Characteristics of children with pervasive developmental disorders attending a developmental clinic in the Western Cape Province, South Africa

Abstract

Background. Little has been published on autism in Africa, and it is not known whether South African children present with the same characteristics and challenges as described internationally.

Objectives. To describe the demographics, history, clinical features, co-morbidity and yield of aetiological investigations in children diagnosed with a pervasive developmental disorder (PDD).

Methods. This was a retrospective review of medical records of children fulfilling Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DSM-IV-TR) criteria for a PDD who attended a tertiary developmental clinic at Tygerberg Hospital, Western Cape, South Africa, over a 2-year period (2008 - 2010).

Results. Fifty-eight children were included. The median age at diagnosis was 42 months (range 15 - 106 months), and 45 (77.6%) were boys. Forty per cent had complex autism (dysmorphism with or without microcephaly), and 12.1% were macrocephalic. Most children (72.4%) were non-verbal (using fewer than 10 non-echoed words), and 89.0% had behavioural problems as reported by caregivers. The diagnostic yield of investigations was low.

Conclusion. The profile of children with PDD attending a tertiary hospital developmental clinic in the Western Cape revealed that a high proportion had severe language impairment, behavioural problems and complex autism.