Abstract
BackgroundChildren with neurological disorders are more likely to present with autism spectrum disorder (ASD) symptoms and get an ASD diagnosis. Despite the large burden of childhood neurological disorders in Uganda, there is limited information on ASD amongst children with neurological disorders in Uganda.AimThe aim of this study was to determine the prevalence and factors associated with ASD symptoms amongst children attending the paediatric neurology clinic.SettingThe study was conducted at the paediatric neurology clinic of Mulago National Referral Hospital in Uganda.MethodsThis was a cross-sectional study of 318 children aged 2–9 years. After obtaining consent, a socio-demographic questionnaire and the Social Communication Questionnaire were administered to the caregivers of the children. Additional questions were administered to assess the prenatal, birth and postnatal characteristics of the children. Sample characteristics were described using frequencies and means. Bivariate analysis was carried out using chi-square test and Fisher’s exact test. Multiple logistic regression models were used to assess which factors were independently associated with ASD symptoms.ResultsThe mean age of the children was 5 years and 58.2% were males. The prevalence of significant ASD symptoms was found to be 45%. Factors negatively associated with significant ASD symptoms were female sex (odds ratio [OR] 0.48 [95% CI 0.24, 0.98]) and ability to speak (OR 0.09 [95% CI 0.04, 0.2]). The history of delayed developmental milestones was positively associated with significant ASD symptoms (OR 3.3 [95% CI 1.59, 6.84]).ConclusionThe prevalence of ASD symptoms is high in children with neurological disorders. Children, especially those with delayed developmental milestones, should routinely be screened for ASD.
Highlights
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterised by persistent deficits in social communication and social interaction and restricted and repetitive behaviours, interests and activities.[1]These deficits occur in multiple contexts and are characterised by deficits in socio-emotional reciprocity, verbal and non-verbal communication used for social interaction and difficulty in developing and maintaining relationships.[2]
Factors negatively associated with significant ASD symptoms were female sex and ability to speak
The history of delayed developmental milestones was positively associated with significant ASD symptoms
Summary
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterised by persistent deficits in social communication and social interaction and restricted and repetitive behaviours, interests and activities.[1] These deficits occur in multiple contexts and are characterised by deficits in socio-emotional reciprocity, verbal and non-verbal communication used for social interaction and difficulty in developing and maintaining relationships.[2] These features vary depending on age, culture and intellectual ability. An early feature of social communication deficit in ASD is impaired joint attention that manifests as lack of pointing, showing or bringing objects to share interests with others or failure to follow someone’s pointing or eye gaze.[3] Deficits in socio-emotional reciprocity, which is the ability to engage with others and share feelings, include little or no initiation of conversation or other forms of interaction with others and decreased or absent imitation of others. Despite the large burden of childhood neurological disorders in Uganda, there is limited information on ASD amongst children with neurological disorders in Uganda
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