Living on with Autism after a Devastating Earthquake: Experiences of Children and Adolescents in Turkey

Introduction: The current study aimed to investigate the psychological impact of the Turkey 2023 earthquakes on children with autism spectrum disorder (ASD) and their parents residing in Hatay, Sanliurfa, and Ankara provinces, encompassing the periods both before and after the Turkey 2023 earthquakes. Method: This cross-sectional, multicenter study included 103 children and adolescents with ASD aged between 6 and 18. Participants were evaluated based on their residence in Ankara, Hatay, and Sanliurfa, three cities affected differently by the earthquake. Parent-report questionnaires were utilized to assess the children's autism symptoms and behavioural problems. The Childhood Autism Rating Scale was used to determine autism severity. The psychiatric problems of mothers were also assessed with self-report scales. Results: Significantly increased levels of core autism symptoms, irritability, and hyperactivity were found in Hatay and Sanliurfa participants after the earthquakes compared to before, while no differences were detected in children from the Ankara group. Scale score increases in the Hatay group, which had to take a more extended break from special education, were higher than in the Sanliurfa group. Participants with late-diagnosed ASD exhibited a more significant increase in their scale scores after the earthquake. Depression, stress and hopelessness scores were the highest, and the life satisfaction levels were the lowest in mothers of the Hatay and Sanliurfa groups. More pronounced increases were observed in aberrant behaviours among children of mothers with low educational levels following the earthquake. Discussion: Our findings demonstrate that the exacerbation of core ASD symptoms and behavioural deterioration after the earthquakes are associated with disruptions in specialized education services, exposure to earthquake-related trauma, and the educational level of mothers.