Franz Lauren, Adewumi Konyin, Chambers Nola, Viljoen Marisa, Baumgartner Joy Noel, de Vries Petrus J
a Department of Psychiatry and Behavioral Sciences , Duke University , Durham , USA.
b Duke Global Health Institute, Duke University , Durham , USA.
J Child Adolesc Ment Health. 2018 Nov;30(3):149-165. doi: 10.2989/17280583.2018.1525386. Epub 2018 Nov 7.
We set out to examine key stakeholder perspectives on early detection and intervention for autism spectrum disorder (ASD) in South Africa. Early detection and intervention improves child and family outcomes and lessens long-term costs. We focused on stakeholders in the Western Cape province, one of the better-resourced in terms of healthcare. Eight senior management level stakeholders, two each from government's Health, Education, and Social Development, and the non-profit sector were identified using purposive sampling. In-depth interviews focused on key implementation- related themes. The National Integrated Early Childhood Development Policy was the most relevant to early detection and intervention. This policy, however, is not ASD specific. This lack of specificity is in keeping with an emerging theme: ASD was only seen within the context of other developmental disabilities, particularly by Health and Social Development. Specific ASD early detection and intervention may not currently align with Health and Social Development departmental goals. These departments are primarily responsible for identifying and providing services and financial support to young children with ASD. Increased ASD knowledge and local South African statistics on prevalence, burden and associated costs may alter this approach. At this time, ASD early intervention may be more closely aligned with Education department goals.
我们着手研究南非自闭症谱系障碍(ASD)早期检测与干预方面关键利益相关者的观点。早期检测与干预可改善儿童及家庭的状况,并降低长期成本。我们聚焦于西开普省的利益相关者,该省在医疗资源方面较为充足。通过目的抽样法确定了八位高级管理层利益相关者,政府卫生、教育和社会发展部门以及非营利部门各两名。深入访谈聚焦于关键的实施相关主题。《国家综合幼儿发展政策》与早期检测和干预最为相关。然而,该政策并非专门针对ASD。这种缺乏针对性与一个新出现的主题相符:ASD仅在其他发育障碍的背景下被看待,尤其是在卫生和社会发展部门。目前,特定的ASD早期检测和干预可能与卫生和社会发展部门的目标不一致。这些部门主要负责识别并为患有ASD的幼儿提供服务和财政支持。ASD知识的增加以及南非当地关于患病率、负担和相关成本的统计数据可能会改变这种做法。目前,ASD早期干预可能与教育部门的目标更为一致。