Keywords:
Autism, neurodevelopment, autism brain, neurotransmitters, concrete thinking, speech therapist, occupational therapist, Nigeria.
Introduction.
Autism Brain and Treatment – Nigeria. What is actually going on in the brain of someone with autism? Treatment options globally and in Nigeria. What roles do parents have to play?
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.
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.
What is actually going on in the brain of someone with autism?
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. The areas of the brain which are responsible for understanding 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 points to a severe form of autism.
Brain activity:
There is problem with the brain cells connecting with one another in autism. So there is difficulty with the brain cells to communicating with each other. And 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 are negatively affected. These are the brain areas that process our emotions, thoughts and beliefs.
There are problems at the corpus callosum, and the cerebella white matters of the brain. The corpus callosum is the area that connects the two halves of the brain. And the cerebellum is the brain area that is involved in movement. So problems in these brain areas cause the restrictive and repetitive behaviors that autism children have.
Issues with neurotransmitters and hormones.
The brain cells communicate with each other through neurochemicals called neurotransmitters. In the autism brain, the neurotransmitters are actually not well balanced. For example, glutamate and GABA, one is higher than the other. We know that some neurotransmitters increase brain activities (excitation), while others suppress brain activities (inhibitory). So, if they are not well balanced, there is going to be a problem.
Oxytocin is low in the brain of children with autism. Actually, oxytocin is a hormone produced in the brain to help people bond. It is called the love hormone, so it helps people socialize with each other. This is the reason children with autism have problems with socializing.
In autism, serotonin, a neurotransmitter, is also low, in early stages when the brain, is developing. This also negatively affects the social interactions and other issues, in autism.
Another neurotransmitter that is not functioning well is dopamine. There are dopamine problems in different parts of the brain, leading to social issues seen in autism.
Treatment options globally and in Nigeria.
Autism orthodox treatment in developed countries:
Treatments of autism are on individual basis. For some, symptoms do get better 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 child with autism build up appropriate words to use while communicating. The therapist also helps in building social skills. That is, the therapist helps the child to learn how to socialize with people.
The earlier the speech language therapist or pathologist is called in, the better the outcome of treatment. This is better 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.
The clinical psychologist uses psychotherapy like cognitive behavioral therapy. One method is called ABA treatment (Applied Behavioural Analysis). Early treatment with ABA, has been known to improve the IQ in some of the children. Social skills training, counseling, etc. are also part of the 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. These methods also gives the parents and family members the knowhow on managing the individual and handle challenging behaviors.
The psychiatrist –
Psychiatrists play an important and critical role in the management of autism. They can also make the diagnosis of autism on a child or an adult.
Most often, the child is brought to the psychiatrist, due to an associated mental illness. These include depression, anxiety, attention deficit hyperactivity disorder etc. It is the role of the psychiatrist to treat these coexisting mental illnesses.
The treatment of many of these coexisting conditions can help reduce some of the behavioral disorders.
The pediatrician –
Most often, the pediatrician is the first to be consulted by parents with children with autism. The pediatrician should be able to spot autism in children at an early age.
The pediatrician treats physical illness that can present themselves in these children. Treating these physical illnesses can help reduce tantrums.
It is also the role of the pediatrician to give the parents information on this disorder.
The pediatrician should also refer the child appropriately and early enough.
The occupational therapist –
Occupational therapists are professionals that also treat illnesses that have social, emotional and psychological effects. They help to teach the persons skills in dressing, using utensils, writing, etc. And the treatments are on individual basis.
The therapist trains the individual in order to get a good job match in adulthood.
The teacher –
Children with autism are different from other children. They have problems in the areas of processing information and learning. Children with autism require high rates of interactions.
The children with autism who have good IQ, can be taught in a regular school, like other children. If he has moderate intellectual problems, he 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 classes.
The children who go into main stream schools will require calm classrooms. They will also require individual attentions from teachers, learning aids and lessons tailored to the child’s specific needs. These learning aids include audio and visual learning materials.
Placing these children in mainstream schools helps them to overcome social issues. It also helps them with their speech and behavioral issues.
The school authorities should protect these children from being bullied by peers. And the school teachers must receive adequate training in order to teach children with autism.
For the employers of adults with autism –
Employment of adults with autism promotes self-esteem and improves quality of life for them.
There should be an appropriate job match for the individual. And the job description must be clear to the individual. There may be need for modification of the work place for the adult with autism. And there should also be job training for the individual.
Autism treatment in 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 when accessing treatments. And Treatment for people with autism is done out of pocket, making it very financially involving.
At present, it is difficult to ascertain the number of speech therapist in Nigeria, due to none availability of records. 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.
Teaching children with autism in Nigerian schools –
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.
Presently in Nigeria, there is no government social policy for autism. There is no curriculum in schools for children with autism.
What roles do parents have to play?
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.
Need for a stable home:
There is need to have a stable home, free from all forms of abuse.
Parenting practices:
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.
Need for proper medical treatment:
Ensure that the child gets the treatments needed. This could be from any of the treatment specialists mentioned above.
Concerning education:
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. There may be need to bring in grandparents to help, or a live-in nanny. These will give you the opportunity to look after yourself socially and medically. Take out time to socialize and rest.
