Keywords: Autism, brain, neurodevelopmental, neurotransmitters, speech therapist, occupational therapist, Nigeria.
Introduction.
Autism Brain and Treatment – Nigeria. What is actually going on in the brain of someone with autism? What are the treatment options in Nigeria?
The disorder called Autism is a neurodevelopmental disorder that starts in childhood that lasts throughout the life span. It is actually due to the combining factors of genes and environmental issues. The brain issues actually start in the womb. But the symptoms get quite glaring between the ages of 2 to 3 years.
In Nigeria, the disorder is not fully known by people, and for this, it is attributed to spiritual factors. Even among the health workers in Nigeria, some believe that it is due to supernatural cause. Some equate it to intellectual disability. Only recently, the Nigeria populace is beginning to hear and read about the disorder. Thus in the past, these children were hidden away from members of the community.
Incidentally, autism is a lifelong disorder that lasts till adulthood. Adults living with autism have problems with theory of the mind, i.e. having difficulty in interpreting how others feel and think. They may also not understand body language.
They do concrete thinking and do not understand humor. In concrete thinking, the person takes in words on their face value. And they can develop interest in abstract things, subjects and certain aspects of academic, like astrology studies. But they also have interests in computer, music, etc.
Inside the brain with autism ( Autism Brain and Treatment – Nigeria. )
In autism, there is problem with the development of the brain from an early age. The genetic and environmental factors combine to cause problems in the brain.
Anatomy issues.
Low oxygen in the brain:
Due to low oxygen in the brain of the developing fetus, many parts of the fetal brain are negatively affected. Even the cortical and sub cortical areas, which are responsible for decoding facial expressions, the use of eye contact and joint attention, are not functioning well.
Brain growth:
In early life of the child with autism, there is excessive brain growth, but this is followed by reduced brain growth in the cerebral areas. This excessive initial brain growth makes the heads of some of the children with autism, slightly bigger than it should be. But this increase in the size of head is not seen in adolescents due to the later decrease in the size of the head. Large head size is a pointer to the severity of autism.
Brain activity:
There is problem with the connectivity of the brain cells in autism. So there is difficulty with the brain cells to communicate. So there are problems with receiving signals from one brain region to another.
Other issues:
The prefrontal cortex and the temporal parietal areas of the brain, that process emotions, thoughts and beliefs are adversely affected.
The issues at the corpus callosum, and the cerebella white matters of the brain, cause the restrictive and repetitive behaviors in autism.
ISSUES WITH NEUROTRANSMITTERS AND HORMONES.
Neurotransmitter issues:
There is actually imbalance in the neurotransmitters, especially between the excitatory and inhibitory. For example, glutamate and GABA. There is also dopamine dysfunction in different parts of the brain, leading to social deficits seen in autism.
Hormone:
Oxytocin is also implicated in autism, because it modifies glutamatee and GABA. In autism, serotonin is reduced in early developmatal stages in the brain, predisposing to the social and other issues.
Autism orthodox treatment in developed countries ( Autism Brain and Treatment – Nigeria. )
Treatments are individualized. For some, symptoms do improve with age, but for others, it gets worse. Autism treatment requires a multidisciplinary approach. It includes the parents, teachers, speech therapists, pediatrician, clinical psychologist, psychiatrist, occupational therapist, etc.
Speech language therapist:
They are known as speech language pathologists. The speech therapist helps the person with autism build up appropriate words to use in communication. And helps in building social skills.
The earlier the speech language pathologist is called in, the better the outcome of treatment. This could be at the preschool age.
The clinical psychologist:
One of the roles of a clinical psychologist is to make the diagnosis of autism, on a child or adult. The psychologist uses many different techniques to arrive at the diagnosis of autism. Such techniques like cognitive behavioral therapy, social skills training, counseling, etc. to treat.
The treatment goes to both the individual and the family members. These different methods help to encourage the individual to interact well with others. The methods also empower the parents and family members on how to manage the individual and handle challenging behaviors.
The psychiatrist:
Psychiatrists play an important and critical role in the management of autism. They are able to make the diagnosis of autism on a child or an adult.
Majority of the time, those with the disorder who visit the psychiatrist, do so due to an associated mental illness. These include depression, anxiety, attention deficit disoders etc. It is the role of the psychiatrist to treat these coexisting mental illnesses. And the treatment of many of these coexisting conditions can reduce some of the behavioral disorders.
The pediatrician:
Most often, the pediatrician is the first port of call for parents with children with autism. The pediatrician should be able to spot autism in children at an early age.
Pediatricians treat the physical illness as well and this can help reduce tantrums. It is the role of the pediatrician to educate the parents on this disorder. And to refer the child appropriately and early.
The occupational therapist:
Occupational therapists are professionals that also treat persons with illnesses that boarder on social, emotional and psychological effects. They help in developing skills in dressing, using utensils, writing, etc. And the treatments are individualized. And the therapist trains the individual in order to get a good job match in adulthood.
The teachers:
Children with autism are different from other children in the areas of information processing and learning. So the children with autism require high rates of interactions.
The children with autism who are academically capable can be taught in a regular school, as their peers. Even if they have moderate intellectual issues, they can still be in the main stream school, but in a slower class. But for those whose symptoms are severe, they require behavioral programs and not academic.
Those in main stream schools require calm classrooms, individual attentions from teachers, learning aids, lessons tailored to the child’s needs. And the teachers must be adequately trained to teach children with autism.
Teaching children in mainstream schools helps in overcoming social issues, speech and behavioral problems. But in the main stream schools, adequate provisions must be made for audiovisual learning, and handling issues on sensory processing. There is also need to prevent these children being bullied by peers.
For the employers of adults with autism:
Employment promotes self esteem and improves quality of life for the adult. There should be an appropriate job match and job description must be clear to the employee. And there may be need for modification of the work place.
There should be an appropriate job match and job description must be clear to the employee. Also there should be on the job training for the employee with autism.
Autism treatment in Nigeria ( Autism Brain and Treatment – Nigeria. )
The traditional and religious treatment.
Traditional treatment.
In African, Nigeria inclusive, mental health conditions are not fully understood. This has culminated to the causes of mental health conditions be ascribed to spirits and witches. So in many cases oracles are consulted, sacrifices are offered and the use of herbs administered.
These traditional methods are still in use today, not just because of ignorance but to reduce stigma brought about by the mental health condition. The traditional methods of treatment are more acceptable by the community.
Religious forms of treatment.
Due to the people’s belief on the spiritual cause of mental health condition, autism inclusive, they turn to a spiritual being for help.
But unfortunately, in some of these churches and prayer houses, the children with autism are termed witches. They are flogged, chained and denied food and water. These are done in order to drive away the evil spirits perceived to be the causes of their conditions. Children with mental health conditions can have some of their body parts burnt in the name of deliverance.
Orthodox medical treatment.
The orthodox treatment for children and adults with autism should be the same as those obtained in developed countries. But unfortunately, Nigerians have limited treatment options. This frustrates parents in accessing treatments.
There are only 300 speech pathologists in Nigeria as at 2015. Majority are based in the western parts of Nigeria. The clinical psychologists are very few. There is an estimated population of 350 psychiatrists in Nigeria to serve 200 million people as at 2020. Occupational therapists are very few in Nigeria and most practice in big hospitals.
The teachers in the mainstream schools are not adequately trained to handle children with autism. The pupils and students are not easily identified by teachers. These children are labeled as weak, dull and underachievers, by teachers. The teachers also see them as trouble makers, stubborn, aggressive, quiet or withdrawn. This is because the teachers misunderstand the reason for these pupil’s academic and maladaptive behaviors. Some people use stigmatizing words like mentally retarded or imbeciles. Some of these pupils are also labeled as dumb and deaf.
So regular schools in Nigeria reject them, but there are very few special schools which are underfunded. Yet, there are limited teaching aids in these schools.
In Nigeria, there is no government social policy for autism. There is no curriculum in schools for children with autism. Treatment for people with autism is done out of pocket, making it very financially involving.
The role of parents.
Get educated on the subject. This requires getting a lot of information about autism. There is need to seek out other parents with similar issues and form or join a local group.
There is need to have a stable home, free from all forms of abuse.
Patience and the show of love are very important from the parents and siblings.
Consistency is imperative, and changes must not be made without pre-informing the child. Thus there is need to keep to routines.
Study the child and understand the things that can bring on the challenging or positive behaviors. Pay very close attention to the child’s body language.
It is important to reward good behaviors, with praise, star charts or token, etc. it is also important to have scheduled time for playing with the child.
Ensure that the child gets the treatments needed. And there must be a close relationship between the parents and teachers. The parents and siblings may need to learn sign language.
Have time for yourself. So there is need to get support from family and friends. May need to bring in grandparents to help, or a live-in nanny.
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