Opinion Article - Journal of Juvenile Psychology and Behavioural Sciences (2019) Journal of Juvenile Psychology and Behavioural Sciences (Special Issue)
Causes of developmental disorder - a social perspective from communities in GhanaHilda Aboagyewaa Agyekum*
Department of Social Work, University of Ghana, Accra, Ghana
- *Corresponding Author:
- Hilda Aboagyewaa Agyekum
Department of Social Work, University of Ghana, Accra, Ghana
Accepted date: November 16, 2018
Developmental disorder is a much delved into topic these days, with the scientist bringing out the medical cause of these disorders; there is also a need to look into what the society thinks about the disorder and its causes. Disability has been a part of human society and knowing the views people have about them is very important. This study aimed at bringing out what people in the Abelemkpe and Dzorwulu vicinity think are the causes of developmental disorder. The study focused on the sociological perspectives these participants have about the disorder. The study was developed from a qualitative methodology and used semi structured interview guides. Form the study it was brought to light that participants view developmental disorders to be spiritual conditions with spiritual causations. The study also brought out other causes of the disorder to be the mother’s negligence during pregnancy as well as other medical conditions that could lead to the disorder. The study brings out explanations for these themes. The research suggests that participants, both learned and unlearned participants’ believed developmental disorders have a spiritual causation though they had other factors they believed could cause the disorder. It was however noticed that participants that had tertiary education were more broadminded and knew more about developmental disorders and their causes.
juvenile, child, mental health.
Disability has been defined by the World Health Organization as “an umbrella term, covering impairment, activity limitations and participation restrictions.” It defines an “impairment” as a problem in body functioning or structure; an “activity limitation” as a difficulty encountered by an individual in executing a task or an action; and “participation restriction” as a problem experienced by an individual in involvement in life situations. To summarize, disability is the general term given to a situation where an individual finds it difficult in adjusting and operating normally in his environment. Over the years disability rates has seen an increase worldwide, with Ghana not being an exception. From the 2010 population census in Ghana, three percent of the Ghanaian economy is classified as persons with disability, with the disorder occurring more in females than in males.
Developmental disability has been defined by the centers for disease control and prevention as a group of conditions due to an impairment in physical, learning, language, or behavior areas. It has been estimated that one in every six children in the United States had a developmental disability, with it having a greater chance of occurring in males than in females . These developmental conditions begin during the developmental period and usually last throughout a person’s lifetime . Boyle and friends asserted that, at age 12, there is an increase in the number of children with developmental disabilities, especially with autism and attention deficit hyperactivity disorder. Most developmental disorders are diagnosed under the age of 9. It is easily noticed when there is a communication disorder, where children are having difficulties speaking by the school going age . The major cause of developmental disorder has been said to be from either small  or extreme environmental stress , there are however cases where no cause for the developmental disability is found .
The sociocultural perspective of people refers to the people’s way of viewing circumstances surrounding them, as well as how they interpret this circumstance. Ghana is particular has a very strong spiritual worldview , as such, they mostly rely on their belief system to explain situation and the issue of disability is treated likewise. Ginsburg and Rapp  are of the view that, disability is not simply lodged in the body, but created by the social and material conditions that “dis-able” the full participation of a variety of minds and bodies. It therefore explains the fact that, an individual is disabled because the environment in which he finds himself does not have the favorable conditions needed for him to life a fulfilling and comfortable life. Thus, if societies create an enabling environment, there will be no disables in the world. An instance is the inclusion of wheelchair users in public life, which has led to an aspect of universal design that is fundamental to a fully democratic built environment [9,10].
The current study is designed to have a qualitative background. The study developed a semi structured instrument as a guide in the data collection process. Each interview spanned between thirty to forty minutes. The study was conducted in the Greater Accra region of Ghana. The locality the study focused on was Abelemkpe and Dzorwulu. This study area was selected based on its blend of literates and illiterates. A total number of thirty participants were interviewed for the purpose of this research. Fifteen of the participants were employed in the formal sector while the other half was employed in the informal sector. The formal sector in this study refers to persons in jobs with normal working hours and regular wages, where as those in the informal sector referred to participants who did their own petty trade. Twenty five of the participants have had formal basic education, fifteen have had education to the tertiary level and twelve have vocational skills training and three have never had any education at all. The ages of the participants ranged from twenty six to fifty. To ensure gender homogeneity, nineteen females and eleven males were interviewed. Interviews were conducted by the author of the article and the main themes that the study looked at were what the causes of developmental disorders were and what the participants thought about them.
Theme 1: spiritual
From the interviewed conducted, all participants attested to the fact that developmental disorders can be attributed to the spiritual. They all gave different opinions on this issue. They were of the opinion that, the devil has power to cause the disorder. Even though most of them, especially those who had received higher learning education gave other causes for the disorder, they ended up saying the spiritual realm had a part to do with the disorder. A participant had this to say:
Yes, I know it is genetically caused, but it has to do with the spiritual. The world is more spiritual than physical (Participant 6).
There were participants who attributed the disorder to mothers offending others when they are pregnant or a family member offending someone. One female participant expressed her sentiments as:
Disability is spiritual. Usually when a mother is pregnant and she likes insulting people, she is likely to give birth to a child with disability (Participant 20).
When asked by the interviewer if she knew any of such circumstance, she attested to the fact that, there was a very disrespectful lady in her hometown who gave birth to a child with a developmental disability because of her disrespect. Another participant had this to say:
In my hometown, these children are not given birth to, the only situations where they are is when you have been cursed by the gods. It could be the fault of the parents or anyone in the family (Participant 16).
Other participants were of the view that it was God’s way of testing the spirituality of the parents of children with disabilities. They gave opinions on the fact that parents with children with developmental disabilities are being tested by God to know if they could withstand the trail and remain faithful. One participant went on to give a biblical example about how God put Abraham to test.
One participant was however of the view that it is God’s way of allowing suffering into the world. He expressed himself this way:
Well I believe it is the devil that causes these disabilities, but it is God that allows them. I mean He has the power to prevent these things but why is He not, and what exactly is the plan for creating disabled persons (Participant 1).
An analysis of the views of these participants revealed that they believe the disorder is spiritually caused. The participants with less education strongly believed that the disorder is spiritual whiles those with higher education though they thought it was spiritually caused raised other causes too.
Theme 2: mother’s negligence
Usually how well or bad a child grows up in Ghana is attributed to the mother and it was no surprise when participants in the study stated that some activities of the pregnant mother causes developmental disabilities. Some participants were of the view that developmental disorder is as a result of accidents that occur when the mother is pregnant. A participant said the disorder can be caused by the mother being injured and the repercussions affecting the child. A participant shared that:
I am aware when you are pregnant and you are scarred; there is a higher probability of the child getting scared too. In the same manner, when the mother is going through psychological problems like stress and those things, there is a high probability of the child getting a developmental disability (Participant 1).
When you are pregnant and you sleep on your stomach, there is likelihood that the child will be born with disabilities (Participant 15).
There were participants who explained that mothers contracting infections during pregnancy could also have babies with developmental disabilities. Few of the participants, especially the males stated that, if the mother is indulged in alcoholism and smoking, there is a chance of bringing forth a child with developmental disability. It was realized that most of the men in the study supported the idea that the activities of the women lead to the disability. These are the views of two male participants:
Some women like alcohol too much. These women when they put to birth their children are not proper (Participant 3).
I am yet to see an alcoholic woman who has a child without any disability, especially a developmental or intellectual disability. This is especially true when they take it while pregnant (Participant 4).
Theme 3: medical implication
Developmental disorder is a medical condition, though the actual cause is unknown, participants in this study shared the ways in which these disorders could come about medically. Most participants that agreed to this point had attained higher education and seem to be knowledgeable in the medical aspect of the condition. Even though they acknowledged that their views were not factual, they still had a medical responds to give when asked if they thought it was a medical condition. The major point recorded in terms of medical cause was the use of vaccination and wrong injections for babies. They shared that when babies are injected with the wrong kind of vaccines they tend to get disorders. A ready explanation for this causation factor was not given, but most of them seem to project the same thought. One female participant shared this:
When a mother is going for weighing, she should be very careful of the medicine and injection that they use. Most times a wrong injection could cause your child to be disabled for life (Participant 9).
Another major factor under the medical cause of the disorder is random malfunctions in genetic formation. The participants were of the opinion that when there are mutations in the normal process of fetal development, by random, naturally-occurring factors, that affect gene formation and replication, a number of different circumstances could arise, that could trigger a developmental disorder. One of the participants who had a scientific background explained the disorder accordingly:
Developmental disorders are a result of mutation deformations or malfunctioning during fetal development. I don’t know how to break this down, but when the baby is developing in the womb there are a number of changes that happen genetically and chromosomally. Any wrong change could lead to a child developing any disorder at all (Participant 26).
Parents of the children cannot do anything to prevent this
At this point the parent has no hand in this. Though it has something to do with the lifestyle of parents, especially the mother, there are still times that the mother is living healthily but can still have a child with disability. That is why I initially told you it bulges down to the spiritual (Participant 26).
Participants brought other causes of the disorder which could be having a premature baby that is the child being delivered before 40 weeks. Some were of the view that having a premature baby will mean that the child is not fully developed and is not able to withstand all disorders like a child who was born on a full course would have been able to. This assertion was made by both participants with higher education and basic education. Another point that runs through was lack of oxygen to the child during birth. They detailed that when a child is being pushed out and it takes longer than necessary, it could lead to the child developing a developmental disorder.
Discussion and Conclusion
From the results it can be deduced that the disorder could be a result of the spiritual, environmental factors and biomedical conditions. The participants brought out various explanations to their claims. Boucher  is of the view that there is no one cause that results in developmental disorders, however, different causation factors lead to it, as such, it is almost impossible to pinpoint the disorder to one cause. Ghanaians have a spiritual world view, and most happenings are attributed to the spiritual world. This study aggresses partially to what Anthony  has said about the potential causation of autism, which is a developmental disorder. He asserted that Ghanaians in general see disorders being caused either from a medical perspective or a spiritual perspective, not paying much attention to their environment or genetics. However, in this study, participants acknowledged the effects of the environment, this pertaining to what the mother does when pregnant that affects the unborn child. Their actual claim to that is the mother’s womb is the environment the child grows in till birth, thus, anything that happens there before birth could affect the child.
In this study, participants made it known that the disorder is spiritual and the causes though are being attributed to other factors have a spiritual base. The cause of developmental disorders could result from the mother or any member of the family insulting or causing someone some pain, and the person retaliating by causing a child in that family to have a disorder. This point is authenticated by the works of Anthony ; he specified that when impairment is believed to be caused by magic, it is typically thought to be retribution for a transgression committed against someone close to you who either directly enacts justice or hires a spiritual practitioner to do so for them. This being said, the study went ahead to postulate that mothers who like to insult people when they are pregnant, women cheating on their husbands, a lady running away from her matrimonial house to marry another man or when someone is cursed could upshot in developmental disabilities.
In as much as participants thought developmental disorder is as a result of what a family member did wrong, there was a participant who said God was to be blamed for the disabilities. He was of the view that, God is the one who creates man, and there is therefore no need for Him to create a child with disability if he is being fair. He went on to explain that, God has the power to prevent disabilities so if there are children with disabilities then the cause is God since He could have prevented it.
The issue of mothers being the cause of developmental disorders was raised as another cause of the disorder. Mothers carry the fetus till birth and any activity she performs while carrying the fetus is believed to have an effect either positively or negatively on the child. Participants in the study were of the view that some harmful activities mothers indulge in while pregnant cause the disorder. Mothers are blamed for their children with disability’s tantrum, a study conducted revealed that mothers are thought to not have brought up their children well that is why they throw tantrums in public, this is particularly true for children with developmental disabilities . In the study mothers were said to cause disability in their children when they do not behave in acceptable ways as deemed fit by the society. Participants shared that mothers that took alcohol for instance were more likely to bring forth a child with disability. They also mentioned the sleeping pattern of mothers causing the disorder. They commented that when mothers lie on their stomach, there is a higher chance of the fetus being born with a disability.
Boucher  in his study that, the cause of developmental disorder can be attributed to two things, the genetic and the environmental. He went on to expatiate that genetically, a child can get a disorder through chromosomal changes during fetus formation and a fetus is also susceptible to disability through the internal and external activities that affects it while in the womb. In this study participants attributed the cause of the disorder to wrong vaccines being administered to babies. They started that a wrong vaccine though interned to protect the baby rather exposes it to disabilities; this claim has being documented also by Speaks . They also gave other medical explanations to the disorder. Some of the issues raised were premature birth and lack of oxygen to the child during birth.
From the study it can be deduced that, both learned and unlearned participants’ moved towards the spiritual cause of the disorder though different reasons were given. However, participants that had tertiary education were more broadminded and knew more about developmental disorders and their causes.
This study serves as an avowal to Agyekum  that Ghanaians usually have no idea of the cause of developmental disorders till they bring forth one.
The study cannot be generalized since it does not have enough sample size. The study also faced challenges with getting participants for the study, especially those in the formal sector.
I am grateful to God for making this study a success. I am immensely grateful to Mr. Vincent Macauley who has been of great support throughout the study. My appreciation also goes to all participants who took part in the study; this would not have been a success without you.
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