The Children Nigeria Is Still Not Seeing: Inside the Cost of Autism, Stigma
Oluwatobi Adu 
ABUJA, Nigeria – For some Nigerian families, autism begins with a child who does not speak when expected, struggles with social interaction, avoids eye contact or becomes distressed by changes in routine.Relatives may dismiss the signs as delayed development or bad behaviour. By the time professional help is sought, months or years may have passed. For others, diagnosis brings a new set of challenges: finding trained therapists, paying for repeated sessions, securing an inclusive school and confronting beliefs that autism is a curse, spiritual affliction or the result of poor parenting.Nigeria’s autism challenge is therefore not only about the condition itself. It is also about delayed recognition, limited data, shortages of specialists, expensive therapy, inadequate institutional support and stigma. For families such as Oluwatoyin Odunuyi’s, the consequences can be measured in both money and missed opportunities. Oluwatobi Adu, writes.
When a Brother Became a Family’s Teacher
Odunuyi, founder of Your Safe Space NG and an autism advocate, said she noticed differences in her younger brother Tobi long before his diagnosis at seven.
He was not speaking, struggled to remain in class, walked on his toes, experienced meltdowns and developed strong attachments to unusual objects.
A move to a special school helped him improve, with specialist teachers playing an important role in his development and supporting the family.
But the diagnosis did not end the difficulties.
Odunuyi said her family has faced misconceptions from people who view autism as a spiritual problem or mental illness.
Supporting Tobi has also required constant planning around his meals, communication, behaviour, health and education. As he grew older, the family had to adapt to new challenges associated with adolescence and adulthood.
The financial burden has been equally significant.
The family pays for individualised educational plans, therapy and other forms of support, while also meeting his dietary needs.
Yet Odunuyi said Tobi’s abilities show why autism should not be treated as a limitation.
He is learning to play the keyboard and sew, she said, and the family continues to focus on his strengths and potential.
The World Health Organization describes autism as a diverse group of neurodevelopmental conditions, with abilities and support needs varying widely. Early support, inclusive education and appropriate interventions can improve communication, participation and quality of life.
The question is whether Nigeria has enough of those services.
A National Problem Without Reliable Numbers
Globally, the WHO estimated that about one in 127 people had autism in 2021, while noting that prevalence varies between studies and remains unknown in many low- and middle-income countries.
Nigeria faces an additional challenge: the absence of a comprehensive national picture of autism.
Without reliable data, policymakers have limited information for planning diagnostic services, therapy, inclusive education, assistive support and long-term care.
Grace Feranmi Olufemi, a special-needs educator, said schools could play a major role in early recognition.
Teachers who receive appropriate training can document developmental concerns and encourage parents to seek professional assessment, she said.
Possible warning signs include delayed or unusual speech, difficulties with social interaction, repetitive behaviour, strong preferences for routines and unusual sensitivity to sound, light or touch.
But recognition is only useful if families can access support.
Olufemi said children with autism can learn in mainstream schools when trained teachers, individualised education plans and collaboration between parents, schools and therapists are available.
That support is particularly difficult to access outside major urban centres, where families may have to travel long distances to see specialists and pay transport and treatment costs.
Awareness Is Rising, But Understanding Remains Limited
Autism advocate Dorcas Oyebode said public discussion of autism has increased in recent years, with more organisations advocating for families and more parents sharing their experiences.
But she warned that awareness does not necessarily mean understanding.
Children are still described as stubborn, badly behaved or possessed because people do not understand developmental differences. Some families also encounter misconceptions within professional settings, she said.
For parents, another problem is knowing what to do after noticing developmental concerns.
“If we tell a parent, ‘You should get your child assessed,’ but there is no accessible and affordable place for that parent to go, then we still have a problem,” Oyebode said.
She called for investment in diagnostic centres, therapists, inclusive schools and public education, as well as better training for health workers and teachers.
Families, she said, also need reliable information and places where they can ask questions without being judged.
Where the Health System Falls Short
Dr Ozioko, a paediatrician, described autism as a neurodevelopmental condition affecting social communication, interaction and behaviour, often alongside restricted or repetitive behaviours.
She said autism does not have one single identified cause but involves an interplay of genetic and environmental factors.
Current evidence supports associations between autism and certain genetic, prenatal and birth-related factors. However, claims that poor antenatal care, lack of prenatal vitamins or vaccines directly cause autism are not supported by current evidence.
This distinction is important in an environment where families may receive conflicting explanations about the condition.
What is clearer is the importance of early identification.
Developmental differences may become noticeable in infancy and early childhood, including reduced social engagement, delayed language and difficulties responding to social cues. The WHO notes that autism can often be identified by around age two, although many people are diagnosed later.
Ozioko said some children are missed because health workers lack sufficient training or access to appropriate screening tools.
Genetic testing is also available in only a limited number of places and can be prohibitively expensive, particularly because some tests are conducted outside Nigeria.
The shortage extends to behavioural therapists and other specialists. Ozioko said some facilities advertise special-needs services without having adequately trained professionals.
She called for government-supported training for healthcare workers, psychologists, therapists and other professionals involved in neurodevelopmental care.
The Price of Support
Even when families find qualified professionals, the cost of therapy can make sustained treatment difficult.
Ozioko said behavioural and speech therapy can require frequent sessions, with some services costing tens of thousands of naira per visit. For many families, that makes long-term treatment unaffordable.
The result can be interrupted therapy, delayed intervention and additional pressure on caregivers.
She advocated government subsidies for diagnostic and therapeutic services, alongside expanded access to trained behavioural therapists and genetic testing.
From Awareness to Action
Nigeria’s autism challenge has moved beyond the question of whether people know the condition exists.
The more difficult question is whether recognition leads to meaningful support.
A child whose developmental differences are identified early needs somewhere affordable to go. Parents need accurate information rather than blame. Teachers need training to recognise warning signs. Doctors need screening tools and referral pathways. Families need affordable therapy, while schools need the capacity to include children with different learning and communication needs.
The WHO has emphasised that autism support extends beyond healthcare to education, employment, social care and community support, while autistic people and their caregivers need accessible services and protection from stigma and discrimination.
For Nigeria, that means moving beyond occasional awareness campaigns towards a coordinated system built around reliable data, trained professionals, affordable services and inclusive education.
For families like Odunuyi’s, Tobi’s experience demonstrates what can happen when a child receives support and is allowed to develop according to his abilities.
Autism may be part of a child’s story.
But stigma, neglect and inaccessible care do not have to be.
About the Author
Mirian Gom 
Hope Ajayi