ASD in Developing CountriesAutism Spectrum Disorder (ASD) awareness and subsequent treatment are much lower in developing countries than they are in the United States. Early intervention is crucial to treating this condition. However, in countries with low levels of awareness and limited resources, many children do not receive the attention they need to mitigate the effects of their ASD. A new prescription drug called bumetanide shows positive results in reducing core ASD symptoms. It might be a promising way to treat children with ASD in developing countries.

What is Autism Spectrum Disorder (ASD)?

Autism Spectrum Disorder (ASD) is a disorder that causes developmental delays due to atypical neurological development. In those affected by ASD, delays are identifiable in early childhood and persist throughout the lifespan, varying in intensity based on the severity of the disorder.

Some symptoms of ASD are atypical eye contact, repetitive behaviors and the inability to consistently understand social cues. They also include the difficulty in communication and cognitive impairment.

Many people with ASD are smart individuals capable of independently living. However, sometimes, the disorder prevents people from properly functioning or taking care of themselves. To ensure people with ASD are as successful as possible, doctors encourage early intervention that helps children learn skills to combat ASD. Intervention strategies teach these children how to communicate their thoughts and understand what others are thinking, as well as other general coping skills that offset the difficulties of ASD. The earlier these skills can be learned, the more beneficial and effective they are.

ASD in Developing Countries

ASD occurs worldwide, but many countries have strong stigmas against it that discourage openly treating or even talking about ASD. Additionally, there is a large deficit of information about ASD in developing countries. In many of these countries, doctors are not easily accessible. Even when they are, they are not properly trained on how to treat ASD. Thus, a large number of children and people in general with ASD remain undiagnosed and, consequently, untreated.

85% of people with ASD are estimated to live in developing countries. As a result, organizations such as the Global Autism Project strive to raise awareness of ASD. The Global Autism Project is in the process of training teachers to work with those with ASD in developing countries. This provides important tools for destigmatizing and diagnosing ASD.

However, studies have identified that the best intervention strategy currently obtainable is to provide information about behavioral treatment to family members. Providing them with this information allows them to implement the treatment. While this holds the potential for success, it has also been found that this is extremely hard to consistently execute in families that are suffering from poverty.

Bumetanide: A New Drug to Reduce ASD Symptoms

There are countries that lack these resources to holistically work with children with ASD. As a result, a new drug called bumetanide could improve symptoms. It could also work as a treatment system for those who lack other resources and options.

Bumetanide works to stabilize the ratio of two important neurotransmitters: GABA and glutamate. A study observed the effects of this drug. When bumetanide was implemented consistently in three to six-year-olds, the severity of their ASD symptoms declined. For example, many showed improved eye contact and cognitive processing. There are other prescription drugs that have been used to treat ASD, but they all cause multiple and sometimes severe side effects as well. Bumetanide had few side effects, with none proving to be severe.


The improved ratio of GABA to glutamate aids children with ASD in learning. It helps promote the development of healthy brain pathways. Forming these beneficial pathways early on can hold lifelong benefits by permanently improving brain development. Thus, bumetanide can serve as an accessible treatment for children with ASD in developing countries. It creates lasting improvements without requiring continuous doctor appointments and therapy sessions.

Hannah Allbery
Photo: Flickr

Mental Health for Syrian Refugees
Since the Syrian crisis in 2011, the displaced population has migrated to neighboring countries such as Turkey, Lebanon and Jordan. Currently, 50 percent of the population are children without parents. Mental health issues have risen in the Syrian refugee community since then and the world has stepped up in treating the debilitating aspects of suffering traumatic events. This article highlights the improvements in the mental health of Syrian refugees.

Challenge and Impacts

Refugees that have to leave their homes and migrate elsewhere face many obstacles and challenges. Post-migration challenges often include cultural integration issues, loss of family and community support. Refugees also experience discrimination, loneliness, boredom and fear, and children can also experience disruption. Circumstances uproot them from friends and family and cut their education short. Refugees experience barriers in gaining meaningful employment and they face adverse political climates.

Depression, anxiety and post-traumatic stress disorders (PTSD) are all effects of exposure to traumatic events. Traumatic events for Syrian refugees include war terrorist attacks, kidnapping, torture and rape. Meta-analysis all show a positive association between war trauma and the effects of certain mental health disorders. For example, a study examining the mental health of post-war survivors from Bosnia, Croatia and Kosovo showed PTSD as the most common psychological complication.

Post-Traumatic Stress Disorder is a debilitating disorder that intrudes on the patient’s mind. It also intrudes on relationships and the patient’s ability to live a quality life. Thoughts of suicide and/or avoidance are also symptoms of PTSD.

A study of Syrian trauma and PTSD participants found that those between the age of 18 and 65 have experienced zero to nine traumatic events. Of those, 33.5 percent experienced PTSD and 43.9 percent depression. Another study in Lebanon showed that 35.4 percent of Syrian refugees will experience a lifetime prevalence of PTSD.

According to the United Nations High Commissions, 65.6 million people worldwide are “persons of concern.” That total includes 22.5 million termed “refugees” and several other millions termed “asylum seekers” or “internally displaced persons.” Survivors of torture account for 35 percent.

Health Care and Integrated Care

The National Institute of Mental Health identifies integrated care as primary care and mental health care; cohesive and practical. Primary care practitioners recommend conducting a thorough history check of any exposure to or experience of traumatic events. Health care professionals must be able to effectively address mental health issues. Barriers have long been the cause of mental health issues left untreated. Such barriers include communication, lack of health practitioners to patients in need, the physical distance patients must travel and the stigma of having the classification of “crazy.”

Treatments and Evidence-Based Interventions for Refugees

There have been several test instruments that provided significant results in the treatment of mental health as well as scalable interventions. Currently, the only FDA-approved drug both abroad and in the U.S. are paroxetine and sertraline; both selective serotonin reuptake inhibitors (SSRI). Other instruments include the Narrative Exposure Therapy, Eye Movement Desensitization and Reprocessing. Many found EMDR to be successful in reducing episodes of PTSD and depression in a study with Kilis refugees.

In 2008, the World Health Organization launched the Mental Health Gap Action Programme (mhGAP). This endeavor focused on assisting low and middle-income countries in providing effective mental health treatments. Inventions such as Task-shifting, E-Mental Health and PM+ fall under the mhGAP umbrella. First, the task-shifting initiative aims at alleviating the pressure on a limited number of specialized practitioners. Task-shifting shifts duties and tasks to other medical practitioners which otherwise highly-trained specialists would perform. This initiative is cost-effective and proves to be a promising alternative. Refugees can receive treatment in primary and community care locations instead of specialized facilities. Meanwhile, E-Mental Health and PM+ aim to address multiple mental health symptoms at once, while allowing treatment to remain private and within reach to Syrian refugees. Finally, the EU STRENGTHS, also created under the mhGAP umbrella, strives to improve responsiveness in times of refugees affected by disaster and conflict.

Many Syrian refugees continue to face obstacles and barriers, however, there is hope. Initiatives such as those mentioned in this article provide a promising outlook for the continued mental health improvements of Syrian refugees.

Michelle White
Photo: Flickr