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Awareness of Effective Interventions for Autism among Practicing Pediatricians in the UAE

Michelle P. Kelly1*, Binu George2, Nipa Bhuptani3 and Shaljan Areepattamannil1
  • 1 Emirates College for Advanced Education, United Arab Emirates
  • 2 King's College Hospital London, Abu Dhabi, United Arab Emirates
  • 3 Applied & Behavioral Training Institute, United Arab Emirates

Background and Goals of the study Autism Spectrum Disorder (ASD) is a lifelong developmental disorder characterized by impaired communication and social interaction skills and a lack of flexibility in interests and behaviors (American Psychiatric Association, 2013). According to the Centers for Disease Control and Prevention (CDC; 2018) approximately 1 in every 59 children has been diagnosed with ASD. Despite the fact that ASD is on the rise, there is paucity in the literature examining this disorder and its treatment in the Middle East and specifically the Gulf Cooperation Council (Kelly et al., 2016). Once a child has been diagnosed with ASD, parents must then seek out “treatment” or intervention options. Kelly, Tennant & Al-Hassan (2016) found that on average, parents of children with ASD in Abu Dhabi were currently using seven different treatments at the time of the survey, with one parent reporting the current use of 28 different treatments for their child with ASD. When parents first become aware of potential “red flags” for ASD and are searching for intervention options, their first point of contact is typically their family doctor or the child’s pediatrician. Awareness of ASD among healthcare providers has been examined in many parts of the world including: Lahore, Pakistan (Imran et al., 2011); Karachi, Pakistan (Rahbar, Ibrahim & Assassi, 2011); USA (Stone, 1987); Nigeria (Bakare et al. 2009; Igwe, Ahanotu, Bakare, Achor & Igwe, 2011); and Australia (Barbaro et al., 2011). These studies have indicated that healthcare professionals tend to harbor sub-optimal awareness. While poor awareness towards children with ASD has been reported in many parts of the world, such information is still limited in the Middle East (Al-Farsi et al., 2011). In order to fill the gap in the existing literature, the purpose of this study was to determine the level of awareness about effective interventions for ASD among practicing pediatricians in the United Arab Emirates (UAE). Methods An initial online, self-developed survey was created by the investigators and pilot tested on a sample group of non-pediatric doctors practicing in the UAE. Subsequently the survey was modified and distributed to approximately 250 pediatricians who are all members of a specialist WhatsApp group for pediatricians in the UAE. The survey collected demographics of the test population as well as explored awareness of causes, characteristics, diagnostic criteria and effective interventions for ASD. Summary of Results A total of 232 responses were obtained with almost equal gender distribution. Pediatricians were asked to rate the effectiveness of 49 different interventions. These interventions were categorized by the authors as established, emerging or unestablished, based on the National Autism Center (2015) report which evaluated educational and behavioral intervention literature for individuals with ASD below and above the age of 22 years. Respondents recognized the effectiveness of many established interventions including those based on the science of Applied Behavior Analysis (86% rated this as “very effective” or “effective”); Early Intensive Behavioral Intervention (EIBI; 91%); and Pivotal Response Treatment (PRT; 32%). Support was also found for emerging interventions including music therapy (55%) and Picture Exchange Communication System (PECS; 69%). Several unestablished interventions were also reported by pediatricians as being effective, including facilitated communication (74%); auditory integration therapy (68%); shock therapy (11%) and special diets (37%). Furthermore, there was some support for treatments that don’t work or are untested (Association for Science in Autism Treatment, n.d.), including chelation (13%), and hyperbaric oxygen therapy (17%). Conclusion Given the importance of the role a pediatrician may play when identifying interventions for children with ASD, it is necessary that doctors be aware of the researched effectiveness, or the lack thereof, of interventions for individuals with ASD. The results of this study demonstrate the need for pediatricians to further develop and update their knowledge of the evidence-base for currently available treatment options in the UAE.

References

References Al-Farsi, Y.M., Al Shafee, M.A., Al-Lawati, K. S., Al-Sharbati, M.M., Al-tamimi, M.F., Al-Farsi, O.A….Al-adawi, S.S. (2017). Awareness about autism among primary healthcare providers in Oman: A cross-sectional study. Global Journal of Health Sciences, 9(6), 65-75. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington, DC: Author. Association for Science in Autism Treatment. (n.d.) Learn more about specific treatments. Retrieved from: https://asatonline.org/for-parents/learn-more-about-specific-treatments/ Bakare, M. O., Agomoh, A. O., Ebigbo, P. O., Eaton, J., Okonkwo, K. O., Onwukwe, J. U., & Onyeama, G. M. (2009). Etiological explanation, treatability and preventability of childhood autism: A survey of Nigerian healthcare workers' opinions. Annuals of General Psychiatry, 8, 6. Barbaro, J., Ridgway, L., & Dissanayake, C. (2011). Developmental surveillance of infants and toddlers by maternal and child health nurses in an Australian community-based setting: promoting the early identification of autism spectrum disorders. Journal of Pediatric Nursing, 26, 334-347. Centers for Disease Control and Prevention (2018). Data & Statistics on Autism Spectrum Disorder. Retrieved from: https://www.cdc.gov/ncbddd/autism/data.html Igwe, M. N., Ahanotu, A. C., Bakare, M. O., Achor, J. U., & Igwe, C. (2011). Assessment of knowledge about childhood autism among paediatric and psychiatric nurses in Ebonyi state, Nigeria. Child and Adolescent Psychiatry and Mental Health, 5(1), 1. Imran, N., Chaudry, M. R., Azeem, M. W., Bhatti, M. R., Choudhary, Z. I., & Cheema, M. A. (2011). A survey of autism knowledge and attitudes among the healthcare professionals in Lahore, Pakistan. BMC Pediatrics,11(1), 1. Kelly, M. P., Alireza, I., Busch, H. E., Northrop, S., Al-Attrash, M., Ainsleigh, S., & Bhuptani, N. (2016). An overview of autism and applied behavior analysis in the Gulf Cooperation Council in the Middle East. Review Journal of Autism and Developmental Disorders, 3(2), 154-164. Kelly, M.P., Tennant, L., & Al-Hassan, S. (2016). Autism treatment used by parents in Abu Dhabi, United Arab Emirates. Austin Journal of Autism & Related Disabilities, 2(3), 1024. National Autism Center (2015). Findings and conclusions: National standards project, Phase 2. Randolph, MA: Author. Retrieved from: http://www.nationalautismcenter.org/resources/ Rahbar, M. H., Ibrahim, K., & Assassi, P. (2011). Knowledge and attitude of general practitioners regarding autism in Karachi, Pakistan. Journal of Autism and Developmental Disorders, 41(4), 465-474. Stone, W.L. (1987). Cross disciplinary perspectives on autism. Journal of Pediatric Psychology, 12(4), 615-630.

Keywords: Autism Spectrum Disorder, pediatrician, intervention, Treatment, Awareness, UAE

Conference: 4th International Conference on Educational Neuroscience, Abu Dhabi, United Arab Emirates, 10 Mar - 11 Mar, 2019.

Presentation Type: Poster Presentation

Topic: Educational Neuroscience

Citation: Kelly MP, George B, Bhuptani N and Areepattamannil S (2019). Awareness of Effective Interventions for Autism among Practicing Pediatricians in the UAE. Conference Abstract: 4th International Conference on Educational Neuroscience. doi: 10.3389/conf.fnhum.2019.229.00020

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Received: 07 Feb 2019; Published Online: 27 Sep 2019.

* Correspondence: Dr. Michelle P Kelly, Emirates College for Advanced Education, Abu Dhabi, United Arab Emirates, michellepatriciakelly@gmail.com