title: Thinking globally to meet local needs: autism spectrum disorders in Africa and other low-resource environments.
abstract: OBJECTIVE
  Most people with autism spectrum disorders (ASDs) live in low and middle-income countries, yet almost everything we know about ASD comes from high-income countries. Here we review recent research from Africa, with some references to research in other low-resource environments. We examine publications on screening and diagnosis, intervention, clinical presentation of ASD, cultural perspectives, and neuroscience and technology.
  
  
  RESULTS
  Open-access screening and diagnostic tools represent a positive, but nontrivial, future goal. Recent efforts at 'low intensity' community-based interventions are encouraging, but many significant scalability challenges remain. Proposals that ASD in Africa is more severe and overrepresented in high socioeconomic families are likely to be attributable to ascertainment biases and the absence of standardized phenotyping tools. Cultural perspectives and innovative use of technology and neuroscience have the potential to generate novel strategies of global relevance, but research priorities have to be determined by local needs.
  
  
  CONCLUSIONS
  To have a real impact on clinical services, training, and research in local communities, clinician-scientists should start by thinking globally. ASD research in Africa and other low-resource environments remains limited and of questionable quality and highlights the need to build high-quality research capacity in these low-resource environments.
authors.affiliation: Division of Child and Adolescent Psychiatry, University of Cape Town, Cape Town, South Africa.
authors.forename: Petrus J
authors.initials: PJ
authors.lastname: de Vries
mesh_terms: D000349:Africa; D000067877:Autism Spectrum Disorder / Q000175:diagnosis* / Q000628:therapy*; D002659:Child Development Disorders, Pervasive / Q000175:diagnosis* / Q000628:therapy*; D004777:Environment; D005544:Forecasting; D006801:Humans; D012106:Research; D012111:Residence Characteristics