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Vietnam Today

Falling through the cracks

Released at: 02:35, 25/07/2014

Falling through the cracks

The education and treatment needs of autistic children are going largely unmet in Vietnam.

by Le Diem

“Autism? What’s that? A mental illness?” Ms Tuyet Hanh has lost count of how many times she’s been asked such questions since her five-year-old daughter was diagnosed with autism. Although the number of children being similarly diagnosed has increased recently throughout Vietnam, most people have only a vague understanding of the disorder. Early detection and treatment faces a range of difficulties from this lack of understanding.

The number of children diagnosed as autistic has been rising over the last decade, reaching thousands of cases each year compared to only dozens in the early 2000s, according to research by Dr Ngo Xuan Diep, Head of the Psychology Faculty at the University of Social Sciences and Humanities. Dr Diep determined that, although no official figures on autistic children were released, an average of 700 to 800 cases were identified annually at each paediatric hospital such as the Children’s Hospital 1, the Children’s Hospital 2, and National Hospital of Paediatrics (NHP).

Before 2000 autism cases were rarely diagnosed and people had no idea about detecting it. The development of the internet together with medical advances allowed local people to access more and better knowledge about the disorder. More children have been detected as suffering from autism by their parents, resulting in increasing number of diagnoses at hospitals, particularly in urban zones where the level of education and living standards is higher.

However, although recognition of the disease has become more common, many people misunderstand it and early detection is missed, according to Dr Ngoc Minh at the NHP.

When Ms Hanh’s daughter, Ngoc Dung, was taken to Dr Minh, her situation was severe and the treatment was harder. Many of his other patients were also detected late. “Autism is still thought of as a mental illness by many Vietnamese parents,” said Dr Minh. “Unusual expressions in their children at an early age are usually put down to slower growth rather than being symptoms of autism.”

Even after recognising the symptoms, some parents are reluctant to acknowledge their child may be autistic. In Vietnam, autism or mental problems in a child is usually blamed on poor parental care. Many parents therefore try to hide their child’s situation and delay taking them to a hospital. Instead, they try to give them greater care and attention (though perhaps in inappropriate ways), and simply wait for them to improve. Other parents find it hard to accept such a sad diagnosis, seeking further tests and losing the best time for treatment.

The cause of autism is very complex, according to Dr Diep. There is not just one but a collection of causes, such as gene disorders, abnormal development of the brain, hereditary factors, or complications during pregnancy. So when recognising the symptoms in their children parents should pay greater attention to ensure early detection and treatment, rather than torturing themselves by misunderstanding the problem and holding negative views.

According to specialists, the best time for autism detection and treatment is before the child is 36 months old. If detected and treated at this stage the child may still see positive natural development and self-reliance in their life and be able to integrate better into the family, their school, and other social environments. The success rate is about 70 to 80 per cent. Conversely, if detection is late or early but treatment is delayed, the child may deteriorate and become dependent on others for the rest of their life.

Detection and treatment is not only a long process but also quite expensive. And in Vietnam resources to assist the child and their parents are in short supply. Treatment centres for autism are limited in the country at the moment, according to Dr Diep. More private centres have been opened recently but the cost is unaffordable for many if not most. Both public and private centres are usually located in big cities, and only meet a fraction of demand. Together with difficulties in finding a treatment centre for their children, parents are also confused about selecting which treatment to pursue. As the causes of autism cannot be clearly specified, treatment also differs at different centres.

Along with a lack of treatment centres, dedicated education facilities for autistic children are also sorely lacking. Mr Dinh Huy, whose son is autistic, said that his child was moved between nearly a dozen primary schools after he finished kindergarten. “After two or three days at a new school he would be sent home,” he said. “His unusual behaviour, like shouting or running out of the class during the lesson, was considered to be affecting the other students so we were asked to take him out of the class.”

Primary school teacher Ms Xuan Mai said that many parents don’t want their children to play with an autistic child, which means that the child has fewer opportunities to communicate with others of the same age.

As demand for dedicated education for autistic children has been rising over recent years, the shortage of schools and teachers specialising in and experienced in the field has become evident, according to Ms Nguyen Nu Tam An, lecturer at the Special Education Faculty of the Hanoi National University of Education. Furthermore, a standardised curriculum for autistic students is yet to be introduced, with each school providing different programmes. “Education for autistic students is very much different from general education,” she said. “It requires a special curriculum and a team of specialised and experienced teachers and assistants.”

In such tough circumstances, parents are the best doctors for their autistic children, according to specialists. They firstly should accept their children’s condition to avoid feeling depressed or dispirited, Dr Minh advised. They must prepare for a long rough road, which can only be endured with patience and love. The most important things is to help wake up their child’s emotions and communication with others, so they develop some level of social and psychological awareness.

Dr Diep agreed with Dr Minh that parents play the key role in the treatment of autistic children. He also encouraged all parents to be more understanding. “I look at an autistic child as a project that needs many people to come together, including parents, therapists, educators and the community as a whole,” he said. “If an autistic child is given love and patience and treated fairly, they can approach a normal life.”

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