Autism spectrum disorder (ASD) was first defined in early forties by an American child psychologist named Leo Kanner [1]. ASD is a condition related to brain development that influences how an individual perceives and socializes with others, producing problems in social collaboration and communication. The word "spectrum" in autism spectrum disorder denotes to the varied number of symptoms and severity which comprise disorders that were previously considered isolated — autism, Asperger's syndrome, childhood disintegrative disorder and an unspecified form of pervasive developmental disorder [2, 3].

ASD arises in the initial childhood and gradually roots problems functioning in society. In the early stages, only few children seem normal and later show autism symptoms between 18 to 24 months [4]. While some children with autism can live self-sufficiently, others have severe incapacities and need care and support for the rest of life [5].

About 1 in 100 children are identified with autism spectrum disorder around the world. Its occurrence approximates more over time and varies significantly within and across socio demographic groups [6]. Autism is commonly identified in boy babies and children born less than 36 weeks of gestation and it has a strong association with genetic disorder. In US the incidence rate is gradually increasing over the last few years and one in 45 children born with it [7].

The incidence in India is 1 in 100 to 1 in 166 children. Statistics displays that the number of children reported with autism in India is growing due to lack of awareness, deficit of basic facilities, and poor diagnosis. In India 18 million children are found with autism. Bihar is the first leading state in India. In Karnataka one in every 66 children has autism [5-7].

The reason for autism is unknown.  Evidence shows that source of cause may be gene-environment relations or likely caused by genetic [8]. Risk factors for autism consists of gender, males are three to four times more likely to develop autism than females, family history, parents’ age, and other conditions such as fragile x syndrome, other than these, the use of unnecessary medications during prenatal period has also been recognized as a risk factor [9]. 

Some children show signs of ASD in early childhood, such as reduced eye contact, lack of reaction to their name or insignificance to parents. Other children may grow normally for initial few months or years of life, but then abruptly become quiet or aggressive or lose communication skills they've previously learned. Signs and symptoms typically start to appear by 2 years of age. Each child with ASD will develop distinctive pattern of behaviour and level of severity — from minor to major capacities of work. Children with ASD will struggle to learn and have signs of lower than normal intellectual capacity [10].

Core deficits of autism are identified in 2 areas: social communication/interaction and restrictive, repetitive patterns of behaviour. Children with ASD have need facilities in behavioural, academic, health, recreation, family support, and other areas. Regular screening for ASD around 18 to 24 months of age with ongoing developmental observations need to be recommended in primary care as ASD can be diagnosed as early as 18 months of age and has evidence-based interventions that may lead to progressive functioning. Primary care providers and health care professionals should be aware of diagnostic criteria for ASD, appropriate etiologic assessment, and co-occurring medical and behavioural conditions that disturb the child’s function and value of life [11].

Children with autism need available health facilities, including preventive, promotive services and treatment of short term and long-term illness. Children with autism have higher rates of unmet health-care needs compared with the normal population. They are also more susceptible various emergencies. Common barrier is formed by health-care professionals is lack of awareness, knowledge and understanding of autism [5].

Having sufficient social awareness and a good understanding of the symptoms of ASD will help in early detection of autistic children. Inadequate knowledge, mainly in parents, health care professionals, and school teachers, leads to late identification of ASD in children [12]. Based on this report, there is a tremendous need to assess the knowledge of ASD, and to discover any gap in awareness or lack of information in primary school teachers. This is important for the implementation of management strategies for ASD.

A non-experimental descriptive survey research design was conducted with the objective to assess the knowledge regarding autism among primary school teachers at Kolar district, Karnataka. Non-probability convenient sampling technique was used to select 84 primary school teachers in various Government and Private schools at Kolar District. The inclusion criteria: who were willing to participate in this study and who were able to read write and understand Kannada or English. Teachers who attended any training programs related to autism were excluded in the study. Data collection tools include subject data sheet and structured knowledge questionnaire. A set of structured knowledge questionnaire was prepared to assess the knowledge. The google form was prepared which consists of 25 questions with multiple choice. The score of teacher’s knowledge was categorized as Good knowledge (above 19 - 25 scores) – above 75%, Average knowledge (13 to 18 scores) – 50-75% & Poor knowledge (below 13 scores) – below 50%. The content validity of questionnaire was obtained and modified as per the expert’s suggestions. Ethical permission was obtained from the institutional ethical committee.  SDUCON/IEC/134/2023. Permission was obtained from concerned School higher authorities. Google form was sent to the teachers who were working in both government and private schools. Results were presented as mean, frequencies and percentages. Chi Square test was used to determine the association between the Knowledge scores with selected socio demographic variables.

Majority (33.33%) of the primary school teachers were between the age of 35 – 39 years, who were (61.90%) females, had (30.95%) 6-9 years’ experience and 64.28% were postgraduates who were working at government schools.

[Table. 1] shows that mean knowledge score of parents was 10.11 ± 3.19. Majority i.e. 71.42% of the school teachers had inadequate knowledge, 16.66% had average  knowledge and none of the teachers had adequate knowledge regarding Autism among children.

Even though the incidence of autism is increasing the awareness about autism is still inadequate as reported by various studies A study conducted in India to assess the awareness and knowledge on autism shows that 95% of the teachers had awareness but among those 83% of the teachers had inadequate knowledge on autism [13]. Another study done in Omani also shows that teachers had lack of awareness on autism [14]. A study done in Singapore also shows that teachers had deficit knowledge on autism [15]. One more study also reveals that teacher’s level of knowledge on Autism was 48.7%, which was inadequate [16]. In this descriptive study majority of the teachers know that autism is a developmental disorder of brain, but majority (71.42%) of the teachers had inadequate knowledge on overall autism like causes clinical manifestation, diagnosis and management and none of the teachers had adequate knowledge. It implies weak level of knowledge among school teachers who were working both in private school at urban areas and government schools at rural areas of Kolar District.

Teachers play a pivotal role in identifying children with developmental disabilities and counsel the parents and guide them on referral. So, it is important that school teachers have to gain adequate awareness and knowledge about autism spectrum disorder, to identify the early symptoms of ASD, for earlier intervention, appropriate education planning, and arrangement of family support services [16]. Teachers cannot initiate any interventions or actions without basic knowledge about Autism. Teachers must have the skills and ability to identify the early signs to refer the children suspected with ASD to specialists and discuss the issue with children’s parents. Therefore, they must have adequate knowledge of early signs of ASD, correct belief, and ASD identification skills [17]. Management is more effective when children with ASD are detected earlier. Routine, standardized screening for ASD in children and timely access to diagnostic evaluation can reduce disparities in age at diagnosis [18]. Most of the studies revealed that knowledge of autism among primary school teachers was inadequate which indicates that there is an urgent need to develop professional development or certification programs to train teachers to work with children with ASD [18, 19].

We acknowledge the primary schools teachers for their participation in the study.