Psychosocial Needs of Children with Autism Spectrum Disorders in Sub-Saharan Africa: A Review Through the Social (Dis) Empowerment Model
Children with autism spectrum disorder in sub-Saharan Africa experience psychosocial challenges shaped by interacting social, cultural, economic, educational, and health-system factors. This review examines these challenges through a modified version of Friedmann's Social Empowerment Model, adapted to the context of children with autism spectrum disorder and their families. The adapted framework includes seven interconnected bases of social power: financial resources, access to health care and services, access to school and vocation, defensible life space, social networks and social organisations, stigma and discrimination, and funding and research. Evidence from peer-reviewed and grey literature was organised thematically around these domains to identify how social disempowerment affects psychosocial adjustment and participation. The review shows that limited household income, out-of-pocket payment for services, scarcity of trained professionals, and weak public support systems restrict access to early identification, intervention, education, and family support. Educational exclusion is compounded by limited teacher training, inadequate individualised support, and few structured pathways to vocational preparation. Stigma and discrimination further reduce participation by affecting care-seeking, school inclusion, peer relationships, and caregiver well-being. Deficits in safe and supportive environments, weak social networks, and limited locally led research reinforce the invisibility of autism in policy and service planning. The modified empowerment framework provides a useful way to understand these overlapping barriers and to identify intervention points. Strengthening each base of social power through family support, accessible services, inclusive education, anti-stigma strategies, and locally relevant research may improve psychosocial outcomes for children with autism spectrum disorder in sub-Saharan Africa.