Background: In Ethiopia, children identified with autism spectrum disorder (ASD) and their families face substantial challenges in obtaining timely diagnosis and appropriate services, including limited public awareness, cultural stigma, and shortages of trained professionals. Understanding how social and communication difficulties manifest in children identified with ASD within Ethiopian service settings is essential for designing culturally and contextually responsive interventions. Objectives: This study aimed to describe the social-communication characteristics of children enrolled in two major autism-focused centers and to examine contextual influences shaping their communication profiles. Methods: A mixed-methods approach was employed. Quantitative data were collected from parents or guardians of 110 children using the Social Communication Questionnaire (SCQ). Qualitative data were gathered through five focus group discussions with 56 service providers. Descriptive and inferential statistical analyses were applied to SCQ scores, while thematic analysis was used to analyze qualitative transcripts. Results: Overall, 90% of participating children scored above the SCQ clinical cutoff of 15, indicating pronounced social and communication challenges, though these scores represent symptom patterns rather than confirmed diagnoses. No significant differences in SCQ scores were observed by age or gender. Thematic analysis identified four major contextual influences on children’s social-communicative behaviors: cultural beliefs about disability, multilingual communication environments, systemic barriers to service access, and persistent community stigma. Conclusions: These findings underscore the need for culturally adapted screening tools and community-based interventions that account for sociocultural and structural influences on communication. Strengthening early identification, reducing stigma, and improving service accessibility may enhance support for children with ASD in low-resource, collectivist settings.
Zeleke et al. (Thu,) studied this question.