Indicators of Autism in Iranian children

Autism occurs in every country of the world. However its prevalence varies greatly acrossnations with higher rates being reported in more affluent, English speaking countries. Thelower rates in less developed countries have been attributed to a lack of knowledgeable personnel in child assessment and diagnostic services and their slow response to parental concerns [1]. While this is certainly a major impediment to early identification, other social and cultural factors may play a part. In particular, expectations of children’s development and behaviours may mean that parents attach less significance to certain early indicators of Autism across different cultures [2]. If this were so, then screening and other assessment tools developed in Western countries may not be sufficiently sensitive to detect early signs of Autism in other societies [3].This chapter summarises the findings from two studies in Iran that identified the items thatbest discriminated children who had a diagnosis of autism. In the first study, the GilliamAutism Rating Scale - Second edition GARS ll [4] was used. Comparisons are drawn between three groups of children aged 3 to 16 years: those with a compared diagnosis of Autism; children with intellectual disabilities and those whose development was considered to be normal.The second study focussed on the Autism Diagnostic Interview- Revised (ADI-R) [5]. Thistool was developed for use by clinicians to assist in making a diagnosis of autism usuallyafter referral that follows from the use of a screening tool such as GARS. In all the performance of 333 children (84%) with a confirmed diagnosis of Autism could be confirmed with those of 64 (16%) who were not given this diagnosis although they had screened positive.The findings from these two major studies together identify those indicators of autism thatappear to be more culturally specific to Iranian or similar cultures. However comparisonsare drawn with similar data from other countries to underline the universality of certain autistic traits [6]. Nevertheless the implementation of tools for the identification of childrenwith autism has to be located within wider considerations; notably the education of parentsand professionals around indicators of atypical child development and the possible environmental influences on children’s behaviours.