Autism Spectrum Disorder: An Explainer for Africans 

By: Swabirah Sulaiman, BSc. Physiology, Clinical Physiologist. Medically reviewed by: A. Odutola, MB BS, PhD, FRCSEd.

Octoober 27, 2025

Image showing an autistic African child and his happy family in the background. Image is captioned “autism spectrum disorders an explainer for Africans” and is AI generated from Sora AI. Click on image to enlarge.

 

Highlights

• Autism is a complex disorder, still underrecognized and understudied in Africa 
• Although the exact prevalence is unknown, there is a growing burden of Autism in Africa
• Due to a lack of knowledge, many Africans attribute being autistic to supernatural causes, causing fear and stigma in the society
• Autism can occur on different levels with different signs and symptoms; no two autistic individuals are exactly alike  
• It can be diagnosed as early as 18 months, and there are many diagnostic and screening tools
• While some individuals need round-the-clock care, others can manage well with little assistance 
• Showing love, patience, care, and support is very helpful for autistic individuals 
• Targeted behavioural therapies and early interventions can help them live a fulfilled life

 

Introduction

The exact prevalence of Autism Spectrum Disorder (ASD) is not accurately documented in Africa, but it is believed to be widespread and steadily increasing. More concerning is that there is poor knowledge about the condition in Africa. 

In most African societies, awareness of ASD is founded on untrue narratives, speculations, and myths that do more harm than good. 

To spread awareness and give more insights, this article will help you know and understand:

• What autism is. 
• How is it caused 
• How it is diagnosed and treated 
• And what you and the community at large can do to help autistic individuals live healthy and productive lives

 

What is Autism Spectrum Disorder?

Autism spectrum disorder (ASD), or autism in common language, is a term used to describe a group of complex neurodevelopmental conditions that affect how the brain develops and works. It is marked by difficult social and behavioural interactions. [1]

ASD affects how people with the condition talk, walk, behave, and react. 

ASD is diverse in its features. This means that no two individuals can have the same features and characteristics. 

 

Levels of Autism Spectrum Disorder

Because of the complexity of the disorder, the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria emphasise that ASD should not be classified by specific features only, but as a range of symptoms with different severity levels. [2, 3]

Cartoon illustration depictiing the levels of autism with different communication challenges, mild, moderate and severe. AI generated from Sora AI. Click on image to enlarge
 

• Level 1 (Mild)

Individuals at this level have noticeable social communication challenges but can often function with little assistance. 

For example: Obinna, a young school boy may find it hard keeping up with conversations in class, but can speak well and understand with help. Patience brushes her hair using a particular comb at a particular time in the morning, but if unable to do so on occasions she can manage well with assistance.

• Level 2 (Moderate)

This level indicates more significant challenges with social communication and more obvious repetitive behaviors needing more support.

For example: Obinna can speak in simple sentences but finds it hard to talk and connect with others on his own. Brushing his hair the same way each day is a must, which can make him frustrated when interrupted. 

• Level 3 (Severe)

The most severe level, where individuals have severe deficits in verbal and nonverbal social communication skills and very restricted repetitive behaviors that markedly interfere with functioning.

For example, Obinna can only say a few words and short sentences, so people often don’t understand him. Patience has a very specific way of brushing her hair every day—if anything changes, she gets very upset and confused. 

 

Signs and Symptoms of Autism Spectrum Disorder

It's important to remember that some of the signs and symptoms described below may also be present in people who do not have ASD. 

But for people with ASD, these traits can make daily life and the little things that come easily to others really challenging for them.

They include: [3, 4]

• Delayed speech or lack of language 
• Difficulty making eye contact 
• Repetitive behaviors (hand-flapping, rocking) 
• Gets upset by minor changes
• Has peculiar reactions to the way things sound, smell, taste, look, or feel
• Anxiety, stress, or excessive worry
• Lack of fear or more fear than expected
• Delayed cognitive (higher order brain functions) skills 
• Must follow  routines, difficulty with change 

 

Causes of Autism Spectrum Disorder 

Infoposter depicting environmental and genetic factors like gene mutation, advanced age, nutrient deficiency, pollution and pregnancy complications that have been proposed to cause autism. AI generated from Sora AI. Click on image to enlarge.

 

The exact cause of autism is unknown, but the general science backed belief is that it is caused by a complex mix of factors in the environment and factors that one is born with or inherits.

In Africa, many strong cultural beliefs and misinformation are widespread about the cause of autism, leading to circumstances that pose a threat to autistic individuals and their families. It is important to note that the development of ASD is complex and involves both genetic and environmental factors. [5]

• Genetic factors

Genes are the tiny biological components that structure our bodies, and are responsible for particular characteristics that make us unique from each other. When there is a problem (mutation, for example) in one or many of these genes, a lot of issues arise. Different types of gene mutations, like SUV420H1, ARID1B, CHD8, and mtDNA, have been found to cause ASD.

• Environmental influences 

Early exposure, especially when a baby is in its mother's womb, to different types of environmental disturbances, can cause ASD. This happens when exposure to these vices is passed from mother to baby. They include: [5]

• Air pollutants
• Chemicals
• Nutrient deficiency (selenium & vitamin D) 

 

Risk Factors for Autism Spectrum Disorder

Other environmental influences also play a significant role, contributing to altered neurological, mental, behavioral, and cognitive symptoms characteristic of ASD. [5]

• Advanced parental age 

It has been shown that parents having children at above 40 years of age in women and above 50 years in men increases the risk of bearing children with ASD. This is because at an older age, changes in the genetic components of the male sperm and female egg are more likely to occur, and these can cause ASD in the developing baby.  

• Exposure to steroid hormones 

Steroid hormones like testosterone, oestrogens, and progesterone are very important for early brain development. Recent research shows that people who are exposed to higher amounts, like mothers with polycystic ovarian syndrome (PCOS), a disease that causes increased steroid hormone levels, are more likely to have children diagnosed with ASD. [5]

• Others: 

  • Pregnancy complications– studies have shown that problems like uncontrolled blood sugar during pregnancy (gestational diabetes), high blood pressure (hypertension), and other conditions disturb the fetal environment in the womb and activate the cells that fight against germs and other harms (immune cells) in the mother, thereby increasing the likelihood of the baby developing ASD [5]
  • Early birth – babies born when their organs have not been fully developed may have a higher chance in developing ASD
  • Sex – male children are said to have a higher risk of developing ASD compared to females 

 

How is Autism Spectrum Disorder Diagnosed?

Healthcare providers diagnose ASD using standardized clinical processes that include history taking, physical examination, and laboratory based tests (if applicable). [4, 5] 

Clinicians use the DSM-5 standards to guide diagnosis. The standards require that for ASD to be diagnosed, the symptoms observed currently or from history must fall within these two broad groups: 

A. Persistent deficits in social communication and social interaction

Examples of the deficits include:

1. Deficits in social-emotional interactions, such as:
   1. Abnormal social approach and failure of normal back-and-forth conversation
   2. Reduced sharing of interests, emotions, or affect
   3. Failure to initiate or respond to social interactions
2. Deficits in nonverbal communicative behaviors used for social interaction, such as:
   • Poor verbal and nonverbal communication
   • Poor eye contact and body language
   • Poor understanding and use of gestures
   • Lack of facial expressions and nonverbal communication.
3. Deficits in developing, maintaining, and understanding relationships, such as:
   • Difficulties adjusting behavior to suit various social contexts
   • Difficulties in sharing imaginative play or in making friends
   • Absence of interest to make friends or play with age mates.

B. Restricted, repetitive patterns of behavior, interests, or activities

At least two of the following examples are required to be present:

1. Repetitive patterns in motor movements, use of objects, or speech 
2. Insistence or clinging inflexibly to routines, or ritualized patterns or verbal nonverbal behavior. This can show as:
   1. Extreme distress at small changes
   2. Difficulties with transitions
   3. Rigid thinking patterns or greeting rituals
   4. Need to eat the same food or do the same things over and over daily.
3. Highly restricted, fixated interests that are abnormal in intensity or focus, such as:
   • Strong attachment to, or preoccupation with unusual objects
   • Excessive perseverance with unusual interest
4. High or low reaction to sensory input or unusual interests in sensory aspects of the environment, such as:
   • Indifference to pain/temperature
   • Excessive response to specific sounds or textures
   • Excessive smelling or touching of objects
   • Visual fascination with lights or movement.

Additional conditions for the diagnosis of ASD include:

• Symptoms must have been present from early in development, but may not become clearly observable until later in development

• Symptoms cause clinically significant impairment in social, occupational, or other activities of daily living

• Symptoms are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay 

Note that ASD may co-occur with other neurodevelopmental, intellectual or language disorders 

 

Screening Tools for Autism Spectrum Disorder 

In their efforts to determine whether a child may have ASD or not, healthcare providers use a variety of standardized screening tools, some of which include:

• Modified Checklist for Autism in Toddlers (M-CHAT)
• Autism Diagnostic Observation Schedule (ADOS)
• Autism Diagnostic Interview-Revised (ADI-R)
• Childhood Autism Rating Scale (CARS) and Social Communication Questionnaire (SCQ)

While medical investigations such as hearing tests, genetic analyses, and metabolic screenings are critical for identifying co-occurring or syndromic conditions, they do not independently establish an ASD diagnosis. The integration of different tests with an experienced multidisciplinary team ensures a personalized diagnostic process that capture the complexity of ASD.

 

Treatment & Support

There is no specific cure for autism, but there are intervention strategies in place to help an autistic individual adapt to challenges of the condition and live a healthy, independent, and productive life. They include behaviour therapies and medications, as considered to be necessary by your doctor to support symptoms. [4]

Cartoon illustration showing ways to support autistic individuals through therapy, early school intervention and improved funding. Image is AI generated from Sora AI. Click on image to enlarge.

 

Interventions for Autism Spectrum Disorder

• Applied behaviour analysis (ABA)–helps children with autism learn practical communication and daily skills through step-by-step teaching and positive rewards. [4]

• Cognitive behavioural therapy (CBT)–used to teach autistic individuals how to change negative thoughts and behaviors using techniques like relaxation and facing fears, improving their overall well-being. [6]

• Education training–use of music and play therapies to improve social skills, through engaging and supportive activities.

• Technology devices– use of devices like talking tablets, virtual reality games, and helpful robots make it possible to learn how to communicate and interact with others in fun and simple ways. Many of these devices may not be available especially in rural areas of Africa.

These help in teaching ASD individuals how to: 

• make eye contact, 
• share attention with others 
• use language for specific purposes—like asking for things or naming objects
• daily skills such as handwashing and toilet training 

Importance of Early Intervention 

It’s important to start helping a child with autism as early as possible because their young brain is very ready to learn and grow during this time. Research has shown that when children around 1.5 to 2.5 years old begin therapy early, they can make big improvements in things like learning, adapting to daily life, and even in the way autism affects them.

Support from Parents and Caregivers 

As a parent or caregiver of an autistic individual, it is understandable how tough and unbearable it may be. But care, patience and love provide tremendous benefits that make autistic individuals thrive. You need to focus on:

• Providing them with an easy routine to follow
• Recognizing they are different and adapt to changes 
• Showing them you love and care for them 
• Spreading positive attitude through rewards and encouragement 

Medications 

Medications for autism don’t fix the core challenges but can help with related issues like anxiety, anger, or repetitive behaviors. They include: [4]

• Risperidone and aripiprazole–used to calm irritability and aggression, but may cause tiredness or weight gain.
• Drugs like fluoxetine or sertraline—help with anxiety or depression in people with autism.

Scientists are still working on new treatments to better target autism symptoms in the future.

Note this is only for information purposes and only your specialised healthcare professional can provide you with guidance on which drugs to use.

 

Challenges in the Management of Autism Spectrum Disorder

Individuals with ASD suffer challenges in every aspect of their lives, and without proper care and support, it poses a great threat to their quality of life. In Africa, they often struggle with: [6]

• Learning at school
• Employment
• Independent living
• Stereotyping and social isolation
• Bullying
• Family distress
• Financial strain 
• Lack of available support services 
• Poor access to health and social care

 

How to Tackle the Challenges of ASD in Africa 

To tackle the challenges posed by autism in Africa involves individual, school, government and community support through: [6]

Awareness and education

• There is a need for developing public community programs that support awareness campaigns about ASD, early signs, and available services.
• Support and advocate for the inclusion of autistic education in school curricula.

Diagnosis and assessment

• Expansion and improvement of diagnostic services with trained professionals.

Evidence-based interventions

• Promote professional training in evidence-based therapies like cognitive behavioural therapy (CBT), which would be adapted to local cultures in Africa.

Financial support

• Build partnerships among government, non-profits, and private sectors to fund autism care.

Stigma reduction, social inclusion and family support 

• Implementing anti-stigma campaigns, promoting inclusive education, and community integration.
• Providing support groups, and community initiatives to foster social support and inclusion.

 

Conclusion

Autism is a complex developmental disorder that presents significant challenges for affected individuals, families, and communities, especially where services are limited in African societies, due to lack of awareness and expertise to manage it. Understanding what ASD entails is the first step towards curbing this problem. 

Support a society where autistic individuals can thrive by spreading awareness, advocating for better treatment and fostering community empathy and care.

 

Frequently Asked Questions (FAQs):

• Is ADHD the same as autism?

No, ADHD is attention deficit hyperactivity disorder, which involves mainly difficulty in paying attention to details for a sustained period of time.

• Which parent carries the autistic gene?

The allele or phenotype that contributes to autism comes from both parents.

• Does acetaminophen (paracetamol) taken by mothers during pregnancy cause autism?

There are a lot of debates on whether taking paracetamol during pregnancy can cause autism. Autism is caused by a complex interaction between genetic and environmental factors, and there is no evidence that paracetamol causes it.

• Can African herbal medicines cure autism?

While some say these non-conventional treatments may be helpful, there is little scientific evidence that supports the successful use of herbal medicines in treating ASD in the African population. [6]

 

References:  

1. Hodges H, Fealko C, Soares N. Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation. Transl Pediatr 2020; 9(Suppl 1):S55–65. Available from here.

2. IACC Subcommittee Diagnostic Criteria - DSM-5 Planning Group | IACC [Internet]. [Cited 2025 Oct 7]. Available from here.

3. CDC. Signs and Symptoms of Autism Spectrum Disorder. Autism Spectrum Disorder (ASD) [Internet]. May 14, 2024. [Cited 2025 Oct 7]. Available from here.

4. Abualait T, Alabbad M, Kaleem I, Imran H, Khan H, Kiyani MM, et al. Autism Spectrum Disorder in Children: Early Signs and Therapeutic Interventions. Children 2024; 11(11):1311. Available from here.

5. Wang M, Zhang X, Zhong L, Zeng L, Li L, Yao P. Understanding autism: Causes, diagnosis, and advancing therapies. Brain Research Bulletin. 2025; 227:111411. Available from here. 

6. Aderinto N, Olatunji D, Idowu O. Autism in Africa: prevalence, diagnosis, treatment and the impact of social and cultural factors on families and caregivers: a review. Annals of Medicine & Surgery 2023; 85(9):4410–6. Available from here. 

 

Related: Common Autism Myths in Africa and How to Disprove Them

 

Published: October 27, 2025

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