Key Stakeholder Perspectives on the Feasibility of Implementing Early Childhood Autism Spectrum Disorder (ASD) Interventions in South Africa

Background: Autism spectrum disorder (ASD) is a major public health challenge worldwide. Early intensive intervention services have been shown to reduce core ASD symptomatology, but there are many barriers to implementing these services in low resource settings. Training caregivers to deliver intensive early ASD intervention may help to overcome many of the implementation barriers, but there is limited research about the feasibility of delivering a caregiver-mediated early ASD intervention in low resource settings and the compatibility of such interventions with existing platforms of care. Study Aims: This study explored key stakeholder perspectives on the feasibility of implementing early ASD intervention services in the Western Cape Province of South Africa. Methods: Eight in-depth interviews with District and Provincial representatives from the Department of Health, the Department of Education, the Department of Social Development, and two non-governmental organizations were conducted. Results: Stakeholders identified 20 current policies relevant to ASD in South Africa, future directions for ASD policy, and perceived barriers to ASD early intervention services. All participants reported a strong desire for early intervention services and identified key potential facilitators to early intervention. Conclusion: Caregiver mediated early ASD intervention may address barriers to ASD services in the Western. This study identified perceived barriers to such interventions as well as facilitators to delivering a caregiver mediated intervention. Adaptions of caregiver-mediated early ASD interventions in the Western Cape must be affordable, simplified to be delivered by paraprofessionals, and adapted to include local cultural components such as language.