Familial History, Pre- and Post-Natal Conditions and Observed Phenotype - Case Studies of Some Individuals with ASD

Background:

The African autism population is one of the most understudied and often underrepresented globally. The unavailability of sufficient data on this population has impaired much progress in autism research in Africa. This is partly due to the little awareness of the disorder among the general public as well as public stigmatization/discrimination and non-inclusion of with autism and special needs as a whole. Also, partly due to the limited participation of affected families/families of interest in research studies and surveys.

Objectives:

The present study aimed to acquire background data of individuals with ASD directly form affected parent/guardian.

Methods:

The study utilized a direct one-on-one interview of consented participants using a researcher designed structured questionnaire. The interview questionnaire consists of 84 semi-structured questions divided into seven sections highlighting data on Sociodemographic, Diagnosis, Family history, Pre-natal and Post-natal, Few months and above, and Treatment. The previously designed, Autism Phenotype Questionnaire (APQ) was also administered to consented participants. All participants were requited from the Neuro-paediatric clinic of University of Lagos Teaching Hospital (LUTH) and the Child and Adolescent Unit of the Federal Neuro-psychiatric clinic, Oshodi Annex Lagos. Statistical analyses were done using IBM SPSS version 20.

Results:

A total of twenty-seven (27) parents (mothers) and guardian consented to the study. Observed mean age was 7.96±4.33 years with an age range of 2-19 years and male: female ratio of 1.7:1. A total of 92.59% (25/27) of the cases had other unaffected siblings, three of whom were unaffected twins. Also, 25 0f the 27 cases (92.59%) had been appropriately diagnosed with 76% (19) having other co-morbid diagnosis. Seizure disorder was the most observed co-morbid disorder (12; 63.16%), followed by ADHD (6; 31.58%), others include developmental delay and Cerebral Palsy (CP). All pregnancies were carried to term and uneventful with the exception of a case where the gestation period was for over 10 months and two cases where the mothers had malaria during pregnancy. The overall mean birth weight was 3.33±0.61 years. About 80% of cases could respond to their names and perform simple tasks such as turning on and off the TV. In over 80% of the cases, loss of speech and hyperactivity/aggression was the main concern, others include lack of responsiveness to environment and tantrums. In 74.07% (20) of the cases combined intervention of pharmacological and non-pharmacological (therapies) was employed in the management of affected individuals. Medications such as, Carbamizine, Tagretol, Neurovites, Omega 3 were the most commonly prescribed alongside, speech, occupational therapies and physiotherapy.

Conclusions:

More could still be learned through participation of families in research studies. Public sensitization and inclusion of stakeholders in future research studies will go a long way in bridging the gap of the African autism population data.