Autism Spectrum Disorder In South Africa Research Articles

A narrative review of acupuncture treatment for Autism Spectrum disorder

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterised by impaired reciprocal social communication and interaction, as well as restrictive behaviours, interests, and activities. Researchers estimate that approximately 2% of the South African population is affected by ASD. The prevalence of ASD in South Africa remains unknown, and minimal research has been conducted within the schooling systems to accurately inform the rates, distribution, and profile of needs for children with this disorder. The aim of this study was to conduct a narrative review of acupuncture treatment for ASD. A literature search targeted sources with the highest level of evidence and relevance to the topic. Searches were conducted on credible databases, focusing on high-quality publications with the most up-to-date information. A small number of studies (n=6) met the criteria for this narrative review. The studies reported statistically significant improvements in areas such as cognition, comprehension, social interaction, behaviours, speech and language, as well as food and noise sensitivity. Treatment was well tolerated, with minimal adverse effects. It may be concluded that there is evidence supporting the efficacy of acupuncture treatment for ASD; however, the quality of the studies has been relatively poor, and the sample sizes were insufficient. Research on this topic is still in its early stages, and these findings need confirmation through further high-quality research.

The needs of individuals with autism spectrum disorder when transitioning into the labour market

INTRODUCTION: South Africa, like other regions of the world, has an increasing prevalence of autism spectrum disorder (ASD). The transition of these individuals into the labour market is of concern. The aim of this study was to explore the perceptions of individuals with ASD and their parents in terms of their unmet needs in relation to transitioning into the labour market and the role an occupational therapist can play METHODS: A qualitative explorative descriptive research method was used. Purposive sampling selected young adults with ASD currently or previously employed in the open labour market. Data were collected using email interviews with individuals with ASD and face to face interviews with their parents. Data were analysed using inductive thematic analysis RESULTS: Two themes were identified: Transitioning was really hard, and Occupational therapists can do more. The results emphasised the lack of services in preparing adults with ASD for finding and maintaining employment, as well as suggestions for the role of occupational therapy in facilitating prevocational skills, job seeking skills and supported employment CONCLUSION: There is a lack of services for individuals with ASD transitioning into the labour market particularly in relation to vocational orientation and rehabilitation. Occupational therapists are ideally situated to provide services to meet needs of individuals with ASD transitioning into the world of work Implications for practice • Occupational therapists need to play a role in developing vocational rehabilitation services in preparation of individuals with ASD into the labour market. • There is a need to investigate what is currently offered and what can be added regarding occupational therapy programs supporting transition from school into employment for individuals with ASD in South Africa. • Vocational rehabilitation services and transition programs should be developed in conjunction with individuals with ASD to ensure issues that are relevant to the population of individuals with ASD are addressed.

Clinical utility of three sensory modulation measures for the child with ASD in South Africa: A practitioner's perspective

ABSTRACT BACKGROUND: There is need for the assessment of sensory modulation in children with Autism Spectrum Disorder (ASD) to be culturally, environmentally, economically and language sensitive to the South African population. It is assumed that the measures in current use are not appropriate, acceptable, practical or accessible for the South African child with ASD AIM: This study sought the practitioners' perspective on the clinical utility of three sensory modulation measures for children diagnosed with ASD in South Africa METHODS: A quantitative survey method was used to collect data from a purposive sample of 31 SAISI Occupational Therapy members nationwide RESULTS: Urban participants accounted for 83% of the sample, 80% were in private practice and 67% from English-speaking practices. All three measures demonstrated some level of clinical utility. The Sensory Processing Measure (SPM) was found to be more appropriate than the Sensory Profile (SP) (p<0.007), although the SP was more accessible than the SPM (p<0.002). Amongst non- English speakers the Sensory Experiences Questionnaire (SEQ) was more acceptable than the SPM (p<0.045 RECOMMENDATIONS: The SPM should be used in an interview format, with recommended changes and translation into the caregivers' home language, until a South African specific sensory screening measure, which can be readily reproducible in several local languages, is developed Keywords: Sensory Profile, the Sensory Processing Measure, Sensory Experiences Questionnaire, culturally sensitive, language appropriate

Profiles of public and private autism-specific schools in Gauteng

Background: Despite inclusive education (IE) policies and legislation being introduced in South Africa (SA), learners with autism spectrum disorder (ASD) are still placed in autism-specific public and private schools. Limited data are available on who makes use of the two different types of schools. Results may provide information on the profiles and education of learners with ASD in Gauteng schools. Aim: A quantitative, cross-sectional, comparative research design was used to compare the profiles of autism-specific public with autism-specific private schools and learners in Gauteng Province. Setting: The research was conducted in two autism-specific public and two private schools. Methods: Two survey questionnaires were used to collect data from four principals of two autism-specific public and two autism-specific private schools and 150 caregivers of learners attending the participating schools. Results: Results showed that because of their size autism-specific public schools make a significant contribution to the education of learners with ASD in Gauteng, compared to autism-specific private schools. Autism-specific public schools offer more therapy services than the autism-specific private schools, despite lower fees than autism-specific private schools. Significantly more black learners attend autism-specific public schools than autism-specific private schools. Regardless of the differences in population groups across the participating schools, the mean age when caregivers became concerned about their child’s development was similar across the two types of schools. Learners enrolled at the autism-specific private schools were diagnosed with ASD earlier than learners enrolled at the autism-specific public schools. Also, they commenced school earlier than the learners in the autism-specific public schools. Lastly, three of the four principals expressed a preference that learners with ASD be placed in autism-specific schools. Conclusion: The results highlight the need to raise awareness of ASD symptoms among parents with young children in all communities and to determine the barriers that hinder IE for learners with ASD in SA.

Onset of Intervention for Learners in Autism-Specific Government-Funded Schools in South Africa

ABSTRACT Late identification of children with ASD remains a concern. Due to limited research in low and middle-income countries (LMICs) such as South Africa (SA), the early management of autism spectrum disorder (ASD) should be further explored. The aim was to describe the demographic characteristics and early management of ASD that may influence identification, diagnosis, and intervention of learners with ASD in SA. Participants included 234 (28.4% of total approached) caregivers of children with ASD enrolled at the only six autism-specific government-funded schools in SA. Data were collected from parent-completed questionnaires. The majority of caregivers became concerned about their child’s development on average at 25.2 months, but only a few (3.8%) thought it was ASD. Late identification was significantly associated with the respondent, nationality, qualification of the father and qualification of the mother. It appears that late identification sets a trajectory of late intervention. Factors underlying the trajectory appear to be unfamiliarity with ASD, and limited services and schools for children with ASD. Public awareness should focus on early symptoms associated with ASD risk to expedite early intervention.

Increasing global access to early intervention for young children with ASD

In their recent paper, “Caregiver descriptions of joint activity routines with young children with autism spectrum disorder in South Africa”, Ramseur and colleagues examined the applicability of an early intervention model for children with autism spectrum disorder (ASD), which was developed and validated in more highly resourced settings, to the diverse cultural context of South Africa (1). They highlighted the importance of this work by noting the dearth of ASD research on the African continent; for example, Africa is yet to see an ASD prevalence study, and as of 2017, a scoping review identified only 53 peer-reviewed publications on ASD published in sub-Saharan Africa (2). Moreover, none of the publications focused on early intervention in Africa. Thus, Ramseur et al .’s study represents an important step forward in addressing the needs of children with ASD in South Africa.

Caregiver descriptions of joint activity routines with young children with autism spectrum disorder in South Africa.

Coaching caregivers to deliver Naturalistic Developmental Behavioral Intervention (NDBI) strategies to their young child with autism spectrum disorder (ASD) could help address the provider capacity barrier in sub-Saharan Africa. However, the behavioral and developmental research that underpins NDBIs is overwhelmingly drawn from high resource settings. Therefore, our understanding of joint activity routines, including play and family routines in which NDBI strategies are embedded, may have limited applicability in low resource, culturally diverse environments. Important questions remain on how to adapt NDBIs to be relevant in the family lives in these settings. This study aimed to elicit descriptions of joint activity routines from caregivers of young children with ASD in South Africa, to understand whether an NDBI-informed caregiver coaching could 'fit' within the multicultural, multilingual South African context. Four focus groups were conducted with 22 caregivers of young children with ASD who were recruited from the Western Cape Education Department autism waiting list. Data were analyzed through directed content analysis, which uses inductive methods to determine salient themes and subthemes. The predetermined initial coding classifications were based on joint activity routine categories of object-based play, sensory social routines, and family routines. Participants' descriptions of caregiver-child interactions aligned with a-priori joint activity routine categories. During object-based play, caregivers engaged in turn-taking, taught developmental skills (for example cognitive, language, and fine motor skills), and participated in child-directed activities. During sensory social routines, caregivers described active, physical play, awareness of child affect, increased child expressive language, and willingness to engage with different play partners. During family routines, caregivers detailed child participation in mealtime and bath time. These data suggest that South African caregivers of young children with ASD use joint activity routines to engage their children and teach them new skills, thus suggesting a degree of 'fit' between South African caregiver-child interactions and an NDBI-informed caregiver coaching approach. However, more information on family routines and which caregiver interacts with the young child with ASD during these routines would help tailor these interventions for low-resource African settings.

Feasibility of utilizing autism navigator® for primary care in South Africa.

There is a significant research-to-practice gap in early detection of young children with autism spectrum disorder (ASD) worldwide but particularly in low- and middle-income countries (LMICs) where expertise is limited and high-quality training is difficult to access. Autism Navigator® for Primary Care is a web-based course designed to increase awareness of red flags of ASD in the second year of life and thus promote earlier detection and referral for intervention. It contains extensive video illustrations that offer rapid access to multiple exemplars of ASD red flags. This study examined aspects of feasibility of the Autism Navigator® for Primary Care in one LMIC, South Africa. A mixed-methods quasi-experimental design was used to examine relevant professionals' implementation of the course and measure changes in their knowledge of red flags after training. Perceptions of the acceptability, demand, and practicality of the course were explored in focus groups. Sixty-two providers completed the course online with a 94% completion rate. Built-in learner assessment pass rates ranged from 88% to 100%. Second-language English speakers took longer to complete the learner assessments, and professionals with less access to the Internet spent less time in the course. Participants' perceptions of the acceptability, demand, and practicality of the course were mostly positive with some suggestions made for local conditions. Results supported the feasibility of the course in this LMIC with some supports required pertaining to language and Internet access. We propose that this training has the potential to lower the age of detection of ASD in South Africa and other LMICs. Autism Research 2018, 11: 1511-1521. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Professionals in low- and middle-income countries urgently need training to recognize red flags of autism in very young children. The feasibility of utilizing the Autism Navigator® for Primary Care course for this training was explored with 62 South African professionals. After training, professionals' knowledge of early red flags improved, and most reported the course important and needed in South Africa. They found the web-based design mostly acceptable, practical, and culturally applicable. The course could help lower the age of autism detection.

Positive and negative cognitive appraisal of the impact of children with autism spectrum disorder on the family

BackgroundThis paper investigates the measurement of cognitive appraisal in the context of childhood disability in a middle-income country, and describes how South African families positively and negatively appraise the impact on the family of raising a child with autism spectrum disorder (ASD). MethodWe used the responses of 180 parents who completed the Family Impact of Childhood Disability (FICD) Scale, which was part of the survey data gathered in a larger study that examined the perspectives of families of young children with ASD in South Africa. Participating families were recruited from 35 disability-related service providers in the Gauteng province. ResultsOur findings provided preliminary evidence about the suitability of using the FICD Scale in the South African context. The results indicate that the participating families perceived the impact of their child with ASD as both positive and negative. ConclusionsThe results of this study supported the universal properties of positive and negative appraisal when raising a child with a disability. Like other families in other countries, the participating families perceived the impact of a child with ASD as both positive and negative and revealed that parents are able to re-create positive meanings about the impact of their child diagnosed with ASD.

A retrospective case report on demographic changes of learners at a school for children with Autism Spectrum Disorder in the Gauteng Province

Limited research has been published about the demographic characteristics of children with Autism Spectrum Disorder (ASD) in South Africa. Describing the profiles of learners from a school for children with ASD may contribute to local knowledge in the field. A retrospective comparative design was utilised to compare the demographic characteristics of learners over two time intervals: 1992-2002 (Group 1, n=32) and 2003-2014 (Group 2, n=109). A total of 141 historical admission records in paper-based files were reviewed. Results indicated that there is a large male gender bias (8.4:1) in learners, which increased over the years. The age of the child when parents first became concerned and the age at diagnosis and assessment at school increased over both time periods. There was also an increase in the diversity of home languages after 2002. Parental qualifications decreased, but social class improved in recent years. The low qualification of a mother was associated with an advanced age of the child at school entry. The data serves as a point of reference for future studies about the characteristics of school children with ASD in South Africa.