Aug 2026· Journal of Clinical Medicine of Kazakhstan· 0 citations
TL;DR
This narrative literature review synthesizes evidence on social, medical, and structural barriers affecting children with ASD, with a focus on healthcare access, comorbidity-related medical vulnerability, and public stigma in Kazakhstan and internationally.
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental condition with a steadily increasing global prevalence. Despite advances in early diagnosis and intervention, children with ASD and their families continue to face significant challenges related to healthcare access, social inclusion, and stigma. These challenges are particularly pronounced in low- and middle-income countries but remain relevant worldwide. This narrative literature review synthesizes evidence on social, medical, and structural barriers affecting children with ASD, with a focus on healthcare access, comorbidity-related medical vulnerability, and public stigma in Kazakhstan and internationally. Databases including PubMed, Scopus, Web of Science, Google Scholar, eLIBRARY.ru, and KazNEB were searched for Russian- and English-language publications Access to ASD-specific services—such as early intervention, behavioral therapy, and speech and neuropsychological support—remains limited due to shortages of trained specialists, long waiting lists, and high out-of-pocket costs. Children with ASD frequently have comorbid chronic conditions, increasing their need for general healthcare, yet health systems are often poorly adapted to their sensory, communicative, and behavioral needs. Persistent stigma across social, educational, and medical settings further restricts access to care, while socioeconomic inequalities exacerbate disparities. Overall, children with ASD, particularly those with comorbidities, constitute a highly medically vulnerable population. Addressing these challenges requires integrated policy approaches, workforce development, expansion of publicly funded services, and targeted efforts to improve public awareness and reduce stigma.
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.
Y. C. Adeniyi, Aderinsola M. Adeniyi· Journal of Advances in Medic...· 0 citations
Autism Spectrum Disorder (ASD) is a lifelong neurodevelopmental
condition characterized by deficits in social communication and the presence of
restricted or repetitive behaviors and interests. Increasing prevalence rates underscore
the importance of early identification and timely intervention. This review
examines current and emerging diagnostic and management approaches to ASD.
Standardized diagnostic frameworks, such as the DSM-5 criteria, remain central
to clinical assessment. Recent advances in screening tools have enhanced early
detection. Due to the heterogeneity of clinical presentations, individualized care
is necessary. Management strategies commonly integrate behavioral and developmental
interventions, educational support, family involvement, and, when appropriate,
pharmacological treatment for associated symptoms. Functional outcomes
are further improved by strategies, such as executive function training, occupational
therapy, technology-assisted therapies, and caregiver-mediated programs.
Research indicates that extensive family involvement and coordinated, interdisciplinary
care lead to improved long-term outcomes. To maximise functioning,
engagement, and quality of life, the existing literature generally supports a
comprehensive, flexible, and person-centred approach that takes into account
each person's unique needs and strengths.
D. I. Khan, Sana Jameel· Current Psychiatry Research...· 0 citations
There is an urgent need for prospective longitudinal studies to adequately map the aging trajectories of this population of older adults with ASD, which constitute a vulnerable population.
J. P. S. Gontijo, Marcelo H S S Martins, L. M. Alves· Trends in Psychiatry and Psy...· 0 citations
The Mental disorders in children and adolescents represent one of the largest unaddressed health burdens globally. Approximately half of all lifetime mental disorders begin before the age of eighteen (Solmi et al., 2022; Kessler et al., 2005), yet most affected young people never receive formal care, and the treatment gap is widest in low and middle income countries (Kieling et al., 2011; Patel et al., 2007). This paper reviews five interconnected domains of youth mental health: depression and anxiety, school based mental health systems, suicide prevention, digital mental health interventions, and the relationship between trauma exposure and resilience. Evidence was drawn from systematic reviews, meta analyses, randomised trials, and institutional reports published mainly from 2010 onward, and synthesised narratively. Three consistent findings emerge across domains. First, prevalence estimates for internalising symptoms rose measurably during and after the COVID-19 pandemic, particularly among adolescent girls (Racine et al., 2021). Second, effective interventions exist at every level of the care pyramid, but implementation fidelity, workforce capacity, and sustained funding determine outcomes more reliably than the choice between comparably evidenced intervention models (Durlak and DuPre, 2008; Werner-Seidler et al., 2021). Third, protective factors operating at family, school, and community level account for a substantial share of variance in outcomes following adversity (Masten, 2014; Ungar, 2011), which shifts the policy question from deficit reduction alone toward the deliberate construction of protective environments. The paper concludes with implementation priorities for resource constrained settings, including task shifting to supervised non specialist providers (Singla et al., 2017; van Ginneken et al., 2021), integration of mental health into existing school health platforms (Fazel et al., 2014), means restriction and responsible media reporting as population level suicide prevention measures (Gunnell et al., 2017; Niederkrotenthaler et al., 2020), and cautious, evidence anchored deployment of digital tools (Grist et al., 2019; Torous et al., 2018).
B. Imtiaz· Pakistan Journal of Positive...· 0 citations
Background The global increase in autism spectrum disorder (ASD) diagnoses is expected to substantially increase demand for long-term rehabilitation services. However, little is known about how this increase affects rehabilitation service utilization and capacity in low- and middle-income countries. Methods We conducted a retrospective longitudinal study of children receiving developmental care at a tertiary rehabilitation center in Salvador, Brazil (2017-2026). Patients were classified into Childhood Autism, Other ASD, and non-ASD diagnostic groups according to ICD-10 diagnoses. Temporal trends in admissions and patients under follow-up were analyzed using generalized additive models and segmented Poisson regression. Factors associated with follow-up duration were evaluated using multivariable Cox proportional hazards models. Results Among 2,123 eligible children, 833 (39.2%) had Childhood Autism, 462 (21.8%) had Other ASD, and 828 (39.0%) had non-ASD diagnoses. Compared with children with non-ASD diagnoses, those with Childhood Autism entered care at younger ages, were predominantly male (77.9% vs. 57.2%), attended more visits, and remained under follow-up longer (all P<0.001). Admissions of children with Childhood Autism increased by 30.2% annually before 2023 but declined thereafter (-19.6% annually; P<0.001). Despite this decline, the number of children with Childhood Autism receiving ongoing rehabilitation continued to increase, reflecting prolonged follow-up. In adjusted analyses, Childhood Autism was associated with a substantially lower hazard of reaching the last recorded follow-up visit than non-ASD diagnoses (adjusted hazard ratio, 0.35; 95% CI, 0.30-0.40; P<0.001). Conclusions The rapid increase in ASD admissions fundamentally reshaped rehabilitation service utilization. Because children with ASD remained under follow-up substantially longer than those with other developmental conditions, they accounted for an increasing share of the rehabilitation caseload, even after new admissions began to decline. These findings highlight the importance of planning rehabilitation services according to both new admissions and the cumulative demand generated by long-term follow-up.
J. A. Aguilar Ticona, A. F. Ferreira-Stagliorio, G. de Oliveira Costa et al.· medRxiv· 0 citations
Background Families of children diagnosed with autism spectrum disorder (ASD) often face challenges associated with treatment, caregiving, and education, which lead to substantial expenses. In Kazakhstan, the economic impact of ASD on families remains insufficiently studied. Therefore, our aim was to examine the financial burden and identify factors associated with financial difficulties among these families. Methods A cross-sectional study was conducted at the Regional Children’s Psychiatric Dispensary in the Karaganda region of Kazakhstan in 2023. The survey was administered to parents of children with ASD under 18 years of age both in person and online. Of the 285 questionnaires distributed, 239 were included in the analysis. The primary outcome was the presence of financial difficulties among these families. Regression analysis identified several variables associated with monthly expenditures related to caring for a child with ASD. Results Among the participating families, 90.79% reported experiencing financial difficulties related to caring for a child with ASD. Non-medical expenditures accounted for the largest proportion of total monthly expenditures (38.08%). Multivariable logistic regression showed that older child age was associated with lower odds of financial difficulties (OR = 0.76, p < 0.001), whereas families living in urban areas had higher odds of reporting financial difficulties than those living in rural areas (OR = 6.30, p < 0.05). Conclusion These findings provide insights into the economic challenges experienced by families of children with ASD in Kazakhstan and suggest the importance of continued development of government support.
G. Kayupova, A. Muzafarova, N. Delellis et al.· Frontiers in Public Health· 0 citations
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