Autism presenting to two child mental health clinics at a tertiary care center in central Sri Lanka: A retrospective clinical record review

Abstract

Background: Although clinical and demographic patterns in presentation of autism in the developed world have been extensively studied, comparable data from developing countries remain scarce. While a few attempts have been made previously to describe autistic children in some areas in Sri Lanka (SL), there are gaps in the understanding of autism in the local setting. Methods: Data on all patients diagnosed with autism in two child mental health clinics at a tertiary care center in central SL were abstracted retrospectively from clinic records over a period of 30 years since the inception of the clinics. Diagnosis of autism in these clinics has been based on criteria in the International Classification of Diseases-10thversion. Results: Autism had been diagnosed in 77 patients. Of them, 58.4% were male. The mean age at first presentation was 6.7 years. While the number of autistic patients presenting to the clinic has increased over time, the age of presentation has remained largely unchanged. Delayed speech (23.4%) and poor social interactions (23.4%) were the two common primary concerns of parents leading to referral. Among medical comorbidities, epilepsy was the commonest (19.5%). The majority of patients (85.7%) had needed help with activities of daily living. In 62.3% of patients, no therapeutic interventions were documented. Conclusions: There are a substantial dearth and delay in presentation of autism in SL. Multiple deficiencies noted in the management of these patients indicate the need to improve awareness as well as resources and services dispensed for autism in SL.