Observation-centered Approach to ASD Assessment in Tanzania

Harrison, Ashley J.; Zimak, Eric H.; Sheinkopf, Stephen J.; Manji, Karim; Morrow, Eric M.

doi:10.1352/1934-9556-52.5.330

Cited by 16 publications

(21 citation statements)

References 37 publications

(23 reference statements)

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“…It was reported that the 23-item questionnaire was modestly successful in identifying a subgroup of children at high risk of being diagnosed as having ASD. A study from Tanzania evaluated the potential use of the Childhood Autism Rating Scale to perform a structured observation to diagnose ASD [16]. In this study, the Childhood Autism Rating Scale was culturally adapted for use in Tanzania.…”

Section: Resultsmentioning

confidence: 99%

“…These challenges are the impetus towards the development and validation of tools in the African context. However, some studies [16, 17] present early, yet very crucial steps towards identification of potential screening and diagnostic tools for the African context. The need to invest more into this process cannot be overemphasized given the potential benefit in accessing tools that can contribute towards early identification of children who have ASD.…”

Section: Discussionmentioning

confidence: 99%

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A Systematic Review of Research on Autism Spectrum Disorders in Sub-Saharan Africa

Abubakar

Ssewanyana

Newton

2016

Behavioural Neurology

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The burden of autism spectrum disorders (ASDs) in sub-Saharan Africa (SSA) is not well known. We carried out a systematic review of the literature to identify published work from SSA. We have systematically searched four databases, namely, Medline, PsycINFO, CINAHL, and Child Development & Adolescent Studies, through EBSCO and identified studies from across SSA. Based on predefined inclusion criteria, 47 studies were included in this review. Most of the identified studies (74%) were conducted in only 2 African countries, that is, South Africa and Nigeria. Additionally, most of these studies (83%) were carried out in the last decade. These studies had four major themes: development of measurement tools of ASD in Africa, examining the prevalence of ASD, identifying risk factors and risk markers, and examining psychosocial issues. We identified only a single population level study aimed at documenting the prevalence of ASD and could not identify a single case-control study aimed at examining a comprehensive set of potential risk factors. All intervention studies were based on very small sample sizes. Put together, our findings suggest that current evidence base is too scanty to provide the required information to plan adequately for effective intervention strategies for children with ASD in Africa.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Systematic Review of Research on Autism Spectrum Disorders in Sub-Saharan Africa

Abubakar

Ssewanyana

Newton

2016

Behavioural Neurology

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“…To date, only two publications have focused specifically on ASD screening and diagnosis in SSA—one each from Tanzania and Uganda [Harrison, Zimak, Sheinkopf, Manji, & Morrow, ; Kakooza‐Mwesige et al, ]. Both studies were cross‐sectional.…”

Section: Screening and Diagnosis Of Asdmentioning

confidence: 99%

“…Both studies were cross‐sectional. In Tanzania, Harrison et al [] used the Childhood Autism Rating Scale, Second Edition (CARS‐2), an observational diagnostic aid for ASD [Schopler, Van Bourgondein, Wellman, & Love, ] as part of a larger test battery to diagnose ASD. A process of cultural adaptation of the test battery for the target population was described.…”

Section: Screening and Diagnosis Of Asdmentioning

confidence: 99%

Autism spectrum disorder in sub‐saharan africa: A comprehensive scoping review

et al. 2017

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Autism spectrum disorder (ASD) is recognized as a global public health concern, yet almost everything we know about ASD comes from high-income countries. Here we performed a scoping review of all research on ASD ever published in sub-Saharan Africa (SSA) in order to identify ASD knowledge gaps in this part of the world. Fifty-three publications met inclusion criteria. Themes included the phenotype, genetics and risk factors for ASD in SSA, screening and diagnosis, professional knowledge, interventions for ASD, parental perceptions, and social-cognitive neuroscience. No epidemiological, early intervention, school-based or adult studies were identified. For each identified theme, we aimed to summarize results and make recommendations to fill the knowledge gaps. The quality of study methodologies was generally not high. Few studies used standardized diagnostic instruments, and intervention studies were typically small-scale. Overall, findings suggest a substantial need for large-scale clinical, training, and research programmes to improve the lives of people who live with ASD in SSA. However, SSA also has the potential to make unique and globally-significant contributions to the etiology and treatments of ASD through implementation, interventional, and comparative genomic science.

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“…Recently the CARS-2 (Schopler et al 2010) was chosen for use in a low resource setting in Tanzania (Harrison et al 2014). …”

Section: Introductionmentioning

confidence: 99%

The diagnosis of autism and autism spectrum disorder in low- and middle-income countries: Experience from Jamaica

Samms‐Vaughan

Rahbar

Dickerson

et al. 2017

Autism

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The administration requirements of the ADOS and the ADI-R, widely used in High Income Countries (HIC), make them less feasible for diagnosis of autism spectrum disorder (ASD) in Low and Middle Income Countries (LMIC). The flexible administration requirements of the Childhood Autism Rating Scale (CARS) have resulted in its use in both HICs and LMICs. This study examines the agreement between assessments using the CARS with those using the ADOS or ADOS-2 and ADI-R in Jamaica. Children aged 2-8 years (n=149), diagnosed with autism by an experienced clinician using the CARS were re-evaluated using the ADOS and ADI-R. The proportion diagnosed with ASD using the ADOS, ADOS-2, and ADI-R was determined and mean domain scores compared using ANOVA. The mean age was 64.4 (SD=21.6) months; the male:female ratio was 6:1. The diagnostic agreement of the CARS with the ADOS and ADOS-2 was 100.0% and 98.7%, respectively. Agreement with the ADI-R was 94.6%. Domain scores were highest for children with more severe symptoms (p<0.01). Despite a high level of agreement of the CARS with the ADOS, ADOS-2, and ADI-R, the CARS should be evaluated further with a broader range of ASD symptomatology, and by clinicians with varying experience before recommendation for use in LMICs.

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Observation-centered Approach to ASD Assessment in Tanzania

Cited by 16 publications

References 37 publications

A Systematic Review of Research on Autism Spectrum Disorders in Sub-Saharan Africa

A Systematic Review of Research on Autism Spectrum Disorders in Sub-Saharan Africa

Autism spectrum disorder in sub‐saharan africa: A comprehensive scoping review

The diagnosis of autism and autism spectrum disorder in low- and middle-income countries: Experience from Jamaica

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