Abstract
Early identification of children with autism is necessary to support their social and communicative skills and cognitive, verbal, and adaptive development. Researchers have identified several barriers to early diagnosis. Data collected in low- and middle-income contexts—where the vast majority of children in the world live—is scarce. In Ecuador, as in many other countries, estimates are lower compared to the global prevalence. Health authorities estimate a prevalence of 0.28% (0.18%–0.41%) in children aged five years old or less. Based on the hypothesis that, as in many parts of the world, children in Ecuador are not routinely screened and that this situation may result from poor recognition of this condition, our objective was to identify potential obstacles to case identification in pediatric settings. Several barriers, consistent with those identified in other countries, were reported by 153 participants on a survey, including lack of time, lack of resources to refer, fear of unnecessarily alarming families, and lack of information to guide families with concerns. The vast majority of participants are aware of the need for a screening tool for autism detection but report a lack of knowledge of its formal application. Most of the barriers reported in this study could be overcome by educational programs tailored to professional needs in order to support the well-being of children with autism and their families.
Highlights
Autism Spectrum Disorder (ASD) is defined by a heterogeneous group of behavioral symptoms that emerge over the first years of life and is characterized by difficulties in social communication, repetitive behaviors, and restricted interests [1]
As they are in contact with families of young children, pediatricians and family physicians can play an essential role in the early identification of ASD
Universal screening for autism in young children in general pediatric settings remains a challenge in many countries worldwide
Summary
Autism Spectrum Disorder (ASD) is defined by a heterogeneous group of behavioral symptoms that emerge over the first years of life and is characterized by difficulties in social communication, repetitive behaviors, and restricted interests [1]. Estimates can vary considerably between studies, regions of the world, and over time, due to differences in sampling techniques, participant’s symptoms’ severity, inclusion criteria, and the degree of qualification of professionals who evaluate the cases. ASD is characterized by a range of co-occurring conditions, such as epilepsy, which will affect at least 20–30% of individuals with ASD at one point during their lives [11]. Similar percentages of these individuals will be affected by gastrointestinal conditions [12] or sleep problems [13]
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