Knowledge and perceptions of autism spectrum disorder among parents in Sudan: a cross-sectional survey

Autism spectrum disorder (ASD) is a neurodevelopmental condition affecting millions worldwide, yet epidemiological data and awareness research remain scarce in Sudan. Parental knowledge is crucial for early recognition and timely intervention. This study aimed to assess knowledge, perceptions, and predictors of ASD awareness among parents in Sudan. A cross-sectional survey using convenience sampling was conducted across four geographic regions of Sudan (North, East, South, and Central) from January to February 2026. Using face-to-face interviews with a structured questionnaire. The questionnaire was culturally adapted for the Sudanese context and demonstrated acceptable internal consistency (Cronbach’s α = 0.72), 947 parents were recruited. Knowledge was assessed using 31 items; scores ≥ 60% indicated good knowledge. Binary logistic regression identified predictors of awareness. Only 10% of participants demonstrated good ASD knowledge. While most recognized autism severity levels (75.2%) and delayed language development (60.6%), substantial misconceptions persisted: 72.4% believed autistic children possess special talents, 59.3% incorrectly endorsed effective non-verbal communication, 42.3% attributed autism to parental neglect, and 39.5% believed autism is curable. Regarding perceptions, 68.8% feared diagnosis would lead to discrimination, and 48.5% felt autism is frequently missed clinically. Older parents (≥ 50 years; OR = 0.27, p = 0.038), fathers (OR = 0.53, p = 0.019), and—unexpectedly—urban residents (OR = 0.54, p = 0.013) had significantly lower knowledge, challenging assumptions about health literacy in cities. Profound gaps in ASD knowledge exist among Sudanese parents, accompanied by widespread misconceptions and stigma. Fathers, older parents, and—contrary to expectations—urban populations require targeted awareness interventions. These findings underscore urgent needs for culturally adapted educational programs, enhanced developmental screening, and strengthened healthcare capacity for early ASD identification in Sudan.