Autism Spectrum Disorders: An Emerging Global Health Problem
The Global Problem
Autism Spectrum Disorder (ASD), falling under the umbrella term of Pervasive Developmental Disorder (PDD), is defined by the International Classification of Diseases, volume 10 (ICD-10) as a disorder first diagnosed in childhood by the clinical manifestation of marked impairment in communication and social interaction, and repetitive or stereotyped behaviors (“Pervasive developmental disorders,” 2010). This definition aligns with the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-V), currently used in the United States (American Psychological Association, 2013).
Children are typically ...view middle of the document...
Undiagnosed and untreated or undertreated children face stigma and exclusion from active participation in society (World Health Organization, 2013). Families often experience isolation and discrimination because of their child’s diagnosis or perceived disability (WHO, 2013). In countries where treatment is available, the costs of care are astronomical. In the United States, the Centers for Disease Control and Prevention (CDC) estimates that a family with a child with an ASD spends $17,000 per year compared to a family without a child with an ASD (2014). The overall cost of treatment for children with an ASD in the United States is estimated to be 11.5 billion dollars in 2011 alone (2014). Globally, the estimated economic impact is expected to exceed billions of dollars (Elsabbagh et al., 2012).
The Global Assessment
Over the past decade, the CDC and Autism Speaks, an advocacy and research, organization have partnered to develop a global epidemiological network to determine the global prevalence of ASDs ((Elsabbagh et al., 2012). Currently, this network is actively monitoring prevalence rates in Australia, Mexico, Finland, Portugal, Iceland, Vietnam, Taiwan, South Africa, and Uganda (Elsabbagh et al., 2012).
In 2012, Elsabbagh et al., published results from a systematic review of epidemiological reports collected from Europe, South East Asia, the Eastern Mediterranean, the Americas, and Africa. The search process revealed limited or unavailable data from many LIC, or significant variation in diagnostic tools used to provide data (Elsabbagh et al., 2012). Using only the data that met study criteria for reliability and validity, the researchers estimated that the global mean prevalence of ASDs is 1 in 160 children (Elsabbagh et al., 2012). By contrast, the reported rates were 2-3 times higher (Elsabbagh et al., 2012). The researchers proposed that in order to determine a global needs assessment, more funding must be devoted to epidemiological studies in order to determine more accurate prevalence rates (Elsabbagh et al., 2012).
The Strategies and the Plan
Before any plan implementation can occur, there are 5 barriers to improving mental health care services in LMIC that need to be breached. First, there needs to be financial resources and commitment by the country’s government; Health care systems that are often over centralized need to be made sustainable; Mental health services need to seamlessly be a part of the primary care process; Practitioners need to be trained and educated specifically about ASDs; The mental health leadership needs to develop more comprehensive understanding of the facets of ASD and its societal impact (Wallace, et al., 2012).
Fortunately, in 2008 Autism Speaks launched the Global Autism Public Health Initiative (GAPH) to address such barriers by promoting local leadership to set community priorities, launching an awareness campaign, assisting with infrastructure changes to aid families and professionals, researching...