Autism Spectrum Disorder in KRI: Early Intervention and Support
Roman Jamal 05/07/2025
Executive Summary
Many children across the Kurdistan Region of Iraq (KRI) are growing up with autism spectrum disorder, but their families often face the challenges alone, without the support or understanding they need. They frequently struggle to find affordable, quality care, and children miss out on crucial early support. Cultural beliefs and fragmented services add to these challenges, while existing resources are often limited to urban areas. Swift policies are needed to establish a unified approach across ministries to improve support services for autistic children, along with additional measures to adapt therapies to local needs, prepare educators, and assist parents.
Introduction
Autism spectrum disorder (ASD) is one of the most common developmental conditions in the world, affecting nearly 1 in every 100 children.1 Children in the KRI are no exception to this case. Despite its prevalence, ASD remains widely misunderstood in the KRI. Many families are still unfamiliar with autism, often mistaking it for shyness, behavioral issues, or even poor parenting. Parental confusion stems from the symptoms of the disorder and the diagnostic process, which are caused by limited public awareness, deeply rooted stigma, and misinformation.
ASD impacts how individuals communicate, socialize, and interact with the world around them. It is often accompanied by repetitive behaviors, unusual sensitivities, and a strong preference for routine.
1- Some children may strongly react to loud sounds or certain textures when touching different surfaces.
2- Others might engage in repetitive actions like spinning the wheels of a toy car for long periods.2
3- Children with ASD may also exhibit both exceptional abilities and deep struggles, for instance, excelling at music or memory tasks.
4- Meanwhile, facing difficulties with everyday social interactions.
5- They may constantly talk to others about their particular interests and be unaware that it is not the case for the other person.
Some children without ASD might share similar traits, but for children with ASD, these behaviors have a greater impact on daily life.
Understanding autism as a spectrum brings clarity, as no two autistic children are the same. Some may speak fluently and have high intellectual abilities, while others may be non-verbal but possess extraordinary visual skills and cognitive abilities. The same applies to their needs, as some may benefit from speech therapy, while others may benefit from occupational therapy or behavioral support. This diversity requires an equally diverse support system that is flexible, inclusive, and grounded in compassion and evidence. Families face hardships and changes to the family structure due to the permanence of the condition. As a result, the child’s condition and adaptation can be affected by the families’ decisions, which might be influenced by cultural norms. On a broader scale, a better understanding of the cultural and contextual dimensions of ASD may enhance support on the matter.
This policy paper presents the unique challenges and opportunities facing children with ASD in the KRI. It explores the current landscape of services, examines the cultural and social barriers to diagnosis, and offers expert perspective to push for urgent policy actions.
Autism Root Causes and Responses
Despite the diversity of symptoms, ASD is not a result of parenting, vaccines, or external influences3 because autism is a condition that individuals are born with. To this day, experts do not know the exact and precise reason for autism in children. Researchers have not found a sole cause of autism, and it is thought to be a mix of factors related to genetics and some other parameters during pregnancy, labor, and delivery.4
Autistic children require early and tailored support since early diagnosis and intervention are crucial, and such support is not always available or accessible in the KRI. Identifying autism in the first few years of life, sometimes even before a child turns two,5 can greatly improve long-term developmental outcomes. Applied Behavior Analysis (ABA) and other evidence-based therapies can help autistic children better manage their challenges and make the most of their abilities.
Some clinical treatments used in the past are now known to be inappropriate and even harmful to children with ASD. For example, early forms of behavioral therapy used strict methods.6 Today’s therapies help autistic kids gain skills without forcing them.
There are other variations of autism, including how it is perceived through different cultures. What may be seen as a clear symptom of ASD in one country, such as avoiding eye contact, may be considered normal or even respectful behavior in another. Western diagnostic tools, which are often used without local adaptation, may not fully capture the experiences of children in the KRI. As a result, the children may go undiagnosed or misdiagnosed, and families may be left with uncertainties in managing the situation.
There is also a heavy emotional toll on families. Parents may feel overwhelmed, isolated, or even blamed for their child’s behavior. Many struggle to find the right words to describe what they are experiencing or the right people to turn to for help. Media portrayals of autism can sometimes offer hope, especially when they show accurate, inclusive, and respectful representations. But they can also perpetuate harmful stereotypes,7 such as equating autism only with savant abilities or social detachment. The children may become marginalized, and their parents may have unrealistic expectations due to these misrepresentations.
Autism in the Kurdish Context
According to the latest numbers by the Kurdistan Autism Association, there are currently 3,9008 individuals diagnosed with autism in KRI. This number is considered significantly low and does not align with global rates. The undercount is due to many autistic children being undiagnosed because misconceptions about autism often prevent families from seeking a diagnosis. Some fear how the label might impact marriage prospects, family reputation, or future opportunities, and not only for the child, but for their siblings as well. As a result, early intervention remains underdeveloped and underutilized.
Cultural stigma surrounding mental and developmental disorders significantly shapes how families respond to early signs of autism. In many Kurdish households, social pressure, and a desire to avoid shame or judgment contributes to a reluctance to seek professional help. This delay in diagnosis has serious consequences, and not only in missing the critical window for early intervention but also in the deterioration of the family’s mental health and parental well-being. Families are often left to navigate the challenges of raising an autistic child without sufficient emotional, educational, or medical support. Even if parents are motivated to seek support, they are defaulting to religious or traditional authorities before medical professionals. Therefore, professional support is delayed and generally occurs when religious means are exhausted.
The situation is made more complex by gender dynamics. Across the region, males make up a significant majority of diagnosed autism cases, roughly 77–80%, according to regional statistics.9 While this reflects actual occurrence differences, it could also indicate gender bias in recognition and diagnosis. Parents of females with autism report greater levels of distress, possibly due to additional cultural pressures or the subtler presentation of the symptoms in girls, which often go unnoticed.
The healthcare and education systems in KRI are still in development. Resources for families with autistic children are limited, and there is a lack of specialized services, trained professionals, and community support. Even the few available services are often difficult to access, especially for families living outside major urban centers. While private therapies exist, they are often costly and inconsistent in quality. Eight government-run and 41 private centers are in the KRI10 with the majority lacking government funds, and the families struggle to cover expenses charged by the private centers. The centers do not follow formal standards in their services, or in the qualifications of healthcare providers. Therefore, families are left without clear pathways for support.
There is insufficient data on the emotional well-being of autistic children and their families in KRI. Existing studies, such as those conducted in Erbil,11 show elevated parental stress and anxiety, predominantly among mothers. The insight is limited in scope, focusing primarily on urban families from middle to high socioeconomic backgrounds, leaving much unknown about the broader Kurdish population.
Community-level advocacy is beginning to emerge, bringing hope to children and families. Organizations like the Hope Autism Society,12 which is a UK-KRI initiative, have tried to urge local governments to take autism seriously by integrating awareness campaigns, training healthcare providers, and developing inclusive education strategies. The Kurdish educators13 have identified key challenges to inclusive education, such as lack of qualified teachers and inadequate infrastructure, and proposed practical steps, including curriculum reform and policy engagement.
Policy Recommendations
- Build a coordinated approach across the Ministries of Education, Health, Social Affairs, and Higher Education to guide diagnosis and services in accordance with international guidelines such as DSM-5, ICD-11, with localized adaptation to meet the unique needs of families and children in the KRI.
- Ensure children with autism have access to free, high-quality education and therapy through public autism centers or an inclusive education system. Support inclusiveness in schools by training educators.
- Adapt and localize international models like ABA, PECS, and TEACCH to Kurdish culture and language. Provide families with continuous guidance, mental health support, and community programs.
- Start awareness campaigns to inspire understanding and acceptance of autism. Engage educators and media in reshaping how autism is viewed to promote early diagnosis and support.
Expert Interview
Dr. Kany Othman
Dr. Kany holds a bachelor’s degree in education and psychology, a master’s in mental health, and a PhD in special education with a focus on childhood mental disorders.
She is a trained WISC-V administrator and a certified British Academy TOT instructor. With over 10 years of experience in higher education, she has worked in education for gifted children, family counseling, and psychological support.
She currently lectures at the University of Sulaimani, teaching subjects related to neurodevelopmental and learning disorders, autism spectrum disorder, and intellectual disability.
What are the most prevalent misconceptions about autism spectrum disorder (ASD) within Kurdish society, and how do these perceptions impact early identification and intervention efforts?
In the Kurdish community, there are two common misconceptions about individuals with ASD:
- Many families mistakenly believe that delays in language development and social interaction (two of the most common signs of autism) are primarily caused by excessive screen time rather than recognizing them as potential indicators of a neurodevelopmental condition. As a result, early diagnosis is often delayed.
- Some families think that individuals with autism inherently have low intelligence or lack the capacity to learn and understand. This belief can lead families to feel hopeless about the potential benefits of therapy and educational training, discouraging them from seeking support.
How do cultural beliefs such as stigma or normalization shape parental and community responses to children showing signs of ASD in the KRI?
In KRI, parenting is often influenced by Eastern cultural norms, where emotional responses tend to outweigh logical reasoning. This emotional response can disrupt the family structure. This perspective can also affect the child's development of independence and self-reliance. ASD is still not recognized or accepted in the same way as physical illnesses, leading to a sense of shame and secrecy around the diagnosis. Parents from highly educated backgrounds often struggle with social stigma. In one of my personal interviews this year, I discovered that some of these families chose to hide their children’s condition or even relocate abroad to avoid judgment. In contrast, families from average socioeconomic and educational backgrounds tended to be more open about this. They were more willing to acknowledge and discuss their child’s condition.
Addressing these culturally rooted reactions can be through targeted awareness programs. Organizing seminars, workshops, and educational courses for parents can help clarify misconceptions, highlight the strengths and potentials of children with autism, and encourage families to view autism as a manageable condition. Research conducted in our community and Sulaymaniyah reveals that many parents of children with autism experience confusion, guilt, anxiety, and even depression. They often believe they caused their children to develop autism.
How would you assess the current availability and quality of clinical, educational, and rehabilitation services for children with ASD in the KRI?
While there are services available in the region, they often lack consistency, scientific rigor, and structured programming. Several key issues contribute to this situation; for example, there is a lack of trained professionals specializing in autism diagnosis and therapy. Another problem is that different clinics and centers use varying criteria and tools to diagnose autism, rather than adhering to universally recognized standards such as the APA’s DSM-5 or the WHO’s ICD-11. Moreover, many families are unable to access support due to financial constraints and the high costs of clinical services. A survey I conducted in Sulaymaniyah highlights these challenges:
- 87% of parents reported that they do not send their children to therapy centers due to the high cost of services.
- 76% of parents are not satisfied with the quality of services provided by centers.
What are the main challenges and obstacles preventing effective integration of early diagnosis services for ASD within the healthcare and education systems in the KRI? What key mistakes have hindered progress so far?
One of the main barriers to effective progress is the fragmented division of responsibilities among various government ministries, such as the Ministries of Education, Social Affairs, Health, and Higher Education. Each operates independently, without a unified strategy or coordinated approach, pursuing its own agenda.
To better understand this issue, I conducted interviews with key stakeholders, including the Deputy Minister of Social Affairs, representatives from autism organizations, members of the diagnostic committee, and school principals. All of them unanimously acknowledged the absence of inter-ministerial communication and confirmed that there is no unified strategy or system in place to ensure effective support for individuals with autism.
Are there any regional or international models of ASD support and intervention that you believe could be effectively adapted to the Kurdish context? If so, which elements would be most transferable?
Yes, there are many well-established global models that the Kurdish community can benefit from, provided they are appropriately localized and adapted to the cultural and linguistic context of the region. Widely adopted models such as ABA (Applied Behavior Analysis), PECS (Picture Exchange Communication System), and TEACCH (Treatment and Education of Autistic and Communication-Handicapped Children) have proven effective in helping children with ASD develop essential skills, including communication, socialization, and daily living behaviors. However, it is difficult to apply any single model in its original form within our society without making necessary local modifications. These models are typically developed in English-speaking countries and often reflect Western cultural norms. Therefore, both language and cultural adaptation are critical for their successful implementation in other settings.
For example, the use of English as the language of instruction can limit effectiveness. Children should be educated in Kurdish to ensure better comprehension and relevance. As for cultural practices, in some Arab countries, for instance, it is common to eat with hands rather than using utensils. If a model teaches the use of cutlery, this may lead to confusion or even shame for the child. Children with autism often respond well to routines, so it is essential that these routines align with local customs. For instance, if the local norm is to eat with a spoon and fork, as is common in many Kurdish households, then the model should reflect and reinforce that practice.
Based on your expertise, what specific policy recommendations would you prioritize to improve overall support for children with ASD and their families? Which measures are most urgently needed to address current gaps?
One of the most urgent actions needed is to ensure that children with ASD have the same right to free and compulsory education as all other children, in other words, an inclusive education system. While education is legally guaranteed for the general population, many children with autism are left behind due to financial barriers and limited access to specialized services.
It is essential that formal and free training centers for children with autism be established and supported by the government. Equally important is the education and support of parents and caregivers. Families need ongoing guidance on how to navigate daily challenges and support their children’s development. Offering workshops, counseling, and community resources can empower families and reduce feelings of guilt or shame.
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- SickKids staff. “Characteristics of Autism Spectrum Disorder (ASD).” AboutKidsHealth - the Hospital for Sick Children (SickKids), March 9, 2009. Read More. ↩︎
- Autistica. “Myths and Causes - Autism | Autistica,” April 9, 2025. Read More. ↩︎
- Professional, Cleveland Clinic Medical. “Autism.” Cleveland Clinic, May 13, 2025. Read More. ↩︎
- Office of Communications. “Early Intervention for Autism.” National Institute of Child Health and Human Development, April 19, 2021. Read More. ↩︎
- Professional, Cleveland Clinic Medical. “Autism.” Cleveland Clinic, May 13, 2025. Read More. ↩︎
- Info. “Autism and Culture: Representation in Media.” Autism Services and Therapy for Kids by Counseling, June 16, 2024. Read More. ↩︎
- Mohammed, Daban. “Kurdistan Autism Association Reports 3,900 Autism Cases, Urges Increased Support on World Autism Awareness Day.” Channel 8, April 2, 2025. Read More. ↩︎
- Mohammed, Daban. “Kurdistan Autism Association Reports 3,900 Autism Cases, Urges Increased Support on World Autism Awareness Day.” Channel 8, April 2, 2025. Read More. ↩︎
- 964media. “Kurdistan Region Sees Rise in Reported Autism Cases,” April 2, 2024. Read More. ↩︎
- Ghazali, Hedayat, Kristie Asaro-Saddler, Pegah Seidi, Narmene Hamsho, and Halmat Faieeq D Mahmood. “Unveiling the Journey: Understanding the Experience of Parents of Children with Autism across the Kurdistan Region of Iraq.” ResearchGate, August 2024. Read More. ↩︎
- Ghazali, Hedayat, Kristie Asaro-Saddler, Pegah Seidi, Narmene Hamsho, and Halmat Faieeq D Mahmood. “Unveiling the Journey: Understanding the Experience of Parents of Children with Autism across the Kurdistan Region of Iraq.” ResearchGate, August 2024. Read More. ↩︎
- Abas, Nazdar Qudrat, and Omar Adil Abbas. “Teachers’ Perspective about Applying Inclusive Education in Iraq and Kurdistan Region: Needs and Challenges.” Journal of University of Garmian, August 2022. Read More. ↩︎
Content Type:iNNOV8 Policy Briefs
