Characteristic Features of Autism in the Nigerian Population

Background:  

The African continent is yet to benefit from the advances made in autism research. This is partly due to misconception about the disorder and its aetiology and mostly due to lack of public awareness even amongst health care givers and the elite is not exonerated. Recently, in Nigeria the awareness of autism has increased tremendously especially in urban cities such as Lagos, however a lot still need to done on the proper description of the Nigerian autistic population so as to allow for tailored management.

Objectives:  

The present study aims to describe the clinical presentations of individuals with autism in Nigeria.

Methods:  

A content validated and researcher developed questionnaire, the Autism Phenotype Questionnaire (APQ) was designed highlighting characteristic features of autism. The APQ consists of 26 semi-structured items/questions divided into two sections. The first section comprises of questions on demographic data while the second section consists of 9 sub-categorical autistic features with a total of thirty-eight options each treated as a variable. A total of five special centers (4 private and 1 government owned) participated in the study and parents, care givers and attending therapists were the respondents of the study. All participants had been previously diagnosed with ASD using the DSM-1V (APA, 2000). Statistical analyses were done using IBM SPSS version 20.

Results:  

With a Cronbach’s alpha of 0.69, the APQ was deemed reliable for the study. A total of 110 dully filled questionnaire analyzed. Observed mean age was 9.14±5.92 years with an age range of 3-32 years and male: female ratio of 2.36:1. A total of 87.27% (96/110) of the cases had other unaffected siblings. The highest percentage age distribution was observed in the 5-9 years age group (50 %; mean ± SD - 6.852±1.459) this is a reflection of the late presentation to clinics of individuals with autism by their families and thus late diagnosis. Of all the associated features, sensory abnormalities (Self Stimulatory Sensory Behaviour) had the least percentage presentation (50%), followed by Self  Injurius behaviour (SIB-58.2%), Sensitivities (80.9%), Tantrums (87.3%) and Self Stimulatory Motor Behaviour (89.1%). No significant difference was observed in the frequencies of reported features by gender and age-group classification with the exception of sensory impairment (F = 4.264. df = 1 p = 0.039) between gender. 

Conclusions:

The late age of diagnosis of autism in Nigeria and other African countries could be as a result of the late help-seeking nature of affected families often due to societal stigmatization. We propose that the APQ can be utilized as a screening tool for autism in Nigeria as it is suitable for the average age of clinical presentation.