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Autism poses special challenges in Africa

The 4-year-old Cote d'Ivoire boy could not walk, talk or feed himself. He was so different from most other children that his grandparents were reluctant to accept him. The slightly older Kenyan boy was so restless that his primary school teachers beat him until they realized he was a star pupil.

The two children reveal different faces of autism – and how society sometimes reacts to this condition.

Videos of the boys appear in "Autism: Breaking the Silence," a special edition of VOA's Weekly Program Straight Talk Africa . It was recorded on Wednesday in front of a small studio audience by people who live with the situation or deal with it professionally.

About 45 minutes after the program, Benie Blandine Yao from Ivory Coast holds her 4-year-old son, who has autism.

The program aims to demystify and deepen the understanding of autism spectrum disorders. It affects the normal development of the brain and often interferes with an individual's ability to communicate, interact socially, or control behavior. The condition can range from easy to difficult.

New CDC Findings

New findings released by the Centers for Disease Control and Prevention this week suggest an increase in the prevalence of autism in the United States [1

96592002] Agency estimates it affects 1 in 59 children, from 1 in 68 years ago a few years ago and 1 in 150 to nearly two decades ago. The study is based on studies of more than 300,000 eight-year-olds in 11 US states.

Worldwide, one in 160 children has an Autism Spectrum Disorder, reports the World Health Organization. In low- and middle-income countries, autism rates are more difficult to determine, including in sub-Saharan Africa with limited access to clinicians.

Everywhere, "poor people are diagnosed later," Scott Badesch, president of the Autism Society of America, said in a video review that sets the stage for discussion. "… There are more services today than ever before, but there is nowhere near the services needed for those who need help."

A complex state

Stigma and superstition can increase the challenges.

Parts of Africa, young people with autism "are called devils, and they are not diagnosed and are not treated," the audience commented on Sierra Leone-born Bernadette Kamara, who runs the BK Behavioral Health Center in suburban Washington ,

Some people believe that the disorder is punishment for a parent's bad behavior or suffering that can be prayed, said Mary Amoah, who was shown with 15-year-old daughter Renata in a related VOA video.

"You do not understand that this is a purely medical condition, it can happen to anyone, regardless of your background," said Amoah, coordinator of a treatment center in Accra, Ghana, for disabled children. "In our part of the world, much needs to be done in terms of education, acceptance and understanding."


Researchers have not identified the exact cause of autism, although they cite genetic and environmental factors.

Panelist Susan Daniels, who directs the Autism Research Coordination Office for the National Institute of Mental Health, part of the US National Institutes of Health, emphasized that the research supported by NIH and CDC is not linked to vaccines In childhood,

even though the state does not have a cure, early intervention shows the quality of life of people with motorism and their family improvers.

Parents need to closely monitor their children from infancy. Usifo Edward Asikhia, Clinical Director of the International Training Center for Applied Behavioral Analysis in Lagos, Nigeria

"If you have a baby that is 12 years old [months] that can not babble, that's a signal," he said. Another reason is the inability to detect objects, a sign of low muscle tone in autism.

Other hallmarks include lack of eye contact or sensitivity to noise, said Daniels. She added that a definitive diagnosis "can not be done properly until the age of two, but most children will not be diagnosed by then."

"Children with autism in Africa are diagnosed on average about four years later at the age of about eight years, as their American counterparts report," the Spectrum Autism Research News website reported in December.

  Health reporter Linord Moudou moderates a panel discussion on autism for

Health reporter Linord Moudou moderates a podium discussion on autism for "Straight Talk about Africa."

Call for cultural sensitivity

Some of these indicators could mislead in assessing African children, said panelist Morenike Giwa Onaiwu, a Texas-based member of the Autism Women's Network. [19659002] "In many African cultures, it is not common to make direct eye contact, it is not a red flag," said Onaiwu, whose parents came from Nigeria and learned that she was autistic only if two of her own six children were positive identified with autism. "Speaking of not babbling, we speak when we have something to say … Certain things can be overlooked culturally because diagnostic criteria are considered by Western standards."

While autism is generally associated with low IQ, The condition also affects people with high mental abilities.

If they can somehow express themselves, they are geniuses indeed, "said panelist Tracy Freeman, a Washington physician with an autistic child. "Their challenge is neurodiversity and getting people to recognize their intelligence."

  Morenike Giwa Onaiwu of Autism Women's Network Clings to

Morenike Giwa Onaiwu of the Autism Women's Network clutching a "stiming" device while talking. 19659026] At one point in the discussion, presenter Linord Moudou noted that Onaiwu was spinning a metal spool in her hands. Onaiwu explained that the reused Christmas Ornament is a "stimulating" device for repetitive movements that allows a relaxing sensory stimulation.

"It helps to calm me down," said Onaiwu. She has other strategies: "Sometimes you might see me rocking … This species helps me to navigate the neurotypical world."

Growing role for governments?

Asikhia said that families dealing with autism have little public support in Nigeria or elsewhere in Africa. Most schools have no education in development delays that should be marked for physicians, he said.

"These teachers just do not know what to do," he added.

Many African countries have no laws that provide public education or health services to adolescents with autism or other developmental disorders

But Chiara Servili, a child neuropsychiatrist and WHO mental health consultant, is seeing increasing interest. Representatives from more than 60 countries endorsed a WHO resolution in 2014 calling on member states to develop policies and legislation to "reduce the global burden of mental disorders" and "provide adequate human, financial and technical resources".

to improve child mortality, she said in a telephone interview. Now there is "much more awareness, not only that they are surviving, but thriving." There is a new focus on early childhood development. "

The WHO is seeking support for family caregivers, teachers, social workers, and other professionals in positions to improve clinical evaluation, Servili said. As a partner, the organization has developed a guide for carers, mostly parents, to help children with developmental disabilities , For example, "we teach them strategies to help kids get involved, put them on the level of the child, put some toys or items out of the house, watch what the kid is doing, and try to follow the lead, "Servili said. "… reinforce every communication attempt."

For a copy of the WHO Caregiver Skills Training Program, contact servili at [email protected]

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