Autism in Sri Lanka
By Ama H. Vanniarachchy
Autism Spectrum Disorder (ASD), a complex and multifaceted neurodevelopmental disorder, is increasingly being recognised in Sri Lanka. Despite on-going efforts to raise awareness and foster understanding, significant challenges remain. Autism is characterised by difficulties in social interaction, communication, and repetitive behaviours, and it manifests uniquely in each individual. This necessitates customised support and interventions. In Sri Lanka, the obstacles posed by social stigma and limited resources significantly impact families and individuals living with autism. However, recent initiatives by advocacy groups, healthcare professionals, and educational institutions are making notable progress in improving awareness, diagnosis, and support systems. This article explores the current state of autism in Sri Lanka, highlighting progress, challenges, and the road ahead for a more inclusive society.
Prevalence and diagnosis
Globally, the prevalence of ASD has increased significantly, rising from 0.62 per cent in 2012 to 1.0 per cent in 2021. This global trend is mirrored in Sri Lanka, where the prevalence of ASD is also on the rise. A key study conducted in Sri Lanka found that 7.4 per cent of children displayed red-flag signs of autism as defined by the American Academy of Neurology and Child Neurology Society. Additionally, one in 93 children (1.07 per cent) aged 18 to 24 months was diagnosed with autism. Although this data is over a decade old, it indicates a higher prevalence than other regions in South Asia and closely aligns with the current global rate.
In the United States, the Centres for Disease Control and Prevention (CDC) estimate that approximately 1 in 36 children is diagnosed with ASD, with the condition being more common in boys than girls. Early diagnosis and intervention are crucial for improving outcomes, with signs typically emerging by ages two or three. Key indicators include difficulties in social communication, repetitive behaviours, and restricted interests.
Symptoms and characteristics
The symptoms of ASD can vary widely among individuals. Common traits include challenges with social interactions, difficulties with both verbal and non-verbal communication, and repetitive behaviours. Individuals with ASD may have unique ways of learning, paying attention, or responding to various stimuli. Some may exhibit exceptional skills in areas such as music, math, or art, while others might struggle with everyday activities.
Causes and risk factors
The exact cause of ASD remains unknown, but research suggests a combination of genetic and environmental factors. Factors that may increase the risk include family history, certain genetic conditions, and advanced parental age. Additionally, prenatal and perinatal factors, such as low birth weight and prenatal exposure to specific substances, have been associated with a higher likelihood of developing ASD.
Intervention and support
Early intervention and tailored support are critical in improving the lives of individuals with ASD. In Sri Lanka, ASD can be diagnosed by community paediatricians, paediatricians, child and adolescent psychiatrists, and psychiatrists. Regular developmental assessments conducted by public health midwives and the Medical Officer of Health (MOH) system facilitate early diagnosis and referral to specialised clinics. Management strategies often involve behavioural and educational approaches designed to enhance communication, social skills, and adaptive behaviours. Common interventions include speech therapy and occupational therapy.
Behavioural and educational approaches
Behavioural therapies, such as Applied Behaviour Analysis (ABA), are widely used to teach and reinforce desirable behaviours while reducing harmful or socially inappropriate ones. Educational interventions, including Individualised Education Programmes (IEPs), are tailored to meet the specific needs of children with ASD, focusing on improving their academic, social, and communication skills.
Speech and occupational therapy
Speech therapy helps individuals with ASD improve their verbal and non-verbal communication skills, enabling them to express their needs and interact more effectively with others. Occupational therapy focuses on enhancing fine motor skills, sensory integration, and daily living skills, promoting greater independence and participation in everyday activities.
Raising awareness
Raising awareness about autism is essential for fostering social acceptance, understanding, and early diagnosis and intervention. Awareness campaigns aim to educate the public about the challenges faced by individuals with autism and the importance of timely support and intervention. These campaigns often involve collaboration between government agencies, non-profit organisations, healthcare professionals, and community groups.
Advocacy and education
Advocacy groups play a crucial role in promoting autism awareness and advocating for the rights of individuals with ASD. They organise workshops, seminars, and public awareness events to educate the community and dispel myths and misconceptions about autism. Educational institutions are also instrumental in raising awareness by incorporating information about autism into their curricula and providing training for teachers and staff on how to support students with ASD.
Challenges and progress
Despite the progress made in recent years, significant challenges remain in addressing autism in Sri Lanka. Stigma and discrimination against individuals with autism persist, often leading to social isolation and exclusion. Limited access to specialised services and support, particularly in rural areas, exacerbates the difficulties faced by families and individuals living with autism.
Overcoming stigma
Addressing the stigma associated with autism requires ongoing efforts to educate the public and promote a more inclusive and accepting society. Community outreach programmes and public awareness campaigns can help challenge stereotypes and foster greater empathy and understanding.
Improving access to services
Enhancing access to diagnostic and therapeutic services is essential for supporting individuals with autism and their families. This includes increasing the availability of trained healthcare professionals, expanding early intervention programmes, and establishing more specialised clinics and support centres across the country.
Autism spectrum disorder is a lifelong condition that necessitates compassion, understanding, and individualised support. By raising awareness and promoting an inclusive society, we can help individuals with ASD reach their full potential and lead fulfilling lives. The journey towards an inclusive Sri Lanka involves continuous efforts in education, healthcare, and community support, ensuring that individuals with autism are valued and supported in all aspects of life.
In conclusion, the recognition and understanding of autism in Sri Lanka are evolving, with notable progress being made in raising awareness and improving support systems. However, significant challenges remain, including addressing stigma, enhancing access to services, and ensuring early diagnosis and intervention. Through collaborative efforts and a commitment to inclusivity, Sri Lanka can continue to make strides towards a more supportive and accepting society for individuals with autism and their families.
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