Pattern of Behavioural Deficits Among Nigerian Children with Autism

Background: Beyond diagnosis of autism spectrum disorder (ASD), interventions are best if need-tailored and predicated on what is known about specific behavioural deficits.   

Objectives: This study is set to profile behavioural and emotional problems among children with ASD in a resource restricted setting.         

Methods: The study participants were made up of 100 children with ASD and their caregivers recruited during the annual autism project done in 2014 and 2015. This autism program is anchored through the collaborative partnership among College of Medicine, University of Lagos; Guaranty Trust Bank and Blazing Trail International, USA. A designed questionnaire was used to collect socio-demographic, clinical and psychosocial characteristics of the participants. Following screening with the Modified Checklist for Autism in Toddlers (M-CHAT) and Childhood Autism Spectrum Test (CAST), clinical diagnosis of ASD was done based on DSM-V criteria. Subsequently, the Strengths and Difficulties Questionnaire (SDQ) was used to profile behavioural and emotional problems across multiple dimensions among the participants. 

Results: The mean ages of the children, their mothers and fathers were 7.7(±5.7), 38.9 (±6.7) and 43.7 (±7.2) years respectively. Majority of the children (74%) were males and more than four-fifths of their mothers (87%) and fathers (81%) had tertiary education. Close to two-thirds (63%) of the children with ASD reported various degrees of difficulties as shown by overall SDQ score that ranged from high (39%) to raised (24%) difficulties.  The domain score on peer problems showed the worse level of deficits, with up to 80% reporting more than average difficulties, while 67%, 36% and 17% of participants reported considerable behavioural difficulties with respect to hyperactivity, prosocial and emotional issues respectively. All participants indicated this encounter to be their index evaluation despite 80.5% of them having had the behavioural problems for more than one year.      

Conclusions:  

Our study observed varying degrees of difficulties across the  behavioural dimensions of SDQ among children with ASD, with worse deficits reported on domains capturing “externalized symptoms”. Given the array of “unattended’’ behavioural problems profiled among children with ASD, there is need for sustained resources including research, training and intervention to address these behavioural challenges.