Rwanda: ECD Experts Enlisted to Assess Autistic Children

16 October 2023

More than 30 professionals responsible for Early Childhood Development (ECD) in every district have been assigned the responsibility of guiding the screening process and determining the condition of autistic children nationwide.

The focus on enhancing the ability to identify autism symptoms, including the inclusion of autistic children in Early Childhood Development Centres (ECDCs), and the effort to combat stigma aligns with a month dedicated to mental health.

Statistics show that seven out of ten autistic people have a mental health condition such as anxiety and depression which also mentally affects their parents.

Autism, also called autism spectrum disorder (ASD) is a neurodevelopmental disorder characterised by challenges in social interaction, verbal and nonverbal communication, and often repetitive behaviours and restricted interest.

Globally, one in 160 children has autism, according to the World Health Organization. However, there are no specific numbers of people with autism in Rwanda.

Diane Iradukunda, Acting Head of the Child Development, Protection, and Promotion Department at the National Child Development Agency (NCDA), said they partnered with schools with inclusive education and other partners to train and deploy professionals to know the number of autistic children and integrate them in ECDCs.

"Parents are often unable to detect early signs of autism. The professionals will lead the awareness campaign so that children have such knowledge because some think that the children were poisoned or have bad behaviours," she said.

Some of the autism symptoms include delayed language skills, delayed movement skills, delayed cognitive or learning skills hyperactive, impulsive, and/or inattentive behaviour, epilepsy or seizure disorder, unusual eating and sleeping habits, unusual mood or emotional reactions, anxiety, stress, or excessive worry, lack of fear or more fear than expected according to Centers for Disease Control and Prevention (CDC).

People with autism have behaviours or interests that can seem unusual, studies have shown. The child avoids or does not keep eye contact, does not respond to name by nine months of age, does not show facial expressions like happy, sad, angry, and surprised by nine months of age, does not play simple interactive games by 12 months of age, uses few or no gestures by 12 months of age (for example, does not wave goodbye).

A child with autism does not share interests with peers at 15 months of age, does not notice when others are hurt or upset by 24 months of age, and does not join other children during playtime at 36 months of age, among others.

"Those trained will also train community health workers to help detect signs of autism. All ECDCs should be well equipped to be inclusive for autistic children," Iradukunda said.

There are more than 50,000 community health workers who are the champions of primary healthcare across the country. "We have a plan for screening to detect disorders at early stages," she said.

Evas Kyomugisha, the founder and owner of Silver Bells, an autism centre in Kigali, said they are involved in a partnership to implement an autism project. This project aims to explore opportunities and possibilities for supporting children with autism in the community.

"Our intervention is dedicated to providing services to children and their families who face challenges related to autism. There is a need to address the needs of these children and work with parents and caregivers.

In our centre, 90 per cent of 65 children are autistic. Most parents leave autistic children at home thinking that they have no future. We have to partner in building capacity for workers in charge of early childhood development in districts so that these children are integrated into ECDCs," she said.

Cost of educating a child with autism

The National Council of Persons with Disabilities (NCPD) has highlighted the high cost of education for children with autism, emphasising the need for government intervention to ensure accessibility for economically disadvantaged families.

At Autism Rwanda in Gisozi, for example, the cost of educating a child with autism is Rwf500,000 per term, while Silver Bells Rwanda in Kimironko charges Rwf760,000 per term. These amounts accumulate to Rwf1.5 million and nearly Rwf2.3 million per year, respectively.

According to the Rwanda Basic Education Board (REB), a curriculum for children with intellectual disabilities including children with autism is also being developed.

Although the government currently provides approximately Rwf90 million in support to disability-focused schools and centres for education and healthcare, this amount is inadequate. NCPD has requested an increase to at least Rwf200 million.

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