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Pilot effort provides an early warning system for autistic children in Malaysia

© UNICEF Malaysia/2007/Mohan
"Noor" and her three-year old son "Mohamad" who has been diagnosed with autism.

In 2007, the United Nations General Assembly designated 2 April 2008 as the first World Autism Awareness Day. The designation provides a landmark opportunity to focus attention on a global epidemic affecting some 35 million people worldwide. 

By Steve Nettleton

GELANG PATAH, Malaysia, 2 April 2008 – Three-year-old Mohamad kneels on the floor, winding and unwinding an electrical cord around his arms. Every few cycles, he turns slightly clockwise, but always with his back to his mother and father, who try futilely to catch his attention.

Mohamad has been diagnosed with autism, a neurological disorder that affects development of social and communication skills.

His mother, Noor, first noticed something was wrong when her son couldn’t walk until he was 20 months old. He couldn’t speak, and seemed unable to understand what his mother said to him.

Once, when Noor was taking a course to become a midwife, she happened across an autistic child. Seeing the similarities with her own son, she convinced her husband they should take Mohamad to a clinic, where her suspicions were confirmed.

“When the doctor said that my son was autistic, I felt sad,” said Noor. “I asked, what is going to become of my son? I was so worried. Worried that when he grows up, will children like him be given any attention by anyone? Can he become like a normal child, go to school and do other things? There were many thoughts. I was confused.”

A disability on the rise

Autism is a little-understood disability in Malaysia, one that often carries a social stigma. (Mindful of this, Mohamad’s family has asked not to be identified by their real names.)
© UNICEF Malaysia/2007/Mohan
With the help of a nurse at the Family Health Clinic in Gelang Patah Johor, a mother uses the screening checklist developed by UNICEF and the Ministry of Health Malaysia to assess if her daughter displays signs of being autistic.

Malaysia’s Ministry of Health reports that autism cases are on the rise. Unfortunately, most cases are not detected until children are already in school. While there is no cure for autism, early treatment during toddler and preschool years can reduce its effects and improve a child’s development.

According to Malaysia’s Ministry of Health, one of the main factors in this slow detection of autism is the absence of any standardised assessment test for health centres to use in screening for the condition.

UNICEF and the Ministry of Health are now working to help clinics and hospitals detect autism at an earlier age. A pilot program is training medical professionals – including psychiatrists, paediatricians, therapists and nurses – on identifying and following up with children who may be autistic.

Early intervention, dramatic improvement

A new screening tool is offering parents and doctors a quick way to assess a child’s mental health. It involves a checklist of 23 questions that measure signs of autism. Children whose scores show a higher likelihood of autism are referred to specialists for further testing.

“We target children between 18 and 36 months old, because that’s the optimum time for intervention to take place,” said nurse Siti Norhamidah at the Masai Clinic in Pasir Gudang, where Noor brought Mohamad for screening. “We provide training and rehabilitation not only at the clinic, also for the parents so that rehabilitation can continue at home and the child can develop as normally as possible.”

Armed with a diagnosis, Noor has begun therapy with her son to help draw him out of his shell. She says after only a few sessions, she has seen a dramatic improvement.

“Before, I felt sad,” Noor said. “I blamed myself. Maybe I’ve done something wrong. I work early in the morning and come back late in the evening. My son doesn’t see me often. That must be why he is not very affectionate with me. I was so worried. Now it’s ok. I can hold him, cuddle him, kiss him. He can kiss me. I feel really touched. Whatever I’ve done was worth it.”






UNICEF correspondent Steve Nettleton reports on early detection for autism in Malaysia, where the disability is on the rise.
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