Department of Special Education and Clinical Sciences, University of Oregon, HEDCO Education Building, Eugene, OR, 97403, USA
| | - Jinlan Zhu
- Department of Special Education and Clinical Sciences, University of Oregon, HEDCO Education Building, Eugene, OR, 97403, USA
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Viljoen M, Mahdi S, Shelly J, de Vries PJ. Parental perspectives of functioning in their children with autism spectrum disorder: A global scoping review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2020; 25:176-198. [PMID: 32862674 DOI: 10.1177/1362361320950055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
LAY ABSTRACT No paper to date has summarized parents' views on the functional challenges and/or strengths of their children with autism spectrum disorder. In this review we set out to perform a scoping review aiming to (a) find and compare existing research from around the globe on parental perception of functioning and (b) summarize results from these papers using the International Classification of Functioning Disability and Health-Child and Youth version framework. Since we know that the place and circumstances we live in can have a significant influence on our functioning in daily life, we were specifically interested in comparing perceptions from high-income countries and low-/middle-income countries. Two researchers conducted a comprehensive search of English studies published between 1990 and June 2016. Papers were summarized and key findings were linked to International Classification of Functioning Disability and Health-Child and Youth categories. Thirty-three studies were identified, of which most were conducted in high-income countries (n = 25/33, 76%) with only six studies in low/middle-income countries (n = 6/33, 18%). Two studies compared views from low/middle-income and high-income countries (n = 2/33, 6%). Functional themes from high-income countries included a range across the International Classification of Functioning Disability and Health-Child and Youth framework while functional themes from low-/middle-income countries were mostly focused on environmental factors. It was difficult to directly compare studies from low/middle-income and high-income countries because they investigated and discussed such different parts of functioning. We suggest that future research should use an approach that will allow researchers to directly compare functional categories in order to get a more accurate impression of the impact of context on functioning.
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Affiliation(s)
| | | | - James Shelly
- Eastern Health Child & Youth Mental Health Service, Australia
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Lee JD, Meadan H. Parent-Mediated Interventions for Children with ASD in Low-Resource Settings: a Scoping Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2020. [DOI: 10.1007/s40489-020-00218-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Bakare MO, Taiwo OG, Bello-Mojeed MA, Munir KM. Autism Spectrum Disorders in Nigeria: A Scoping Review of Literature and Opinion on Future Research and Social Policy Directions. J Health Care Poor Underserved 2019; 30:899-909. [PMID: 31422978 PMCID: PMC6815667 DOI: 10.1353/hpu.2019.0063] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Research about autism spectrum disorder (ASD) in sub-Saharan Africa is sparse and limited. However, research studies coming from Nigeria in West Africa as a country have contributed significantly to the subject of ASD in sub-Saharan Africa. METHODS AND RESULTS This study is a scoping review of research literature on ASD in Nigeria through June 2017 conducted by searching the key terms autism and Nigeria on PubMed and Google Scholar. Included in the review are works concerning case reports and co-morbidities associated with ASD in Nigeria; prevalence of ASD; genetic study of ASD; clinical characteristics of children with ASD; knowledge and awareness about ASD; socio-cultural factors affecting ASD. Expert opinion on social policy and public health issues affecting ASD in Nigeria are discussed. CONCLUSION Wide research and intervention gaps are noted and we suggest directions for future research, social policy development, and intervention services for individuals with ASD in Nigeria.
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Guler J, de Vries PJ, Seris N, Shabalala N, Franz L. The importance of context in early autism intervention: A qualitative South African study. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2018; 22:1005-1017. [PMID: 28914083 PMCID: PMC5832543 DOI: 10.1177/1362361317716604] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The majority of individuals with autism spectrum disorder live in low- and middle-income countries and receive little or no services from health or social care systems. The development and validation of autism spectrum disorder interventions has almost exclusively occurred in high-income countries, leaving many unanswered questions regarding what contextual factors would need to be considered to ensure the effectiveness of interventions in low- and middle-income countries. This study qualitatively explored contextual factors relevant to the adaptation of a caregiver-mediated early autism spectrum disorder intervention in a low-resource South African setting. We conducted four focus groups and four in-depth interviews with 28 caregivers of young children with autism spectrum disorder and used thematic analysis to identify key themes. Eight contextual factors including culture, language, location of treatment, cost of treatment, type of service provider, support, parenting practices, and stigma emerged as important. Caregivers reported a preference for an affordable, in-home, individualized early autism spectrum disorder intervention, where they have an active voice in shaping treatment goals. Distrust of community-based health workers and challenges associated with autism spectrum disorder-related stigma were identified. Recommendations that integrate caregiver preferences with the development of a low-cost and scalable caregiver-mediated early autism spectrum disorder intervention are included.
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Affiliation(s)
- Jessy Guler
- Clinical Child Psychology Program, University of Kansas, USA
| | - Petrus J de Vries
- Division of Child & Adolescent Psychiatry, University of Cape Town, South Africa
| | - Noleen Seris
- Division of Child & Adolescent Psychiatry, University of Cape Town, South Africa
- Department of Psychology, University of Cape Town, South Africa
| | - Nokuthula Shabalala
- Division of Child & Adolescent Psychiatry, University of Cape Town, South Africa
- Department of Psychology, University of Cape Town, South Africa
| | - Lauren Franz
- Department of Psychiatry and Behavioral Sciences and Global Health, Duke University, USA
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Najafabadi MG, Sheikh M, Hemayattalab R, Memari AH, Aderyani MR, Hafizi S. The effect of SPARK on social and motor skills of children with autism. Pediatr Neonatol 2018; 59:481-487. [PMID: 29402579 DOI: 10.1016/j.pedneo.2017.12.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 04/03/2017] [Accepted: 12/19/2017] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND This study aimed to evaluate the effectiveness of a selected group exercise known as Sports, Play and Active Recreation for Kids (SPARK) on the motor and behavioral skills of children with autism spectrum disorder (ASD) using a quasi-experimental design with repeated measures. METHODS Twenty-eight children with ASD (age range of 5e12 years) participated in this study. The participants were examined at baseline, pre-test, and post-test using Bruininks-Oseretsky Test of Motor Proficiency (BOTMP), Autism treatment evaluation checklist (ATEC), and Gilliam Autism Rating Scale-second edition (GARS-2). RESULTS The results showed that the SPARK program significantly improved balance (static and dynamic), bilateral coordination and social interaction (p < 0.05) in children with ASD. CONCLUSION The results of this study suggest that the SPARK's training can be considered as a therapeutic option not only for motor enhancement but also for improving social skills in children with ASD.
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Affiliation(s)
- Mahboubeh Ghayour Najafabadi
- Department of Motor Behaviour, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran.
| | - Mahmoud Sheikh
- Department of Motor Behaviour, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
| | - Rasoul Hemayattalab
- Department of Motor Behaviour, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
| | - Amir-Hossein Memari
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Rezaii Aderyani
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sina Hafizi
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
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Stuckey R, Domingues-Montanari S. Telemedicine is helping the parents of children with neurodevelopmental disorders living in remote and deprived areas. Paediatr Int Child Health 2017; 37:155-157. [PMID: 28498062 DOI: 10.1080/20469047.2017.1315914] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Telecommunication technologies are advancing rapidly with huge investment to improve infrastructure in rural areas. Telemedicine brings the benefits of telecommunication to healthcare, especially in resource-limited and remote communities. The recent literature on telemedicine in paediatrics will be reviewed, with particular focus on its application to help children with neurodevelopmental disorders and their families living in remote regions and/or low-income countries, and gaps identified for future research. Studies show that telemedicine can enable a family's access to appropriately qualified help that physically may only be available hundreds of miles away, helping to overcome geographic barriers. Telemedicine can also train parents and equip them with the knowledge and skills to better care for their children. Despite some technological barriers to implementation, telemedicine can help transform all stages of autism treatment. However, more studies are required in low- and middle-income countries to fully elucidate the benefits offered by telemedicine to autistic children and their families.
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Bello-Mojeed MA, Omigbodun OO, Bakare MO, Adewuya AO. Pattern of impairments and late diagnosis of autism spectrum disorder among a sub-Saharan African clinical population of children in Nigeria. Glob Ment Health (Camb) 2017; 4:e5. [PMID: 28596906 PMCID: PMC5454767 DOI: 10.1017/gmh.2016.30] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 11/11/2016] [Accepted: 12/02/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Autism spectrum disorder (ASD) is a complex group of neurodevelopmental disorders. Studies conducted among Africans living outside the continent indicate that African children are more likely than Caucasian children to have a late diagnosis of ASD. There is a dearth of information on this topic among children with ASD living in Africa. METHODS To determine the pattern of impairments and age at diagnosis in ASD, sixty Nigerian children with a diagnosis of ASD were recruited from a neurodevelopmental clinic. DSM-V criteria were used to make a diagnosis of ASD, while a symptom checklist for ASD was used to determine the pattern of impairments in ASD. RESULTS Ages of the children ranged from 2 to 17 years with a mean age of 9.45 ± 4.33 years with the majority of them (75%) being 12 years or younger. All the children (100%) with ASD exhibited poor eye contact, difficulty in mixing with other children and inability to consistently respond to his/her name. More than a half of them (55%) lack verbal communication. Impairments that were uncommon are in the areas of object attachment (20.0%), odd postures (26.7%) and inappropriate facial expression (30.0%). Mean age at the observation of ASD features was 17.0 ± 6.7 months. Mean age at diagnosis of ASD was 9.00 ± 4.30 years. The mean time lag from a parental concern of ASD features to seeking specialist care was 85 months and to diagnosis was 91 months. CONCLUSIONS Core symptoms/impairments of ASD are present in Nigerian children but a late diagnosis is common.
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Affiliation(s)
- M. A. Bello-Mojeed
- Child and Adolescent Mental Health Service Centre, Federal Neuro-Psychiatric Hospital, Lagos, Nigeria
- Childhood Neuropsychiatric Disorders Initiatives, Nigeria
| | - O. O. Omigbodun
- Department of Psychiatry, University College Hospital, Ibadan, Nigeria
| | - M. O. Bakare
- Childhood Neuropsychiatric Disorders Initiatives, Nigeria
- College of Medicine, Enugu State University of Science and Technology (ESUT), Enugu, Nigeria
- Child and Adolescent Unit, Federal Neuro-Psychiatric Hospital, New Haven, Enugu, Nigeria
| | - A. O. Adewuya
- Department of Behavioural Medicine, Lagos State University College of Medicine, Lagos, Nigeria
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