Interview conducted by Cecilia Wayua, MSc, and Brittany Faith Thacker, EdD, BCBA
Association for Science in Autism Treatment

Introduction

ABA Practitioners in Africa Brittany: In this first of a two-part interview, my colleague and fellow Extern, Cecilia Wayua, MSc had the opportunity to speak with several ABA practitioners in Africa. They discussed autism and the role of applied behavior analysis (ABA) in supporting individuals and families across Africa. During their conversation, our interviewees talked with Cecilia about what brought them into the field, the unique challenges they face, and the innovative ways they are adapting ABA to fit the needs of communities in Africa where cultures, resources, and everyday realities can be very different from the settings where this evidence-based practice is more widely accessible. We are excited to share these interviews with our readers because through these groundbreaking and dedicated practitioners, we’ll get to learn about the state of autism and ABA in Africa, the barriers that still exist, and the possibilities that lie ahead. Stay tuned for Part II of this interview.

Interviewees:

      • Ashley Knochel (Kenya), PhD, BCBA-D, IBA, Behavior Analyst
      • Freda Nabayunga (Uganda), MSc Psychology, IBA Candidate
      • Pooja Panesar (Kenya & Tanzania), DBH, BCBA/QBA/IBA, MEd, Behavior Analyst
      • Martha Angila (Kenya), IBA, Behavior Analyst
      • Priscilla Afriyie (Ghana), IBA, Special Educator
      • Eziafakaku Nwololo (Nigeria), PhD, BCBA, QBA, Behavior Analyst

Cecilia: I am grateful that each of you was willing to take the time to participate in this interview. Can you share with our readers a little bit about your career path and what led you to the field of autism treatment and applied behavior analysis?

Dr. Ashley Knochel, PhD, BCBA-D, IBA, Behavior Analyst, Kenya:

During my time as an undergraduate at West Virginia University I was fortunate to be part of a pilot BCaBA program designed to guide psychology majors toward certification. This opportunity provided me with invaluable mentorship in both research and clinical settings, particularly working with children who exhibited chronic and severe challenging behaviors. Around the same time, I studied abroad at the University of Ghana in Accra, where I volunteered at the Autism Awareness Care and Training Centre. My experience there sparked an even deeper passion for ensuring that high-quality, evidence-based treatment reaches underserved populations globally.

Freda Nabayunga, MSc Psychology, IBA Candidate, Uganda:

Back in 2019 after obtaining an MSc. in Clinical Psychology, one of my first clients needed therapy for their child who had been diagnosed with autism. Unfortunately, I didn’t have concrete knowledge of how to train skills or support behavior change for autistic children. I let the parent know about my limitations, but she requested that I work with her child under the remote supervision of a therapist in Ghana. ABA was highly recommended as a gold standard, and I decided to find out more about it. It was hard to get training to become a BCBA because of my geographical location. I shared this barrier with my supervisor, who had been teaching me to use strategies rooted in ABA to support the child. She shared a phone contact of a lady who might help, and it is this lady that put me in touch with Dr. Jane Paul Weru, a Neurodevelopmental specialist and BCBA-D who was starting a training program for Behavior Therapists in 2020. I signed up immediately and started the course.

Dr. Pooja Panesar DBH, BCBA/QBA/IBA, MEd, Behavior Analyst, Kenya & Tanzania:

I got into the field in 2005 as a 3rd year undergraduate and a junior therapist. My initial experience with ABA and the children I worked with transformed my educational plan, and I changed from pursuing medicine to psychology, neuroscience, and behavior. I then moved back home to Kenya in December 2006 after graduation. A parent with a 7-year-old son on the autism spectrum reached out to me when she saw I had some experience in the field – at that time most people in the region hadn’t heard about autism yet. The parents brought in a table and two chairs, and through a borrowed space and constant guidance from my professor in Canada, I began providing ABA therapy. As others heard and came for services, I knew that I needed the required qualifications to keep this going.

Martha Angila, IBA, Behavior Analyst, Kenya:

I hold an undergraduate degree in Banking and Finance, but my professional path took a transformative turn when someone very close to me had a child diagnosed with Autism. At the time, we were living in Eldoret, a small town in Kenya where autism services were virtually non-existent. Together with the boy’s mother, a medical professional, we began navigating the world of autism support with little guidance. She introduced me to ABA through medical journals she was reading. I wanted to understand the science of ABA deeply and use it to help others. My journey began with a Behavior Technician course, then I went on to also pursue my credentials to become a Behavior Analyst. On January 1st, 2025, I proudly became a certified International Behavior Analyst (IBA).

Priscilla Afriyie (Ghana), IBA, Special Educator, Ghana:

After earning my first degree in Psychology and Sociology in 2013, I received a call from a parent who had gotten my contact through the Psychology Department of my university. He mentioned a group from South Africa offering training in ABA. At that point, I had never really paid attention to the word “autism.” That experience was my first real encounter with autism and ABA. I was trained by professionals from the Star Academy; a South African branch affiliated with the Center for Autism and Related Disorders (CARD) in the U.S. In 2023, I joined a certification pathway with “Find Your Balance,” introduced by a BCBA who came to Ghana with the mission to expand professional standards in ABA. That’s when I began working toward my International Behavior Analyst (IBA) certification. All of this led to the founding of the Mind Bridge Learning Center in 2023.

Dr. Eziafakaku Nwololo, PhD, BCBA, QBA, Behavior Analyst, Nigeria:

Part of my motivation for retiring early (from Chevron Nigeria Limited) stemmed from my desire to improve access to autism resources in Nigeria, considering my personal experience of having a daughter with autism and a network of parents facing similar challenges. This decision led me into the dynamic field of Behavior Analysis. Immediately after I retired in May 2014, I enrolled in school. I started as a Registered Behavior Technician (RBT) and subsequently became a Board-Certified Assistant Behavior Analyst (BCaBA). I established Shades of Life Services in 2014. I went on to pursue my Master of Science in ABA-IDD in the UK in 2016 and founded Shades of Life Care Limited (SOLC) in 2017.

Cecilia: Pooja, ASAT had the good fortune of interviewing you in 2013. How has the autism/ABA field changed since then?

Pooja (Kenya/Tanzania): This is a wonderful question to answer as there has been growth! Over the years, I am excited that many of my previous employees at Kaizora or those who volunteered during my events decided to get into the field of autism and are certified in various areas. In addition, we now have five behavior analysts (3 BCBAs, 1 Qualified Behavior Analyst (QBA) and 1 IBA in Kenya). We also have 2 Applied Behavior Analysis Technicians (ABATs) in Tanzania as well. Autism awareness has increased significantly, where in Kenya the focus is on evidence-based interventions now. There are also more professionals in fields related to interventions which help disseminate information. Courses are also now available locally for two levels of certification in ABA and hopefully this will continue to grow over the next few years.

Cecilia: Wow, that’s amazing progress, Pooja! I can imagine that having more certified professionals and local training options must make a huge difference. Your paths to autism and autism treatment are not only inspiring but also quite diverse, and I am grateful to each of you for describing how you got into the field of autism. Can you please share with our readers how individuals with autism are viewed in your country and the challenges they face?

Ashley (Kenya): Autistic individuals in Kenya, like in many parts of the world, often face a complex mix of misunderstanding, stigma, and systemic neglect. In some communities, autism is still misunderstood or misattributed to spiritual causes, and that can delay access to diagnosis and support. Unfortunately, these views can lead to isolation, discrimination, and even mistreatment of autistic individuals and their families.

Freda (Uganda): There is limited awareness of autism in Uganda, and this condition is largely viewed as a curse in the family because of ritual sacrifice for wealth, witchcraft, or some other misfortune. For others, the fault may lie with either the paternal or maternal lineage, but all in all, it must be because of something bad that was done somewhere. This explanatory model of the causes of autism creates stigma, which sadly results in parents hiding their children at home to avoid judgement or sending them to live with their grandparents/ relatives in villages.

Martha (Kenya): While there is growing enlightenment in urban centers like Nairobi, driven by advocacy, education, and media coverage, much of the country still holds deeply rooted misconceptions about autism. In many communities, autism is not recognized as a neurodevelopmental condition. Instead, it is often misunderstood as a form of mental illness, a curse, or a spiritual affliction. As a result, families may seek spiritual or traditional healing.

Afriyie (Ghana): Traditional beliefs and stigma still present significant barriers— especially in rural communities and even among some urban dwellers. I remember, early in my career, I mentioned to an aunt that I was going to work with an autistic child. Her immediate response was that I shouldn’t because the condition was “contagious.” Others have said that working closely with autistic children might increase my chances of giving birth to a child with autism. Another challenge is the general misunderstanding of what autism is. Many people tend to lump various developmental conditions, like Down syndrome and cerebral palsy, under the umbrella of autism. Then there’s the painful reality of stigma. Parents of autistic children are often blamed for their child’s condition. In some communities, there are still beliefs that the child is a curse or a punishment from the gods. Some families hide their children, avoid social settings, or, in more tragic cases, children are abandoned or harmed, sometimes even left by water bodies as a form of spiritual “sacrifice”.

Pooja (Kenya): Autism awareness has definitely increased significantly in the last decade in Kenya and is still gaining traction in Tanzania. I would say the biggest difference in the perception of autistic individuals is whether you are in the urban areas where education and access to information are more accessible, versus the rural areas, where cultural and traditional views are stronger. In urban areas, there is a shift towards inclusivity, but it is still a novel concept. However, in rural areas, many still hold spiritual beliefs about the etiology of ASD, which in turn dictates the mode of treatment.

Eziafakaku (Nigeria): I have come to realize, and I share this with others, that autism is viewed through the lens that helps an individual cope with the unknown. For instance, those who see it as a spiritual issue are more likely to believe in a supreme being—God. Others interpret it through a medical lens and view it as something that ought to be cured, while some attribute it to poor parenting, madness, or bad behavior on the individual’s part. However, regardless of the perspective one adopts, there is accompanying stigmatization that we are striving hard to dispel.

Cecilia: Your experience across borders shares so many overlaps and reminds us that awareness and advocacy must be a global effort because every autistic individual and their family deserve understanding, dignity, and support. What are some of the challenges parents, caregivers, and teachers face regarding resources and treatments, and what are some initiatives to address those challenges?

Ashley (Kenya): Many parents and caregivers in Kenya are doing the best they can in an environment that often doesn’t provide them with the tools or support they need. Access to early intervention services is limited, especially outside of major cities. Public schools are often under-resourced, and most private interventions are financially inaccessible to most families. In response, we’re seeing a rise in parent-led advocacy groups, grassroots support networks, and training initiatives. At AfriCare ABA, for example, we’ve launched low-cost, community-based programs that empower parents and teachers with practical, science-backed tools, delivered in ways that are culturally relevant and affirming.

Freda (Uganda): I believe that limited awareness about autism is one of the biggest roadblocks that parents of children on the spectrum must negotiate in Uganda. Parents grope in the dark trying to figure out everything on their own, while others move from one specialist to another and finally give up when they do not register progress. In addition, most parents/caregivers cannot afford to provide therapy services for their children. Another challenge that is less spoken about is the emotional toll that parents bear. From when they notice delays, they oscillate between doubt and hope, which wears them down. From my experience, a diagnosis is usually met with denial, anger, and in some cases, a quiet acceptance and a sense of hopelessness. Parents, particularly mothers, go through these challenges without support. There are fathers who abandon their families and while some stay, they may be emotionally absent and uninvolved. Most of the teachers in Uganda have little to no awareness and are ill-equipped to teach children with autism, let alone create inclusive classroom environments. We cannot ignore the fact that teachers are members of the wider community, and they may have the same beliefs and misconceptions about autism as the majority, which get in the way of providing support in the classroom.

Martha (Kenya): A major concern is the prevalence of pseudoscientific treatments that falsely promise to cure autism, which often mislead families. Some commonly peddled treatments include Hyperbaric oxygen therapy, Stem cell therapy (families spend a fortune to travel to India for this treatment, camel milk and use of herbs (ingested or applied on the body). Additionally, the cost of evidence-based therapies like ABA is prohibitively high for many, limiting access to proper care. Teachers also lack sufficient training to effectively support students with autism in mainstream classrooms. Despite these challenges, there are promising initiatives. One such effort is led by the Pan-African Congress on Autism (PACA), which organizes conferences and training aimed at bringing together professionals and parents to promote awareness and the use of evidence-based practices.

Afriyie (Ghana): One of the biggest challenges parents, caregivers, and teachers face in Ghana is simply access. Access to information, to trained professionals, to affordable therapies, and to inclusive schools. Many families, especially those in rural areas, have little to no idea where to turn when a child is showing signs of developmental delay or neurodivergence. Even in urban settings like Accra or Kumasi, where services are more available, cost and stigma become major barriers. Caregivers, especially mothers, often feel isolated and overwhelmed. They may be blamed by family members or discouraged from seeking help due to cultural beliefs. Teachers, on the other hand, may genuinely want to help but lack the tools and support needed to do so effectively, leaving everyone frustrated. There’s still very little government involvement in autism care and special education. There are no fully government-funded centers for autism intervention or behavior therapy. Parents often carry the financial burden entirely on their own, from assessments and therapy to school fees and caregiving support. Public schools are largely unequipped to handle neurodiverse learners, and teachers rarely receive adequate training in inclusive practices.

Pooja (Kenya & Tanzania): Caregiver support is an area of challenge where many parents feel isolated, alone, and may be overwhelmed with which information to follow. Better support systems, training modalities, and respite arrangements are much needed. Both countries need additional training programs for professionals in the field, which would in turn increase qualified personnel providing interventions. Accessibility to services, especially in the rural areas, is sometimes impossible. The government is trying to advocate for inclusion in schools; however, more training for the teachers would also be needed for that to be successful. Personally, as an accredited course provider, I began offering courses in ABA (ABAT and Qualified Autism Service Practitioner-Supervisor (QASP-S) level) this year to bridge the gap. I began with just a few students, and hope that this can continue to grow. In addition, I began an ABAI chapter, Kenya Association of Behaviour Analysis, in 2016, which is finally gaining traction as we have a few more BCBA’s.

Eziafakaku (Nigeria): Parents and caregivers have been misled by numerous ‘snake oil’ therapies, as some do not know any better. For teachers to receive adequate training, the costs associated with training and acquiring resources are prohibitive.

Cecilia and Brittany: We are truly touched and grateful for the work you are all doing in your respective countries. This process has brought startling insight into the lack of educational opportunities for students with an ASD diagnosis as well as those who want to practice as providers in the field of autism treatment. A component discussed by each of you is the stigma associated with an ASD diagnosis derived in misunderstandings and creating limits to an underserved community and population. This is the first part of the interview; in the second part, we will focus on access to information and efforts to disseminate evidence-based treatments for autism. We will also talk about how internationally based organizations such as ASAT can help you in your mission. Thank you again for your commitment to supporting autistic individuals and their families.

Reference for this article:

Wayua, C., & Thacker, B. (2025). Navigating beliefs, misconceptions, and therapeutic practice in Africa: Perspectives from ABA practitioners (Part I). Science in Autism Treatment, 22(10).

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