Pakistan and Autism
Pakistan is situated in South Asia and is the sixth most populous country in the world with population of about 180 million with almost 45 % below age 18. The child and adolescent psychiatry field, including services for children and families with autism and developmental disabilities, are minimal in Pakistan. There are only handful of child psychiatrists and very few child psychiatry departments in the country. The major general psychiatry departments are in major cities of Karachi, Lahore, Rawalpindi, Islamabad, Faisalabad, Multan, Peshawar, and Quetta, to name a few. There is no subspecialty fellowship in child psychiatry or developmental disabilities in the country. There is only one inpatient child and adolescent psychiatry unit in Pakistan, established in 2012, at King Edward Medical University in Lahore (Imran and Azeem 2014).
The current prevalence of autism spectrum disorder in Pakistan is unknown. In Pakistan, various health professionals, including child psychiatrists, general psychiatrists, neurologists, psychologists, pediatricians, and speech and language therapists, make the diagnosis of autism. Along with these professionals, there are strong cultural beliefs in getting treatment from traditional healers. There are no formal screening tools used in primary care practices for autism spectrum disorder.
Recently, two surveys were done in Pakistan, looking at practices and attitudes of health professionals towards Autism (Imran et al. 2011; Rahbar et al. 2011). Various misbeliefs and misconceptions were found in these surveys regarding causes, diagnosis, and treatment interventions for autism.
There are very few schools which are providing specialized programs for this population. One of the earliest established school in this regard is “Amin Maktab School” in Lahore, second largest city of Pakistan. Amin Maktab School was established in 1962. In 1991, outreach programs for underserved areas of Lahore were also established by this institution.
In recent years, various parental groups have played an important part in educating and supporting the families of children with autism spectrum disorders. The most well-known group in this regard is “Pakistan Autism Meet up” which was established by one of the parent Ms. Saira Salman in 2003. This support group currently has hundreds of members across the country and around the world, including parents and health care professionals. This group was started in Karachi, the largest city, and now has branches in Lahore, Rawalpindi/Islamabad, and Quetta as well as active online forum. Ms. Irum Rizwan and another volunteer, Mr. Qazi Fazli Azeem, along with a number of parents and volunteers have played a huge part in the ongoing success of this group. The meetings of this group happen regularly and are instrumental in the support and services for autism spectrum disorder in the country.
Children’s Hospital Lahore has a well-established program for autism and provides diagnostic and therapeutic services. Recently a new autism program was started at Dow University in Karachi in 2013. This program provides wide array of services for children with autism spectrum disorder in the largest city of Pakistan.
There are no federal laws related with services and education for individuals with autism and developmental disabilities in Pakistan. There are limited services for making diagnosis of autism and negligible amount of treatment services, especially none in rural areas where most of the population live.
Recently, College of Physicians and Surgeons Pakistan approved the child and adolescent psychiatry fellowship in Pakistan, which is based on US Curriculum of 2 years training after finishing general psychiatry FCPS. Various individuals have played a key part in developing this fellowship from Pakistan, United Kingdom, and USA including: Prof. Mowadat Rana, Prof. Fareed Minhas, Dr. Nazish Imran, Dr. Ayesha Mian, Dr. Ayesha Minhas, Prof. Atif Rehman, Dr. Dorothy Stubbe, and Dr. Muhammad Waqar Azeem. This fellowship will start in three major academic institutions in Pakistan in 2016. Hopefully, this fellowship will help in training of child psychiatrists with adequate knowledge of autism spectrum disorder and developmental disabilities.
It is important for public and private sector to join hands in providing comprehensive diagnostic, treatment, educational, and support services for these children and families in most need across the country.
References and Reading
- Imran, N., & Azeem, M. W. (2014). Child psychiatry in Pakistan. AACAP News, 45(1), 5–6.Google Scholar