For families with children who have special needs, it can be challenging for both the family and the children to receive the support and resources they need in the Kurdistan Region of Iraq. In the last two years, SEED has worked with two families from the host community who have children that are diagnosed with autism. Although SEED’s focus is not working with autistic cases, our Marriage and Family Therapist has found two effective, holistic, and tailored mental health approaches that helped both families regain control of their lives. These approaches included psychoeducation on autism, emotional support, skills building, behavioral techniques, parent coaching, and modeling appropriate responses towards specific challenging behaviors.
The initial referrals to SEED for both cases were made for the children. However, during the initial assessment, SEED’s Marriage and Family Therapist noticed that the parents, especially the mothers, exhibited symptoms of depression and anxiety. Both mothers felt angry, upset, hopeless, and blamed themselves for their children’s struggles. Our therapist thought it would be more beneficial to address the whole family’s needs for a better result for the children. Therefore, SEED’s approach included direct work with the families, the children, and the parents, providing them with emotional support and parenting strategies.
When SEED first met these children, they were exhibiting different forms of autistic behaviors. One of the children was non-verbal and aggressive, while the other was overly attached and did not fully understand social cues, such as personal space. Both children had difficulty interacting in a typical manner with others, making friends, sitting still, and listening to directions.
Through response modeling, parenting strategies, and a better understanding of the children’s needs, the parents were able to build the strength and positive skills needed to respond to their children in better ways. To increase and reinforce positive behaviors, SEED also used what is known as a ‘Token System’, where a child is rewarded for good and appropriate behavior. This technique was used to help end the first child’s aggression and to help the second child feel more comfortable using the bathroom as they displayed anxiety and fear. Through visual aids, videos, and positive reinforcement, this child’s anxiety decreased and was motivated and able to use the restroom by themselves.
One of the biggest challenges SEED faced while working on these two cases was the lack of resources available for people with autism and for their families in KRI and Iraq. While SEED provided the families with mental health support and was able to strengthen their family system, further resources are needed such as speech therapy and more intensive and advanced behavioral approaches. Both families continue working with centers specialized in autism in Kurdistan, but the services are under resourced. This work was made more challenging still, with the advent of the COVID-19 pandemic and the need to work remotely. Since this made working directly with the children difficult, SEED focused instead on working more closely with the parents and teaching them ways to help their children become more engaged.
Upon closing both cases, both children showed significant improvements in their social and emotional wellbeing, which was reported by the mothers. Both of the mothers shared they feel more hopeful and optimistic, and are willing to work on what they could, and accept what they cannot control. One of the mothers said, “My child may not have the best life, or a normal life compared to other children, but he will have a life, and I will do my best.”
Both families will need continued support as their children grow older. Early interventions, such as these, are vital in helping families better understand autism, learn how to access help, and teach the parents better ways of responding to their children’s special needs.