Autism in children: warning signs

---

Extract from the article: It is crucial to describe the signs of autism in children in order to understand this condition. According to the diagnostic criteria outlined by Ms Adiel Lotri, an occupational therapist specialising in mental health and a graduate of Claude Bernard

---

Autism in children: warning signs

It is crucial to describe the signs of autism in children in order to understand this condition. According to the diagnostic criteria outlined by Ms Adiel Lotri, an occupational therapist specialising in mental health and a graduate of Claude Bernard University in Lyon (France), given the absence of additional tests to establish a diagnosis, such as blood tests or imaging, we must rely on signs and symptoms.

According to the World Health Organisation, 1 in 160 children worldwide has autism spectrum disorder (ASD). In Lomé, according to the Association Togo Merveilles et Mystères (ATMM), approximately 2,000 children are currently living with autism spectrum disorders, according to current estimates. This neurodevelopmental disorder, which mainly affects boys (four times more than girls), causes difficulties in communication, social relationships and behaviour.

What is autism?

Autism spectrum disorder (ASD) is "a group of developmental disorders that share some common characteristics. The causes of these disorders are not known with certainty. Genetic and environmental problems have been associated with some cases, but research is ongoing to better identify the causes," explains Ms. Adiel Lotri, a mental health occupational therapist. Today, it is also not possible to say with certainty that any particular factor is the cause, she says.

Interviewed during an awareness session conducted by the association Autisme Togo merveille et mystère (ATMM) on 6 April 2024, Dr Rissikatou Salifou Ouro-Sama, clinical psychologist at the Saint-Jean-de-Dieu health centre in Agoè, Lomé, adds: "Autism is a neurodevelopmental disorder, which means that the brain develops differently in the foetus, resulting in signs that appear very early in the child, the first of which are detectable from 9 months of age (e.g. lack of response to smiling). It is a developmental disorder characterised by abnormal or deficient development. Autism is not a disease. Genetic and environmental factors are often at the root of it."

How does this disability manifest itself in children?

Ms Adiel Lotri explains that autism affects three areas: social behaviour, restricted interests and communication. ‘The symptoms of autism in children appear before the age of 3. It is therefore essentially a developmental disorder. Autism affects various aspects of a person's daily life and even those around them. Autism spectrum disorders cannot be diagnosed through laboratory tests,’ she emphasises.

Difficult communication

Children with autism spectrum disorder have communication problems. ‘They have difficulty interacting with those around them. We therefore distinguish between verbal and non-verbal autistic people. Some autistic people acquire spoken language, while the second group makes a few sounds of their own,’ explains Ms Lotri.

During an awareness-raising session led by the Togolese Association for the Education and Integration of People with Intellectual Disabilities (ATEIPDI), in collaboration with the ‘Lumière’ centre on 2 April 2023 at the Lycée Moderne 2 in Adidogomé, Ms Jémila, mother of an autistic child, gave a ‘fascinating’ testimony: "When we learned that our son was autistic, our whole world fell apart. The most difficult thing was the lack of communication. I would have given anything for him to simply say “mummy” or look me in the eye. He would sometimes scream for no apparent reason, and I didn't know if he was hungry, in pain or afraid. But thanks to therapy, we learned to communicate in other ways: with gestures, images and pictograms."

 

Psychologist Dr Bêkeyi Agathe Sogoyou, an expert in supporting pupils with learning difficulties/intellectual disabilities and/or ASD, points out that facial expressions are also characteristic, tending to be neutral and without much accompanying body language. ‘This makes it difficult for parents to interpret how they are feeling. Some children know their first name perfectly well, but do not respond when called. Sometimes, adults think this is related to a hearing problem and consult an ENT specialist.’

Other times, children get into the habit of constantly repeating a word or the end of a sentence they have just heard, even if they have received a satisfactory answer or obtained the desired object, notes Ms Lotri. ‘In reality, they don't do this to get a response, but because it is part of their repetitive behaviour,’ says the occupational therapist.

Lack of social interaction

The main symptom of autism spectrum disorders is a lack of social interaction. Specialist Adiel Lotri shows that children with autism seem disconnected from the reality around them and are not interested in their environment or only interested in a single object.

In addition, their gaze is quite ‘characteristic’. One of the symptoms of autism is "not sharing one's attention with another person on the same object or situation, in addition to looking away to the sides in situations that would involve direct contact. Some of these children do not appreciate gestures of affection, such as hugs. They reject these displays of closeness, even with violent gestures if they deem it necessary," says the occupational therapist.

Children with autism spectrum disorders play alone. ‘It is very difficult for them to establish play routines with other children. In addition, their personal play is repetitive, always in the same way and always with the same toys that they chose at the beginning,’ says Ms Essénam Laboé, assistant for children with disabilities (AESH) at Cours Lumière (Lomé).

Abnormal behaviour

The behaviour of autistic children seems strange to those around them. "They engage in activities that others would not do and assign functions to things that are outside the conventional norm. The toys they choose have a different function, and they may play with only one part of the toy without using the whole thing. Of course, their play is repetitive and monotonous," reiterates Ms. Essénam Laboé, AESH.

Rocking is another sign found in some autistic children. "Children rock back and forth, on the spot, sometimes for hours. This behaviour may be accompanied by a vacant stare, always in the same direction. On the other hand, changes in routines are a real problem," explains Ms Lotri.

     Furthermore, according to Dr Bêkeyi Agathe Sogoyou, the life of an autistic child is organised around rituals and repetitions that turn into crises at the slightest change. The child may even have violent outbursts.

Be alert to the signs

If parents are alert to the symptoms of autism and healthcare professionals are able to guide the diagnosis, it will be easier to begin treatment. In addition, Dr Koffi Yaboué, president of the Togolese Association for the Inclusive Education of People with Intellectual Disabilities (ATEIPDI), recommends that teachers be given the tools to identify suspected cases for possible early intervention. "Teachers must be attentive to children's behaviour and draw parents' attention to suspected cases, encouraging them to consult specialists for a diagnosis. We believe that it is at school level that these children can be detected early. The important message is to accept difference and say no to the stigmatisation of these autistic children,‘ he emphasised during an awareness-raising session for teachers at the Sagbado Public Primary School (EPP) on 2 April 2025, on the theme: ’I am autistic and I also have the right to education. No to stigmatisation and discrimination."

The earlier the signs of autism are recognised, the better the child can be supported. Every autistic child can learn, progress, communicate and integrate if they are given support. The most important thing is to create an understanding, inclusive, patient and caring environment, both at home and at school.

William O.