Nigerian Researchers Develop Autism Screening Tool

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By; MATTHEW UKACHUNWA, Lagos

A team of Nigerian researchers have developed an indigenous Autism Spectrum Disorder (ASD) screening tool.

The instrument is called Nigerian Autism Screening Questionnaire (NASQ). 

NASQ was developed by a group of experts who were led by Dr. Muideen Bakare, the Chief Consultant Psychiatrist and Head of the Child and Adolescent Unit of Federal Neuropsychiatric Hospital, Enugu.

NASQ was a two-phase study. The first phase was a community study which has been published and used in community and household survey in the six geographical zones of Nigeria.

“We started in 2016, and published it in journal in 2022,” Bakare explained. 

He said that the team is trying to implement the second phase by carrying out clinical consultation.

He pointed out that the second phase requires them to compare it with standard diagnostic instruments and some other standard instruments.

NASQ came into being based on criteria developed by DSM5, Bakare said. Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM5) is the standard classification of mental disorders used by mental health professionals.

Bakare disclosed that NASQ has been used in household survey based on representation that has been done by the World Bank, together with Nigeria Bureau of Statistics (NBS).

“The need for a free informant-report screening tool that can be used in low resource setting like Nigeria informs development of the screening questionnaire,” the team leader said, adding: For peer review, “So we developed the criteria and we gave it to a number of experts to look at it.” 

Bakare emphasized the importance of providing intervention to people living with autism, and stressed that diagnosis has to be carried out first before finding intervention.

Elaborating on the importance of the indigenous autism questionnaire, the chief consultant psychiatrist said: “How do we make diagnosis where there is no doctor, where there is no developmental psychologist? We need to do assessments. To do assessment you need tools.”

Bakare stated that though there are a number of tools that can be used to do assessment and to diagnose autism, many of them originated from the Western countries.

He declared, “Many of them are developed either in Europe or North America and are unaffordable, especially to us in Africa. Many of them are laden with cultural bias, and they don’t fit into our cultural setting.”

Bakare expressed confidence in the validity and reliability of the Nigerian Autism Screening Questionnaire, and highlighted that it can be used at Primary and Secondary Healthcare Centres.

“We have community healthcare workers that can use these instruments and say okay your child is likely to have autism. That’s the reason why we developed this screening questionnaire, and we intend it to be made available freely, so that everybody in low resource setting, especially in sub-Saharan Africa can make use of it,” the head of Child and Adolescent Unit of Federal Neuropsychiatric Hospital Enugu clarified.

He provided details of how the general household survey was carried out. According to him, the final sample included 12,311 participants who were between one and 18 years old.

Bakare said that most participants were biological children of the informants (86.2 per cent), sex was shifted slightly towards males (53.4 per cent) and a substantial minority (15.9 per cent) had a developmental concern.

“Geographic distribution were consistent with greater population in the north zones, with most (76.1%) living in northern zones and healthy three-quarters (73.2 %) living in rural region,” the research team leader narrated.

NASQ total raw scores had a positively skewed distribution, Bakare added.

On the nature of the condition, he said that autism is a disorder, it is not a disease. “A disease is a condition that you can identify the pathology. Autism is a disorder, it is not a disease,” the mental health specialist clarified.

According to experts, there is no cure for autism, but there are interventions to manage people living with autism.

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