Autistic Spectrum Disorder (ASD) Among Omani Children Below 6 Years: A Five Year Retrospective Descriptive Study

Friday, May 18, 2012
Sheraton Hall (Sheraton Centre Toronto)
10:00 AM
M. Al-Sharbati1, Y. M. Al-Farsi2, Z. M. Al-Sharbati3, A. Ouhtit2, M. I. Waly2, M. M. Al-Khaduri2, M. Al-Shafee4, F. Al-Sulaimani5 and S. Al-Adawi6, (1)Behavioral Medicine, Sultan Qaboos University, Muscat, Oman, (2)Sultan Qaboos University, Muscat, Oman, (3)Behavioral Medicine, Sultan Qaboos University Hospital, Muscat, Oman, (4)Family Medicine, Sultan Qaboos University , Muscat, Oman, (5)MOH, Muscat, Oman, (6)Behavioral Medicine, Sultan Qaboos University , Muscat, Oman
Background:

Autistic spectrum disorders are lifelong developmental neurobiological disorders affecting children <3 years of age. They show impairments in social skills, communication, and stereotyped/repetitive behaviors and interests. They affect boys 3-4 times more than girls. The etiology is attributed to the interaction between both genetic and environmental factors. Comorbidity is high, mainly mental retardation, Attention Deficit Hyperactivity Disorder, epilepsy, and emotional disorders. The prevalence of ASD increased dramatically during the last decade, approaching 1%. No specific treatment exists, but early diagnosis and intervention will improve the outcome considerably.

Objectives:

To identify the profile of ASD among Omani  preschoolers, the comorbidity and the trend of incidence during five years.

Methods:

All children <6 years who have been diagnosed as cases of ASD in the child psychiatry clinic at Sultan Qaboos University Hospital (SQUH), from 2006 to 2010 were included in this study. Every case was reported once only. The diagnosis was based on the clinical assessment, and according to the DSM IV.

Results:

96 preschoolers have been diagnosed as ASD cases in SQUH during five years, boys constituted (80%; n=77). Those who were below 3 years constituted 20 cases (21%), between 3 and <4 were 28 (29%), between 4 and <5 were 29 cases (30%), and between 5 and 6 were 19 (20%). The annual number of cases were: 13 (in 2006), 9 (in 2007), 24 (in 2008), 21 (in 2009), and 29 (in 2010). Family history for ASD was positive in 20 cases (20.9%). The IQ test was done for 27 children, 16 of them scored ≤70, while 8 scored 70 to <90 and 3 only scored early 90s. ADHD was found in 52 cases (54.2%), whereas epilepsy was found in 2 cases. The previous treatment was as follows: 72 (75%) no treatment; 13 (14%) on Risperidone; 6 (6%) on Atomoxetine, 2 (2%) on Methylphenidate. Regarding the Current treatment: there was no treatment in 42 cases (43.8%), Risperidone in 24 (25%), Atomoxetine in 10 (10%), Omega 3 in 10 (10%), Methylphenidate in 3 (3%), speech therapy in 8 (8%), and 2 cases (2%) were given antiepileptics.

Conclusions:

The increased number of reported cases may indicate better awareness, and probably increased incidence. However, one fifth of patients were <3 years, which necessitates more awareness in order to diagnose ASD earlier. This study is in accord with others concerning the male: female ratio, and high comorbidity (ADHD and low intelligence). Although  family history for ASD was positive in (20.9%), mild cases might be missed by inexperienced people. No treatment was given (apart from parental advice) in (43.8%). Most commonly used drugs were: Risperidone (25%), Atomoxetine (10%), and Omega (10%). A limited number have been given speech therapy (8 %) due to many factors such as: lack of specialists, inability to attend, hyperactivity, etc. We strongly recommend an increase in the resources, and improvement of the services presented to children with special needs, particularly ASD cases.

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