Saturday, 28 May, 2022
HomePaediatricsMajor hurdles for SA's autistic children

Major hurdles for SA's autistic children

Children with autism face huge barriers in accessing healthcare and special schools, researchers at the University of KwaZulu-Natal (UKZN) have found, and often, there’s a two-year delay between identifying the symptoms and actually finding health at a special facility.

The study’s analysis of demographics and comorbidities among autistic patients at KwaZulu-Natal Children’s Hospital found 87% of them were first seen after they turned three, risking poor outcomes. Almost half of the children are awaiting a place at a special school, the researchers said.

The Sunday Times reports that attention deficit hyperactivity disorder (ADHD) is the most common comorbidity, affecting 43% of the children. About 4% have been abandoned by one or both parents and 83% are cared for only by their mothers.

Autism Western Cape operations manager Zaida Frank said the findings are similar to those of her organisation. The public health system is just overburdened, she said, and a shortage of special schools is a particular concern.

“The waiting lists for special schools are extremely long. Mainstream schools that can accommodate children on the spectrum also find it difficult,” she said.

“Most autistic children are put on the waiting list for autism-specific schools or special schools. This specialised schooling system is under great pressure due to the large number of children needing a higher level of support.” She added that many special-needs children attend regular schools or day-care centres that are not properly equipped. Many leave school without many prospects.

Writing in the South African Journal of Child Health, lead researcher Sajal Pillai said that of the children (about 100) who were part of the study, only 42% attended school. About 27% of those were in mainstream schools and 15% in special schools.

Pillai said the delay in recognising symptoms before getting appropriate treatment “clearly demonstrates the chasm of awareness and services available to assist children with autism spectrum disorder”.

“We hope this study helps healthcare professionals and the community at large to hear the voices of those children who are so frequently misheard or sometimes not heard at all,” said Pillai.

Study details

A study reflecting the demographics and comorbidities of children diagnosed with autism spectrum disorder at initial presentation to the KwaZulu-Natal Children’s Hospital

S Pillai, M Makhetha, C Aldous

Published in SA Journal of Child Health on 14 October 2021


Autism spectrum disorder (ASD) retards the holistic development of a child owing to both inherent and comorbid medical pathology. Despite the profound effect of ASD on a child’s life, information regarding this neurodevelopmental disorder is limited. In South Africa (SA), there is a dearth of knowledge regarding ASD. In addition, the resources available to accommodate the needs of autistic children are largely insufficient in quantity and quality.

To determine demographics and comorbidities in autistic children at the KwaZulu-Natal Children’s Hospital (KZNCH).

This study was a retrospective chart review conducted at the neurodevelopmental and neuropsychiatric clinics at the KZNCH in Durban, SA. Medical records of autistic children at their initial presentation to KZNCH from 1 January 2017 – 31 December 2017 were obtained and analysed.

The study sample comprised 114 study participants. Most participants (87%) presented above 36 months of age to the KZNCH. A 24-month delay was noted between onset of symptoms suggestive of ASD and presentation to a healthcare facility or KZNCH. Almost 50% of participants were awaiting placement in a special school. Attention deficit hyperactivity disorder (ADHD) was the most common comorbidity, affecting 43% of participants.

The study illustrated the demographic profiles and comorbidities of autistic children presenting to the KZNCH. However, the medical and social shortcomings in KZN elucidated in this study reinforce the necessity for further research to be conducted and resources to be invested to address the plight of children with ASD.


SA Journal of Child Health article – A study reflecting the demographics and comorbidities of children diagnosed with autism spectrum disorder at initial presentation to the KwaZulu-Natal Children’s Hospital (Open access)


Sunday Times article – Gaps in schooling and health care hamstring children with autism, say UKZN researchers (Restricted access)


See more from MedicalBrief archives:


Johannesburg launches autism support programme


Pharma Dynamics: An app to assist parents and caregivers of ADHD children


Psychiatrist using 'outdated' checklist faces HPCSA complaint


SA study links low language ability and poor mental health


MedicalBrief — our free weekly e-newsletter

We'd appeciate as much information as possible, however only an email address is required.