Assessing diagnostic features of autism in Hadza children

There is generally very little information on how autism presents in low and middle-income regions such as sub-Saharan Africa. The feasibility of using autism diagnostic tools in non-Westernised populations is underresearched. Building on our previous work, we investigated the feasibility of observing common items used in autism diagnostic tools in the children of the Hadza people, a hunter-gatherer tribe in northern Tanzania. Using the Development and Well-Being Assessment (DAWBA) and Strengths and Difficulties Questionnaire (SDQ) we identified 4 children from the study population (n=107) who met the diagnostic criteria for autism. Some items in common diagnostic assessment tools which indicate non-autistic Western children were present in non-autistic Hadza children, including co-ordinated gesture use, imaginative play, and shared enjoyment. The autistic Hadza children had some features commonly found in autistic Western children such as differences in 1) the use of eye contact, 2) facial expressions, and 3) social emotional reciprocity. We found evidence of clinical impairment in functioning in the autistic Hadza children, but we observed that the children were wellsupported by their community. Further work is needed to understand the experiences of autistic Hadza children, and the performance characteristics of established autism diagnostic tools in Hadza children.