Abstract
This study poses the problem of the socio-cultural significance of autism spectrum disorders in the Cameroonian cosmogonic universe. In doing so, we set ourselves the objective of understanding the representations and attributions given to this developmental psychopathology which occurs in the individual from early childhood. Based on work carried out in the African anthropo-sociocultural context, we can draw etiological explanations of autism more from the relationships transgenerational cosmic events that the ego undergoes. There is a generalized paranormal attribution both from the nosological and etiopathogenic point of view which always crystallizes on a fatalistic prognosis. Speeches were collected with an interview grid from four (04) mothers of autistic children living in the city of Yaoundé-Cameroon. It emerges from the analysis of the contents that these children are still considered crazy, mentally disordered or “snake children”. In many Cameroonian cultures, children with ASD are considered born to die. For some, they don’t want to stay in the world of the living. For others, they disrupt the family line by being born and dying multiple times; they are inhabited by an evil spirit which threatens the family and we cannot send them to school, because they are useless. This plunges their parents and neighbors into feelings of shame, guilt and hostility that affect their affective exchanges and their socio-cognitive development. This implies the need for better awareness of this disorder and the possibilities of care and schooling for children who present with them.
Keywords
Autism, Mother, Social representation, Child
Introduction
In each culture, mental illness is interpreted by giving it a specific meaning. We thus try to shed light on the origin of the disease for cultural management. In this work, it is about the social and cultural representations of the autistic child in Cameroon. Childhood autism is defined by Kanner [1] as an inability of children to establish normal relationships with people and to react normally to situations, accompanied by a disorder of affective contact, and appearing from the beginning of life. It is a global and early developmental disorder, which appears from the age of 3 years. The criteria that describe it, however, still pose problems due to its categorization in psychiatric disorders and on the other hand to the fact that in the majority of African cultures, it is caused by the curse and/or the presence of impure spirits. It can therefore be seen that in Africa and in Cameroon in particular, the problem does not lie in the existence of autistic disorders but rather in the mastery of its clinical description as it has been developed by the Association of American Psychiatrists [APA] [2] and by the World Health Organization [WHO] [3].
According to the traditional approach, mental illness is of the magico-religious type, divine punishment, attack by evil spirits, sorcery, transgression by the parents (especially the mother) of a prohibition, malevolence or jealousy of a co-wife are very widely spread. Thus in Mali, in the popular consciousness, the mentally retarded is considered as a person animated by evil spirits [4]. It represents the sign of a curse or a deterioration of social and family relations due to a transgression of ancestral laws. In Senegal, among the Wolofs and Lebous, psychopathological behavior stems from aggression from the outside world, either from a human enemy or from an angry spirit. According to Boyer [5], the child can be the object of alienating parental projections. According to her, in the face of relationship difficulties with a child, parents can set up this type of projection. She thus speaks of a particular psychopathological entity described by Zempleni [6] in Senegal: The “nit-ku-bon” child who could be an example of alienating parental projections.
The set of traits presented by the “nit-ku-bon” child, combining a refusal of verbal and visual communication, singular beauty, excessive wisdom, evoke early childhood autism [4]. In Africa, people with autism are sometimes perceived as idiots, victims of faults committed by their parents or other family members [7]. Some are considered as wizards, as lucky charms, or on the contrary as a curse. The Yoruba of Benin also call children with autism Akibus, which means “to be born and die”. They suspect her children of communicating with spirits and wanting to harm their families. In Cameroon, Lolo [8] had observed that autistic children are often considered as “children born to die”. According to her, they don’t want to stay in the world of the living and disrupt family dynamics by being born and dying multiple times. Parents perceive them as inhabited by an evil, and therefore threatening, spirit. These studies give a brief overview of the autistic child in Africa, but what exactly is Cameroon?
The prevalence of autism and ASD in Cameroon is not precisely known due to the lack of a national registry. This prevalence is estimated at 1/165 [9]. Autism statistics in Cameroon as given by the Ministry of Public Health in 2013, amount to 100, 000 children. According to the WHO, tens of millions of people are affected by autism in Africa [10]. This can be explained by the fact that a majority of countries on this continent are under-informed and do not have appropriate structures for the management of this syndrome. This therefore prompts us to question the social and cultural representation of autism in Cameroon. The objective of this article is to grasp the socio-cultural significance of autism in the anthropo-socio-cosmogonic context of Cameroon.
Methodology
This study is qualitative in nature. The qualitative approach is a research method that makes it possible to analyze and understand phenomena, behaviors, facts or subjects [11]. It is a question of apprehending the social and cultural representation of the autistic child in Cameroon. To fully understand this, the clinical approach was used. Its purpose is to describe the phenomena or the set of observable facts, of events as they occur to us. It therefore made it possible to explore the participants according to their perception, their feelings and their subjective reality that they each have of the autistic child. The clinical method by its singularity and its totality has made it possible to grasp the social and cultural representation of the autistic child in Cameroon. We mainly based ourselves on the case, with the aim of understanding in depth the phenomenon as experienced in a very specific context which is that of Cameroon. The study was done during a camp for parent and child with autism in Yaoundé Cameroon.
The sampling technique adopted in this work is called non-probability. Participants were chosen based on their ability to provide interesting and relevant information about how others perceive their child. They are four mothers of autistic children, of Cameroonian nationality. Data collection was done through semi-structured interviews. This made it possible to center the comments of the participants as well as the perception of the others vis-à-vis their children. These voluntary participants, after signing the informed consent, were free to end the interviews at any time. As a data analysis technique, we used content analysis based on verbatim statements.
Results
This section presents the results of the interviews.
Presentation of the Case
The characteristics of the participants are presented in the Table 1.
Table 1: The characteristics of the participants
|
Characteristic |
Mother 1 |
Mother 2 |
Mother 3 |
Mother 4 |
| Age | 49 years old | 31 years old | 39 years old | 45 years old |
| Ethnic group | Bamiléké | Yambassa | Bamiléké | Bamiléké |
| Marital status | Married | Married | Married | Bachelor |
| Child’s age | 4 years old | 7 years old | 10 years old | 11 years old |
| Age of diagnosis | 3 years old | 2 years old | 3 years old | 2 years old |
| Family history of disability | Yes | Yes | No | Yes |
Thematic Analysis of Interview Content
Clinical interviews with each participant highlight a number of factors that explain the representation of the child’s disability.
The Autistic Child Seen as Crazy
Mother 1 addresses the issue of representation by questioning family members about the origin and condition of her child. She says: “The family was wondering what went wrong. We wondered if he was crazy; if he is mad; what have we not done and we really wanted to know what autism is”. But this mother believes that family members who call the child crazy or crazy know nothing about the issue of autism. The words of Mother 3 are in the same direction as those of Mother 1. Her child is also described as crazy or mentally disordered. “Sometimes we say he acts like a madman, we say he acts like a mental disorder”.
Child Seen as a Snake Child
As for mother 2, her verbatims on the social representation of autism are different from those of mother 1. In her environment, we speak of a snake child. “This kind of child is a snake child. It was a nurse who told me to go throw my child in the river, she is a nurse. My daughter if there is any advice I can give you, the child here, eh, it is the kind of child that should be sent back to the ancestors. You have to look for a river, you throw it there and you let it go to see the ancestors”. These words of the nurse show to what extent the Cameroonian medical profession has limits with regard to the diagnosis of autism. The representation of the disease as presented by mother 4 is similar to that of mother 2. She relates: “People always have something to say. Either the mother is a witch, or she tried to have an abortion, or she gave birth to a snake child, or she gave birth to a Mongolian child. With these words, she describes the meaning that society and culture give to the situation of her child who is autistic.
In view of the above, it can be said that autism is still poorly perceived in Cameroonian culture. Society considers children with autism to be lunatics, mentally retarded, “snake” children.
Discussion
This research was devoted to the study of the conception that Cameroonians have of autism spectrum disorders. In Africa, people with autism are sometimes perceived as idiots, victims of faults committed by their parents or other members of their family. We find that autistic children in Cameroon are perceived as crazy or “snake” children. This study is consistent with the study by Ebwel et al. [7] on social representations of autism in Africa where he refers to cultural semantics in the Democratic Republic of Congo to demonstrate that autistic children are assimilated to those with mental retardation and/or deafness. According to Lolo [8], autistic children in Cameroon are considered as “children born to die”. For her, they do not want to remain in the world of the living and disturb the family line by being born and dying several times. Parents perceive them as inhabited by an evil spirit that threatens the family. The Yoruba of Benin also call children with autism Akibus, which means “to be born and die”. They suspect them of communicating with spirits and wanting to harm their family. Children with autism are often hidden away, largely because of the stigma associated with having a child with a disability [12]. Indeed, it is shameful and unacceptable for some parents to have an autistic child. The guilt felt is amplified by the family and the neighborhood who attribute any fault to the consequence of a parental fault.
Conclusion
The aim of this study was to grasp the social and cultural representation of autism as experienced by mothers in Cameroon. Autism is a very severe developmental disorder that requires an extremely rigorous approach in the argumentation and assessment of the severity of the disorder. It is characterized by the inability of children to establish normal relationships with people and to react normally to situations. Within Cameroonian communities, children with autism are assimilated to those with mental retardation. The results of the interviews with the mothers who participated in this study show that autistic children are represented as crazy, mentally disordered, “snake” children… Therefore, it is important to raise public awareness about autism childhood in the Cameroonian context.
References
- Kanner L (1943) Autistic disturbances of affective contact.Nervouschild 2: 217-250.
- American Psychological Association (2000) Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, TextRevision (DSM-IV-TR)
- World Health Organization (1993) International classification of mental and behavioral disorders: clinical descriptions and diagnostic guidelines. Mason.
- Mbassa Menick MD (2013) Impact de la culture dans la prise en charge de l’enfant en pratiques éducative, familiale et sociale. Communication présentée aux conférences sur la semaine de l’enfance, organisée par l’Institut Français du Congo, Pointe Noire (Congo).
- Boyer F (2002) Reflection on the possible vulnerability of “first-born” migrant children in France.17-19.
- Zempleni A (1985) The child Nit Ku Bon.A traditional psychopathological picture among the Wolof and the Lebou of Senegal in L’enfant ancestre.The child Nit Ku Bon.A traditional psychopathological picture among the Wolof and the Lebou of Senegal in L’enfant ancestre 4: 9-42.
- Ebwel J M, Roeyers H, Devlieger P (2010) Approaches to social representations of autism in Africa.Childhood Psy 4: 121-129.
- Lolo B (1991) The dyad of the mother-child relationship or the care of the African child.Transition 31.
- Awa HDM, Um SN, Dongmo F, Chelo D, Manyinga HP N, et al. (2017) Evaluation of the Knowledge, Attitudes and Practices of Health Professionals on Autism in three Pediatric Health Facilities in Cameroon.HEALTH SCIENCES AND DISEASE 18: 1.
- Jarekji A (2010) Autism, a reality poorly understood by Africans.
- Claude G (2019) Qualitative study: Definition, techniques, steps and analysis. Scribbr.
- Grinker RR (2008) Unstrangeminds: Remapping the world of autism.Basic Books.