ASD in Developing Countries

There is vast research about the prevalence of Autism Spectrum Disorder (ASD) and the diagnostic tools and services offered to those with ASD in developed countries. However, in developing countries and less developed countries, the awareness of Autism is not as pervasive as in developed countries. Therefore, this blog aims to provide a brief introduction to the status of Autism research and care in developing countries. 

Reasons for low prevalence rate

Compared to developed countries, the prevalence rate of diagnosed ASD in developing countries is often lower. In developing countries, under-reporting and under-diagnosis are the main reasons for the low prevalence of ASD diagnoses (Taha & Hussein, 2014). Parents tend to wish their child to attend regular schools instead of special education, and most mental health clinicians are less experienced in diagnosing child developmental disorders including Autism (Samadi & McConkey, 2011). Cultural factors also come into play when there are differences in interpreting behaviors and higher tolerance of children’s behavior (Samadi & McConkey, 2011). The lack of awareness and culturally sensitive screening tools for ASD also affects the prevalence rate (Salari et al., 2022). On the other hand, a higher rate of cousin marriages in Arab culture is also an estimated factor linked to ASD (Taha & Hussein, 2014). 

The prevalence rate in different developing countries varies considerably, but the countries that have higher prevalence have a similar rate to developed countries, such as 23/1000 (2.3%) in the US (Maenner et al., 2018). To understand this better, consider the prevalence of Autism diagnoses in different Asian, Arab, and South American countries:

• 3.9/1000 (0.39%) in China (Wang et al., 2018)
• 2.04/1000 (0.2%) in Oman (Al-Mamari et al., 2019)
• 6.26/1000 (0.6%) in Iran (Samadi & McConkey, 2011)
• 3/1000 (0.3%) in Libya (Zeglam & Maouna, 2011)
• 0.17/1000 (0.01%) in Venezuela (Ametepee & Chitiyo, 2009)
• 18/1000 (1.8%) in Saudi Arabia (Al-Salehi & Ghaziuddin, 2009)
• 29/1000 (2.9%) in the United Arab Emirates (Eapen et al., 2007) 

It is important to note that in the more developed Arab countries, such as Saudi Arabia and the United Arab Emirates, the ASD prevalence rate is higher than other Arab countries due to more awareness about ASD. 

Treatments and care

With insufficient awareness about Autism, there are under-developed mental health services for children in developing countries (Hussein et al., 2011). Most mental health services in developing countries are in major cities and provided by private practices, and this could cause a financial burden to families (Al-Othman, 2010). In rural areas, limited service options lead to families relying more on informal support that lack professional training (Mendoza, 2010; Samadi SA & McConkey, 2011). With all that said, services such as Applied Behavioral Analysis (ABA) are available in some Arab countries like Qatar, the United Arab Emirates, and Bahrain (Taha & Hussein, 2014). 

Conclusion

There is a rising awareness about mental health disorders, including more attention to Autism, and this has led to an increased prevalence of diagnosed ASD worldwide, both in developed and developing countries (Uwaezuoke, 2015). However, more research is required to raise further awareness worldwide. This research can lead governments and private practices to implement more culturally inclusive interventions that could benefit people in need. With more public awareness, parents can notice early signs of Autism to find ways to support their children early on. Nonetheless, sufficient evidence-based services should be in place first for the needs of the families. 

References 

Maenner MJ, Shaw KA, Bakian AV, et al. Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2018. MMWR Surveill Summ 2021;70(No. SS-11):1–16. DOI: http://dx.doi.org/10.15585/mmwr.ss7011a1

Salari, N., Rasoulpoor, S., Rasoulpoor, S., Shohaimi, S., Jafarpour, S., Abdoli, N., Khaledi-Paveh, B., & Mohammadi, M. (2022). The global prevalence of autism spectrum disorder: A comprehensive systematic review and meta-analysis. Italian Journal of Pediatrics, 48(1). https://doi.org/10.1186/s13052-022-01310-w

Samadi, S. A., & McConkey, R. (2011). Autism in developing countries: Lessons from Iran. Autism Research and Treatment, 2011, 1–11. https://doi.org/10.1155/2011/145359

Qiu, S., Lu, Y., Li, Y., Shi, J., Cui, H., Gu, Y., Li, Y., Zhong, W., Zhu, X., Liu, Y., Cheng, Y., Liu, Y., & Qiao, Y. (2020). Prevalence of autism spectrum disorder in Asia: A systematic review and meta-analysis. Psychiatry Research, 284, 112679. https://doi.org/10.1016/j.psychres.2019.112679

Taha, G. R., & Hussein, H. (2014). Autism spectrum disorders in developing countries: Lessons from the Arab world. Comprehensive Guide to Autism, 2509–2531. https://doi.org/10.1007/978-1-4614-4788-7_98

Uwaezuoke, S. N. (2015). Autism spectrum disorder in children: The disparities between the developed and developing countries. Autism-Open Access, 05(03). https://doi.org/10.4172/2165-7890.1000152