Autism in Kenya and its Prevalence
By Anthony M. Wanjohi.
Autism is a disorder of neural development
characterized by impaired social interaction and communication, and by
restricted and repetitive behavior. The signs usually begin before a child is
three years old (Autistic disorder, 2000). Autism has a strong
genetic basis, although the genetics are complex. It is unclear whether
the Aspersers syndrome (ASD) one of the three recognized
disorders is explained more by rare mutations, or by rare combinations of
common genetic variants (Abrahams, 2008). In rare cases, autism is
strongly associated with agents that cause birth defects (Stodgell,
2005).
According to Doshen, (2008) the term "autism spectrum" refers
to a range of developmental disabilities that include autism as well as other
disorders with similar characteristics. Shriver, (2010) observed that
different people with autism can have very different symptoms. Health care
providers think of autism as a spectrum disorder, a group of disorders with
similar features. One person may have mild symptoms,
while another may have serious symptoms. But they both have an autism
spectrum disorder. There are various types of the autism disorders:
· Autistic Disorder or “classic autism”
· Asperger Syndrome
· Pervasive Developmental Disorder or "atypical autism"
In some cases, health
care providers use a broader term, pervasive developmental disorder, to describe
autism. This category includes the autism spectrum disorders above, plus
Childhood Disintegrative Disorder and Rett syndrome.
This paper examines
closely Asperger syndrome. The sections covered include
definition of the syndrome, symptoms of Asperger syndrome, prevalence of
Autism in Kenya, history of diagnosis and treatment and interventions.
Asperger syndrome
is a pervasive developmental disorder that is characterized by an inability to
understand how to interact socially. Typical features of the syndrome also may
include clumsy and uncoordinated motor movements, social impairment with
extreme egocentricity, limited interests and unusual preoccupations, repetitive
routines or rituals, speech and language peculiarities, and non-verbal
communication problems.
2.1 Symptoms
of Asperger syndrome
Because the symptoms
of Asperger syndrome are often hard to differentiate from other
syndromes, it's best to let a doctor or other health professional evaluate your
child's symptoms. According to Doshen, (2008)
the key symptoms that would differentiate this syndrome include the
following:
· Inappropriate or minimal social interactions
· Conversations almost always revolving around
self rather than others
· "Scripted," "robotic," or
repetitive speech
· Lack of “common sense"
· Problems with reading, math, or writing skills
· Obsession with complex topics such as patterns
or music
· Average to below-average nonverbal cognitive
abilities, though verbal cognitive abilities are usually average to
above-average
· Awkward movements
· Odd behaviors or mannerisms
2.2 Prevalence of Autism
in Kenya
Autism in Kenya
Autism is a devastating
and complex developmental disorder affecting approximately 4% of the Kenyan
population. (Autism Society of Kenya, 2007).
Due to prevalence of
Autism in Kenya, there are certain societies that have been founded in the
recent times. For instance, one such organization is.Autism Society of Kenya. This
organization came into being in September 2003 when a group of parents who had
autistic children decided to form a society that could advocate for theirs and
their children's needs. The Society offers diagnosis and assessment, produces
literature about autism and provides counseling services and run autism
awareness workshops all over Kenya.
In an effort to cater
for the autistic children, a unit was established in City Primary School in
Nairobi in September 2003 by a group of parents of Autistic children who saw a
need for an educational program tailor made for such children. The unit
currently has 40 children whose ages range from 3 years to 16 years. This is
just but a small percentage of the overall over 500 children in the Nairobi
area alone who have been assessed and found to be autistic.
Today, many schools and
special units combine all people with disabilities into one group irrespective
of the fact that different disabilities require different programs and ways of
handling the individual.
In order to protect the
rights of the disabled, more especially those who are mentally challenged (as
in the case of autistic persons), the Government of Kenya passed a disability
Act in 2003 under which it is an offence to conceal
or imprison the mentally ill or disabled person
2.3 History of diagnosis
and treatment
From the early 1900s,
autism has referred to a range of psychological conditions.
The word
"autism," which has been in use for about 100 years, comes from the
Greek word "autos," meaning "self." The term describes
conditions in which a person is removed from social interaction hence, an
isolated self. Eugen Bleuler,
a Swiss psychiatrist, was the first person to use the term. He started using it
around 1911 to refer to one group of symptoms of schizophrenia. In the 1940s,
researchers in the United States began to use the term "autism" to
describe children with emotional or social problems. Leo Kanner, a doctor from Johns Hopkins University, used it to
describe the withdrawn behavior of several children he studied. At about the
same time, Hans Asperger, a scientist in Germany, identified a similar
condition that now called Asperger syndrome. Autism and schizophrenia
remained linked in many researchers’ minds until the 1960s. It was only then
that medical professionals began to have a separate understanding of autism in
children. From the 1960s through the 1970s, research into treatments for autism
focused on medications such as LSD, electric shock, and behavior change
techniques. The latter relied on pain and punishment. During the 1980s and
1990s, the role of behavior therapy and the use of highly controlled learning
environments emerged as the primary treatments for many forms of autism and
related conditions. Currently, the cornerstone of autism therapy is behavior
therapy. Other treatments are added as needed (Hirsch, 2009).
According to Stokes
(2010) the child with Asperger's will need to be directly taught
various social skills (recognition, comprehension and application) in
one-to-one and/or small group settings. Social skills training will also be
needed to generalize previously learned social skills from highly structured
supportive contexts to less structured settings and, eventually, real-life
situations. It is important to emphasize that children
with Asperger's Syndrome will not learn social relations by watching
other people, or by participating in various social situations. They tend to
have great difficulty even recognizing the essential information of a social
situation, let alone processing / interpreting it appropriately. Tools for
teaching social skills is the best intervention to child
with Asperger's these include the following:
Social Stories - The use of Social Stories and
social scripts can provide the child with visual information and strategies
that will improve his understanding of various social situations. In addition,
the Social Stories/scripts can teach the child appropriate behaviors to exhibit
when he is engaged in varied social situations. The repetitious
"reading" of the Social Story/script makes this strategy effective
for the child with Asperger's Syndrome. A 3-ring binder of Social
Stories/scripts kept both at home and school, for the child to read at his
leisure, has proven very successful for many students
with Asperger's Syndrome
Role-playing -This takes place by role-playing various social situations which
can be an effective tool for teaching a child appropriate social responses.
Video-taping/audio-taping - This takes place by video-taping/audio-taping both appropriate
and inappropriate social behaviors can assist the child in learning to identify
and respond appropriately to various social situations.
Lunch/recess
club -This is a structured lunch/recess time with
specific peers to focus on target social skills for the child
with Asperger’s Syndrome. This strategy can assist in generalizing social
skills previously learned in a structured setting.
Comic
Strip Conversations This can be used to visually clarify social
interactions and emotional relations. Peer partners/buddies: Specific
peer(s) can be chosen to accompany and possibly assist the child
with Asperger's Syndrome during less structured social situations and
when experiencing social difficulties (e.g., out of class transitions, recess,
lunch, etc.). This peer support network should initially be established in a
small group setting.
Individualized visual
social "rule" cards can be taped to the child's desk as a visual
reminder regarding appropriate social behaviors to exhibit. Portable
"rule" cards can be used for environments other than the classroom.
The rules can be written on index cards, laminated, and then given to the child
to carry along as visual reminders of the social "rules" for any
particular context.
Since autism related
disorders usually develops within the first 30 months of age, and are usually
diagnosed by the age of 3, prevention must take place very early, or even pre-natally. According to Autism Society of Kenya
(2007), the following are prevention measures that parents and caregivers
should generally consider as preventive measures -
Insist on early
screening for autism with your pediatrician if any behavioral problems, such as
not using language as a form of expression, are noted before the age of 2.
Children should be "babbling" and using hand gestures, such as
pointing, by 12 months of age, and using single words by 16 months. Phrases
combining two words should be used by the second birthday.
Ask for genetic testing
if the child exhibits any lack of social or verbal development before the age
of 2. Children should be tested for high resolution chromosome studies, known
as karyotype.
Schedule metabolic
testing to prevent the onset of autism, especially if the child vomits on
excessive occasions. This
may indicate metal toxicity or other poisoning in the bloodstream.
Investigate the possibility that
vaccinations may have a role in the occurrence of autism, especially the MMR
vaccine used for rubella, the mumps and measles. Remember that the evidence of
these vaccines and other ones containing trace amounts of mercury,
causing autism are still inconclusive.
Avoid eating foods that may contain unsafe
levels of mercury during pregnancy, such as seafood. There is a growing amount
of evidence that links the incidence of autism to metal toxicity in the
bloodstream.
Communicate constantly with your pediatrician
about the latest research developments in the study of autism and its causes.
While much of the evidence is either contradictory or inconclusive, the overall
picture as to the possible causes of autism has become much clearer in the last
few years.
Autism interventions
attempt to lessen the deficits and family distress associated with autism and
other autism spectrum disorders (ASD), and to increase the quality of life and
functional independence of autistic individuals, especially children. No single
treatment is best, and treatment is typically tailored to the child's needs.
Treatments fall into two major categories: educational interventions and
medical management. Educational intervention can bring about change
of attitude. This is the most important step as disability, especially in most
of the African cultures may be taken as a curse. Thus, education to
change in attitude about various disorders is the first step towards
establishment of accommodative family and society at large.
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of Kenya (2007). Autism in Kenya. Available
online at http://nairobist.com
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Stokes (2010).Children
with Asperger's Syndrome: Characteristics/Learning Styles and
Intervention Strategies.
Shriver, E.K., (2010). Autism Spectrum Disorders (ASDs).
Retrieved October 13, 2010
from http://www.nichd.nih.gov/health/topics/asd.cfm
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Suggested citation in
APA
Wanjohi, A.M. (2010). Autism In Kenya And Its Prevalence.KENPRO Publications.
Available online at http://www.kenpro.org/papers/autism-in-kenya.htm
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