In the US, however, this figure has risen sharply to one in 31, with boys more likely to be diagnosed than girls – a pattern that holds true for SA as well.
Despite its growing prevalence, Dr Birgit Schlegel, a paediatric neurologist at Mediclinic Constantiaberg, says that autism remains widely misunderstood. “There are many misconceptions, often based on the notion that all autistic people are all the same. For instance, that autistic people can't feel emotions and never talk.”
Louise Schoonwinkel, Impaq 8 Apr 2025
Yet the most widespread deceptive myth, according to Schlegel, is that autism can be cured. “Autism is not a disease caused by a virus or bacteria, or something that can be ‘caught’,” she explains.
“We understand it to be the result of a mix of genetic and possibly environmental influences that affect early brain development. While many people with autism can often show a marked improvement in some symptoms, there is no cure as such.”
Autism is a neurodevelopmental disorder characterised by challenges in social communication and interaction, as well as restricted and repetitive behaviours. Some individuals may also be highly sensitive to everyday sensory experiences – such as loud noises, bright lights, certain textures or strong smells – which can feel overwhelming or even painful.
They may also struggle with communication, both in speaking and in understanding body language, facial expressions or tone of voice.
As Schlegel points out, the term ’spectrum’ in ASD refers to the wide range of symptoms and also the wide range of severity. “While earlier diagnostic frameworks distinguished between separate types of autism, the disorder is now classified based on severity and, more importantly, on the level of support required.”
In this sense, effective treatment for autism depends on a highly individualised approach. “No two individuals with autism will have exactly the same needs,” Schlegel explains.
“The most effective interventions combine behavioural, developmental, educational and psychosocial elements – often alongside speech and occupational therapy to help with communication and daily living skills.”
Although autism can be reliably diagnosed by age two, in practice, Schlegel says most children are only diagnosed around the age of five – and some not until adolescence or adulthood. “Later diagnosis often means the individual has lived for years with emotional, behavioural and social difficulties that were not properly understood or supported.”
In South Africa, early screening opportunities do exist. “The Road to Health booklet given to every child at birth helps track developmental milestones up to age five,” she says. “Children who do not respond to social cues, fail to make eye contact, or have delayed speech should be assessed without delay.”
Screening tools such as the Autism Diagnostic Observation Schedule (ADOS) – used by specially trained professionals – can help assess how a child communicates, interacts and behaves in different situations. These tools give families clearer answers and help guide the next steps in support.
Even based on the likely conservative estimate of 1% of the population being affected, hundreds of thousands of people in South Africa are likely living with autism – many of them undiagnosed, due to limited resources, stigma or lack of awareness. As prevalence rises worldwide, so too does the need for accessible screening, informed care, and support for families.
“We need broader awareness and earlier identification,” says Schlegel. “When autism is recognised and supported early, children are better able to adapt and develop, and families are better equipped to meet their needs.
“But to do this well, we must understand the spectrum for what it is – a diverse and lifelong condition requiring compassion, expertise and personalised support.”
Danette Breitenbach 20 Jun 2025
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