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Nigeria’s autism management suffers regulatory shortfall

Nigeria’s autism management suffers regulatory shortfall

The lack of regulatory oversight in the management of autism in Nigeria is fuelling a rise in professional malpractice, misleading the direction of early intervention for children diagnosed with autism, experts have cautioned.

They are increasingly worried that unsuspecting parents and guardians could be entrusting their child’s care to practitioners who lack appropriate professional training and end up receiving misapplied therapies.

Worsening this woe is the unavailability of academic programmes channelled at training in most tertiary institutions within the country, Lanre Duyile, a certified behaviour analyst at the Behaviourprise College of Business and Health Studies, Canada said speaking at the 12th Annual Autism Conference convened by Guaranty Trust Holding Company Plc. on Monday.

Children who need multidisciplinary support from speech to occupational therapists, behaviour analysts and psychiatrists among others are rather assessed by a single practitioner who feigns knowledge of all, Duyile lamented.

For him, an evidence-based therapy which involves a set of treatments or practices that are peer-reviewed and derived from evaluated research that shows real evidence of safety and effectiveness should be deployed by practitioners.

“I see different cases of people who are not fully qualified to carry out the work as if they are qualified. That is an avenue of serious malpractice. It is hit and miss,” he said.

“It is difficult for one professional to be able to work in multiple domains and provide the best support hence; families must seek and recruit specialised professionals rather than those who claim to be able to do everything.”

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While Nigeria has scant data on the population of people with autism, the World Health Organisation (WHO) estimates one in 160 children have autism spectrum disorder (ASD) globally.

Autism and attention deficit lead to the most common health conditions related to learning difficulties among children aged zero to 14 years, a 2011 World Report on Disability by the WHO and the World Bank shows.

Though people with disabilities, in general, are at higher risk of non-fatal injuries from road traffic crashes, burns, falls, and accidents related to assistive devices, the report says children with developmental disabilities were two to three times more at risk.

An autistic child might not speak early; exhibit oddity of behaviour; or suffer communication difficulties. Such a child could be withdrawn into his or her own world and might suffer comorbidities such as hyperactivity or seizure problems.

Muideen Bakare, chief consultant psychiatrist and head, Child and Adolescent Unit of the Federal Neuropsychiatric Hospital, Enugu called for a national representative study that can show the distribution of the disorder across different regions.

He noted that there are pockets of studies on prevalence in clinical settings or schools, which estimate about one to two percent of children in schools have ASD on average.

Bakare said cases of autism have become more frequent than in the last 10 years but noted that professionals were not sure if this is due to increased awareness, changes in social norms or an increase in the prevalence of the disorder.

“There are some cultural factors that have changed in how we raise children with extensive community support. These days, we are more inclined towards the nuclear family, depriving children of early interaction with peer groups. Play is an essential part of development for every child and the play system is with the peer-to-peer group,” Bakare said.

According to WHO, psychological and social interventions are effective at improving the communication and social skills of autistic children, with a positive impact on their well-being and quality of life.

Similarly, Oladipo Sowemimo, consultant emergency psychiatrist with the Neuropsychiatric Hospital, Aro Abeokuta urged that the autism spectrum be treated with a multidisciplinary approach to achieve the best improvements.