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Are children with autism stigmatised? A closer look at attitudes in Bulgaria

Photo: Pixabay

Autism spectrum disorders are growing exponentially around the world. Bulgaria is no exception. While more than a decade ago, one in 10,000 children worldwide was diagnosed with autism, today, on average, one in 70 children has an autism spectrum disorder. No one can explain this phenomenon, but it exists and is a cause of concern for clinicians, parents and educators alike.

In Bulgaria, however, there is still no record of all cases of this disorder, says Dr Atanaska Avramova, head of the day care unit at the Child Psychiatry Clinic at the Alexandrovska University Hospital, in an interview with BNR "Hristo Botev".

Dr Atanaska Avramova
"Being diagnosed and included in a registry can be highly stigmatising for individuals, leading to the distortion of data. So many parents will try to avoid a diagnosis at all costs to protect their child from being stigmatised. 

Unfortunately, paediatricians seem to be inclined to avoid referral to a child psychiatrist. One reason for this is that child psychiatrists are rare in our country.

The age at which autism is diagnosed varies from case to case. Parents usually recognise the problem between the ages of 2.5 and 4, often triggered by difficulties in the child's adjustment to kindergarten, which is the first red flag for them to seek professional help," says Dr Avramova.
A typical child on the spectrum may show isolation, significant speech and learning challenges, and a fixation on sameness or repetitive behaviours. Science identifies individuals with autism as neurodivergent, meaning that their neural connections are different. However, diagnosing these cases can be very difficult. "What we lack in Bulgaria is support for parents," says Ani Andonova, a board member of the Autism Association, adding: 

Ani Andonova
"Receiving an autism diagnosis is an extremely challenging time for parents. Today, however, there are more social services and facilities that accept and support these children. Integration in kindergartens and schools has improved. Children on the spectrum are gradually becoming more accepted, with a positive trend towards inclusion in schools and special educational support centres, tailored to their individual levels of functioning. However, when they reach adulthood, the prospects become bleak. There are very few employment opportunities for young adults with this disorder in our country."
Parents are struggling with the limited options within our country's social system. That's why Ani Andonova highlights the lack of early diagnosis in Bulgaria - an issue that has been discussed for two decades.


"If children were supported by the social system from a very early age, right after diagnosis, their development would be much more successful. Currently, at the Centre for Social Rehabilitation and Integration, we are implementing a programme that actively involves parents, and we are witnessing the significant impact it is making," says Andonova.

Not every child with autism is suited to a school environment, she points out. At the same time, an appropriate place in the education system must be found for each individual case. This requires the formation of a multidisciplinary team to familiarise teachers with the specific needs of each individual autistic child. This measure is usually applied too late and leads to conflict situations in the learning environment, Andonova concludes.


Story compiled by Veneta Nikolova /based on interviews by Alexander Raychev from BNR - Hristo Botev/

Photos: Pixabay, personal archive of Dr Atanaska Avramova, autism.bg
Translated and posted by Elizabeth Radkova


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