Health Essentials
Understanding autism spectrum disorder

Autism spectrum disorder also known as ASD, according to the Centre for Disease Control, is a developmental disability that can cause significant social communication and behavioural challenges in an individual. According to the World Health Organisation in 2021, about one in 160 children has autism worldwide and in the US, it is estimated that about one in 59 children has autism. Even though the statistics in Ghana are not available, it is believed that the situation is no different as many children are diagnosed each day. Autism spectrum disorder begins in early childhood and eventually causes problems in the social functionality of children. Children show symptoms of autism within their first year and a small number of children appear to develop normally in the first year and then go through a period of regression between 18 and 24 months of age when they develop autism symptoms.

Symptoms of autism
The symptoms of autism can be found in three main areas
- Communication:
- One of the first indications of autism in toddlers is the lack of response to their names.
- Children with the autism spectrum disorder are most often non-verbal which means they cannot speak and cannot communicate their needs through speech.
- They do not point or bring objects to share interests.
- They have poor eye contact and lack facial expressions.
- They can’t seem to understand simple questions or directions.
- They may repeat words or phrases verbatim but would not understand how to use them.
- Social Interactions
- They may resist cuddling and holding and may seem to prefer playing alone, they often get lost in their world.
- They have inappropriate approaches to social interactions. they can be aggressive, passive or disruptive.
- Repetitive movements
- They perform repetitive movements such as rocking spinning or hand flapping
- They perform activities that could cause self-harm such as biting or headbanging.
- They develop specific routines or rituals and become disturbed at the slightest change.
- They don’t engage in imitation or make-believe play or pretend play.
Take your baby to see the doctor if he or she:
- doesn’t respond with a smile or happy expression by six months
- Doesn’t make sounds or facial expressions by nine months
- Doesn’t bubble or coo by 12 months.
- Doesn’t point or wave by 14 months
- Doesn’t say a single word by 16 months
- doesn’t indulge in pretend play by 18 months
- Doesn’t say two-word phrases by 24 months
- Loses language skills or social skills at any age.
Do not panic if your child has one or more of the symptoms above. That may not necessarily mean your child has autism. Babies develop at their own pace. However, it is important to see a doctor with your child if they tick any of the symptoms above.
Causes of Autism Spectrum Disorder
Autism spectrum disorder is a very complex disorder and as a result, it doesn’t have a single known cause. It is believed that both genetics and environmental factors play roles in a child developing ASD.
It affects children of all races but certain factors may increase a child’s risk of developing the condition. These include:
- The child’s sex. Boys are more likely to develop autism than girls.
- Family history
- Extreme preterm babies
- Parents age. Older parents are more likely to give birth to autistic children.
Treatment
There aren’t any known treatments for autism, however, when diagnosed early, intervention is most helpful and can improve behaviour skills and language development. Though children usually don’t outgrow autism spectrum disorder symptoms, they may learn to function well.
Autism is on the rise in Ghana and that means we need to come together as a nation and help children who develop this condition. They can do extremely well when given the right support and at any stage of their lives. Children with the autism spectrum disorder are not spiritually possessed, as some Ghanaians believe, they are children who deserve to be loved and supported to grow into their full potential. There are many adults living independently with the condition. Remember that early intervention is key.
The World Autism Awareness Day is marked internationally on April 2 every year, and there is a call for people to include autistic children in Quality Education. It is commendable to know that the government of Ghana has passed a law that mandates mainstream schools to accept autistic children. But it shouldn’t end there. There is the need to provide enough education on the condition to teachers, and the whole country at large as well as the building of infrastructure that can support children and people with the condition.
Source:
Augustina Otema Amarh
Autism Mum/ Content Creator
Health Essentials Ghana Limited
References:
- mayoclinic.org
- cdc.org
- https://www.un.org/en/observances/autism-day
Health Essentials
Identifying the geriatric giants & taking appropriate steps

This week I bumped into Deborah, one of my avid readers and I promised her I will be writing this weekend. So Deborah, this is for your reading pleasure and to pick some golden nuggets for the future.
The quest to find the best way to make one’s golden years, happy, exciting, healthy and a time most people look forward to continues unabated. One factor that keeps popping up is the need to grow friendships with people more than 20 years younger than yourself.
Do not take this for granted. It is a form of “social security” since these close friends who are much younger than you will step in to support you in more ways than you can ever imagine.
Some conditions may make life challenging for older adults but knowing these Geriatric Giants helps us to take the necessary steps to reduce our risk.
“Geriatric Giants” refers to a group of chronic health conditions that are common in the elderly, typically 65-year-olds and older.
These conditions quite often co-occur and can impact on the independence, dignity and overall wellbeing and quality of life of an elderly person.
These Geriatric Giants include:
- Impaired Intellect/ Memory (e.g. Dementia)
- one of the major battles we need to deal with is challenges with memory
- Exercise, adopt the Mind Diet, build a great social network and enjoy time outdoors
- Keep reading and solving puzzles for as long as possible
- Instability – leading to much feared falls
- A good reason to indulge in Balance Training and Core Strengthening exercises from today
- Ensure your home is safe; avoid clutter such as cables crisscrossing floors, toys etc. These are all trip hazards and should be avoided
- Many healthy, happy and fun-loving older adults have died soon after a fall with its attendant complications.
- Do whatever it takes to avoid falling
- Immobility (opening the doors to pressure sores, joint stiffness)
- Even when you are unable to move about on your own it is important to get support to change positions as often as possible or get an appropriate mattress or bed that prevents prolonged pressure over any single point.
- Make sure you passively or actively move joints daily.
- Incontinence (urine, faeces or both)
- This is one of the reasons older adults prefer to stay at home and avoid going out to meet friends etc.
- Iatrogenic Disorders – adverse effect of medication
- Quite often most older adults are on several medications and some side effects such as drowsiness may seem to cause more unhappiness and may even lead to falls.
- Inappetite – this may result in poor nutrition
- This may also be linked to loss of teeth thus making chewing very difficult or limited.
- The loss of smell and taste may also reduce the amount of food one may willingly eat.
The power to reduce the impact of the Geriatric Giants starts now and should be a lifetime commitment. It is never too early to start making the appropriate lifestyle modifications, nor is it too late to reduce the impact of the giants on one’s life.
Other conditions that significantly impact on the lives especially of the elderly are:
- Sleep Disorders
- Good sleep has the power to give us energy, improve our thought pattern and even helps us to make good choices.
- Good sleep sets the tone for a healthy life
- Constipation
- This is a challenge that confronts quite a number of older adults.
- Movement, fibre and lots of water go a long way to reduce the stress that frequent constipation generates.
- Fraility
- Muscle loss is real and as we age, we lose a significant percentage of our muscle plus our bones also become brittle.
- Make sure strength training is part of your exercise schedule
- Polypharmacy
- Another headache that needs to be confronted head-on
- Everyone especially older adults need a good primary care physician or a general practitioner who can coordinate all medicines from the different Specialists who may be attending to an elderly person. This ensures that unnecessary medicines are dropped
The goal of care at all times is to optimise the quality of life. As family, professional caregivers and friends we should always show respect so that the dignity of the elderly is preserved at all times. For those of us who are not yet in the age group with such challenges, we need to start the conversation about the type of care we will prefer and take steps to stay healthy and independent for as long as possible. The goal should be a long Healthspan and not just a long Lifespan.
AS ALWAYS LAUGH OFTEN, ENSURE HYGIENE, WALK AND PRAY EVERYDAY AND REMEMBER IT’S A PRICELESS GIFT TO KNOW YOUR NUMBERS (blood sugar, blood pressure, blood cholesterol, BMI)
Dr. Kojo Cobba Essel
Health Essentials Ltd (HE&W Group)
(dressel@healthessentialsgh.com)
*Dr. Essel is a Medical Doctor with a keen interest in Lifestyle Medicine, He holds an MBA and is an ISSA Specialist in Exercise Therapy, Fitness Nutrition and Corrective Exercise. He is the author of the award-winning book, ‘Unravelling The Essentials of Health & Wealth.’
Thought for the week – “There is no magic formula to being happy but making a conscious effort to be happy goes a long way.” – Dr. Kojo Cobba Essel
By Dr. Kojo Cobba Esse
Health Essentials
Why Ghana’s ‘no bed syndrome’ is a policy failure, not a clinical failure -Part 2

The call to action
We must move beyond the cycle of temporary outrage. I propose a four-point blueprint for the Ministry of Health and the government:
1. A Digital Bed-Tracking Command Centre: Legally mandate all public and major private hospitals to update a live, digital bed-registry every hour. The NAS must be able to see a vacancy before they move. This must be matched with the available resources and services so that the right patient will be sent to the right facility.
2. Strategic Capacity Expansion: We must stop building “prestige projects” and start building high-volume stabilisation centres. We need a targeted investment to triple the ER bed count in Accra and Kumasi within 24 months. This should then be extended to other regional capitals.
3. Specialised Emergency Hubs: Designate specific hospitals as “Centres of Excellence” for Cardiac and Stroke care (and for other health emergencies), ensuring they have 24/7 imaging and intervention capabilities as well as the requisite expertise to manage these conditions. Policy makers must incentivise public-private partnerships to ensure that a heart attack in Accra or Kumasi can be treated with the same urgency as one in New York.
4. Develop a nationwide trauma system: This is extremely important because trauma is a major cause of deaths in Ghana. In the US, each state has a statewide trauma system with three levels. Level 1 trauma centres are usually University Teaching hospitals that provide comprehensive trauma care and also play an important role in local trauma system development, regional disaster planning, increasing capacity and advancing trauma care through research. Level II trauma centres are expected to provide initial definitive trauma care for a wide range of injuries and injury severity.
Level III centres provide definitive care to patients with mild trauma. Having such systems is imperative to ensure proper treatment of trauma patients.
Even for those who survive trauma, disability is a major assault on economic potential and viability. Importantly all this cannot happen with a cash and carry system. Emergencies should be managed under a different model to save life and limb first. Obviously, there is a need to ensure that healthcare facilities will be able to recover their investments in emergency care, and that balancing act needs careful consideration.
Frontline clinicians are often forced to bear the public’s anger for infrastructure deficits they did not create and cannot fix. This is a failure of governance, not a lack of clinical care. Responsibility lies with the policy makers who manage the nation’s resources.
The “No Bed Syndrome” is a systemic disease. It cannot be cured with a directive from the Ministry of Health, parliament or a lecture on ethics. It requires a blueprint, a budget, and the political will to treat this like the menacing threat it is.
It is safe to say that non-emergent healthcare is excellent in Ghana for the most part if you can afford it. However, emergency care is suboptimal. We had a sitting president die from an emergency health issue and a former vice president also die from an emergency. If that is not enough warning, it is clear that anyone can be a victim of an emergency.
If we do not act, the next ambulance driving aimlessly through the streets of Accra could be carrying anyone, including the very people who have the power to fix this issue.
Prof. Jonathan Laryea is a Professor of Surgery at the University of Arkansas for Medical Sciences in Little Rock. Arkansas. He is board certified in General Surgery, Colorectal Surgery and Clinic Informatics.
He is a graduate of the University of Ghana Medical School (Class of 1997)




