In Gaza, autistic children confront intensifying trauma, regression and loss of essential therapy

"All of this sounds like small, insignificant things, but for an autistic person, such changes can mean big things," begins Hanan, mother of Raed, an eight-year-old with severe autism.

Speaking from her tent on Gaza's sandy shores, she describes how Israel's two-year genocide upended her son’s life. Once-stable routines — therapy sessions, predictable meals, playtime, and sleep — have vanished, leaving him struggling with anxiety, sensory overload, and speech challenges.

When the Israeli genocide began after October 7, 2023, essential support for autistic children in Gaza started to collapse, alongside the deterioration of healthcare facilities.

With rehabilitation centres now left destroyed, humanitarian aid being restricted, and families still displaced, thousands of autistic children are facing a "double silence": the trauma of war compounded by the lack of access to care and therapy. 

Mustafa Abed, director of the Medical Relief Society’s rehabilitation programme, estimates between 3,000 and 5,000 children in Gaza live with autism.

However, accurate statistics are unavailable due to the Israeli occupation military's devastation of health, education, and social services.

"My son had a certain routine in a calm environment that suited his needs, along with a regular sleeping routine, play time, therapy sessions and specific foods he was comfortable eating," Hanan shares with The New Arab.

Now in the aftermath of the war, her eight-year-old is struggling with anxiety, sleep disturbances, sensory overload and speech problems.

There have been severe restrictions on humanitarian aid by Israeli forces, and the government’s blockade in Gaza has left over a million people suffering from hunger and malnutrition, further inflicting profound trauma and suffering on Palestinian children. 

But Hanan hopes that rehabilitation for children like Raed will be prioritised and offered.

Restoring routine and support

"Autistic children in Gaza have severely suffered from disruptions to their daily routines, which are essential for their psychological and behavioural stability," explained psychologist Bashar Abou Halloup, who works with the Palestinian Medical Relief Society.

Shedding light on the situation of autistic children in Gaza after Israel’s brutal war, Bashar explained that children are more dysregulated than ever, experiencing heightened anxiety and significant regressions in skills they had previously acquired — especially now that vital therapy is no longer available.

The lack of specialised psychological support, caused by Israel's bombing of the centres that once provided these services, combined with constant displacement, unsafe living conditions and a severe shortage of basic resources, including food, has led to significant changes in their psychological behaviour and a complete loss of previously developed skills.

"We cannot wait for infrastructure to be rebuilt; we need mobile teams of therapists, volunteers, and parents who can bring therapy to their children in camps, schools or wherever they are," Bashar stressed. 

“Parents are the children’s primary therapist now,” he added.

"We need to train them in techniques like how to manage dysregulation or overstimulation, how to use sensory toys, and communicate calmly with their distressed children. We also need to help them in creating predictable routines whilst they are in the shelters," Bashar explained.

"But most importantly, we need to offer the parents psychological support, especially given the trauma they witnessed themselves during the war — their mental health directly affects their children’s recovery." 

Recovery amid ruins 

Israel's two-year genocide uprooted nearly 90% of Gaza’s population, leaving nearly 1.9 million Palestinians without a permanent and safe place to live — many have been internally displaced multiple times.

Amid this trauma, families of autistic children now must not only rebuild their homes but also contend with the devastating loss of their children's developmental progress.

For Raneem, mother of 12-year-old Malak, the war's aftermath feels like starting all over again.

"The hard-worn skills Malak had learned over the years have now all vanished,” she told The New Arab.

"She has regressed to early childhood behaviours and now struggles to communicate even her most basic needs, such as when she's hungry, thirsty, or needs the toilet," Raneem explained.

"When she hears a loud sound, now she hides in the corner and trembles."

Even after the ceasefire, the lack of environmental stability and structure has left children like Malak and their families in profound psychological distress.

Speaking on the importance of routine and structure, occupational therapist Zahraa Attieh, who runs a clinic in south Lebanon, told The New Arab, “Now with the ceasefire in place, the focus must shift toward helping children reclaim their sense of safety and structure as routine forms the foundation of therapy for most autistic children."

She said a predictable daily structure can help reduce anxiety and behavioural distress.

For Zahraa, even small consistent daily routines can begin to repair the psychological damage caused by months of chaos and fear.

Drawing from her experience after last year's war by Israel in Lebanon, Zahraa predicts that autistic children in Gaza will face similar, but even more intense challenges.

"Displacement, loud noises, and constant changes in environment are deeply overwhelming for autistic children, and in Gaza, this was coupled with immense terror and famine, so recovery and regulation will take time and patience," she explained. 

The sensory cost of starvation

Children on the autism spectrum may frequently struggle with eating in ways that go beyond mere pickiness. Many display what researchers call "selective eating," rejecting a wide range of foods because of sensory sensitivities — to texture, taste, smell, appearance, or temperature. 

For these children, meals are not simply about nourishment — they are carefully managed sensory experiences.

When routine, consistency and "safe" foods are disrupted, it can lead to weight loss, nutritional deficiencies, gastrointestinal issues, behavioural distress, and more profound emotional suffering.

The famine and food scarcity that Israel created during and after the genocide in Gaza — intensified by severe restrictions on aid — means that many families cannot access the specific foods their autistic children can tolerate: the plain breads, familiar brands, simple textures or consistent meals that provided safety and stability. 

Nine-year-old Kassem, who was diagnosed with autism at the age of three, has regressed in his speech, his mother Nada shares, explaining that he was always "picky and selective with food," but now, in the aftermath of Israel's genocide, his safe food like potatoes, white bread and cornflakes have become "luxuries" they can no longer afford. 

"During the war, I remember one night he woke up crying with his hands on his tummy. He was hungry, but I had nothing he would actually eat." 

The World Food Programme (WFP) said that food deliveries to Gaza have increased since the ceasefire but remain far below the agency’s target of 2,000 tons per day.

Israel has used the starvation of Palestinian civilians in Gaza as a method of war. This tactic has led to widespread cases of malnutrition and starvation and placed children with disabilities who require a specific diet at a particularly high risk of death.

"Mealtime is already challenging with autistic children as they have a preference for certain textures and temperatures, and because of their strong sensory preferences, this can impact what kids are willing to eat, as well as their refusal to explore new food groups," Talida Merhabi, a speech therapist who works with autistic children in Lebanon, tells The New Arab. 

"Given the famine that Gaza faced and the situation of the limited food supplies, it has undoubtedly made it ten times harder for parents to try and feed their child something, especially if their child has sensory difficulties," Talida added. 

Now in the post-war period, experts say that rebuilding food security for families of autistic children must prioritise specialised nutritional and sensory support.

This could mean providing familiar foods and training parents to manage feeding anxiety.

"Children should feel safe again around basic things like food and mealtime," Talida concluded. 

Rodayna Raydan is a Lebanese British journalism graduate from Kingston University in London, covering Lebanon and beyond 

Follow her on X: @Rodayna_46