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@yahoo.com
Website - http://cndinitiatives.com/
- Community Perception of Autism
- Implication for social development
and learning in childhood
Diagnostic Profiling
Is 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.
Autism: The Previous Diagnostic Profiling
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
Asperger’s 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.
PLEASE, DON’T TELL ME I AM NORMAL: Faith
Jegede reflected on her two Brothers with Autism
Community Perception: Misdiagnosis &
Confusion with other Early Onset Neurological
Conditions
- Autism may be confused with some of the comorbid 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).
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.
Local Language Synonyms for Autism
in most African Sub-cultures
Hausa - ????
Igbo - ????
Yoruba - ????
Ijaw - ????
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).
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.
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).
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.
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).
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
Summary: Community Perception of Autism
in Africa as documented by VOA News
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/autism-spectrumdisorders-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.
THANK YOU!