Implementing the Early Start Denver Model in Senegal: Outcomes and Insights from a Low-Resource Context

Area of Science:

• Child Psychology
• Developmental Pediatrics
• Global Health

Background:

• Autism Spectrum Disorders (ASD) present communication and social interaction challenges.
• Early interventions like the Early Start Denver Model (ESDM) are vital but understudied in low-resource regions.
• This study investigates ESDM adaptation in Senegal, addressing African autism care accessibility gaps.

Purpose of the Study:

• To adapt and evaluate the effectiveness of the Early Start Denver Model (ESDM) for Autism Spectrum Disorders (ASD) in Senegal.
• To explore the feasibility of implementing evidence-based autism interventions in a low-resource African setting.
• To identify challenges and facilitators for autism intervention delivery in Senegal.

Main Methods:

• An observational study was conducted in Dakar, Senegal (Jan 2019-Jul 2021).
• Children under 10 with suspected ASD underwent diagnosis using DSM-5 criteria, ADI-R, and ADOS-2.
• ESDM interventions were adapted to local resources, with family and patient engagement.

Main Results:

• Eighty of 114 referred children were diagnosed with ASD.
• Significant socio-economic disparities influenced intervention access and engagement.
• Clinical characteristics did not differ significantly, but socio-economic factors impacted service utilization.

Conclusions:

• Adapted ESDM interventions demonstrate potential for resource-limited settings like Senegal.
• Socio-economic disparities and service accessibility remain significant challenges.
• Integrating ASD services into health policies is recommended for enhanced efficacy and accessibility.