LETTER OF TRANSMITTAL

Date: December 4th, 2017

To: Mercy Corps Organization

From: Lanya Ali Ahmed “Student at American University of Iraq, Sulaimani”.

Subject: Recommendation Report: We Should Care About Autistic Children in Iraq, Specifically

Kurdistan.

Attached is a “Recommendation Report: We Should Care About Autistic Children in Iraq,

specifically Kurdistan”. This repost uses mercy Corps organization as the foundation of the
recommendation report. The report tends to inform the readers about the current situation that
autistic children are facing in the country and recommend for a serious action to change the lives
of these children.

To prepare the report I used secondary sources including two reports that were done in Baghdad
and Erbil about some families that have Autistic child, and my post experiences.
I found out lack of awareness and spread of misunderstanding among the families of these
children are common in the region. Moreover, limited numbers of schools and centers are
available for these children in Iraq and Kurdistan. For instance, only one public school is
available in Sulaimani that fulfills only 47 students. Finally, University of Sulaimani does not
have neurological department, so the capabilities of the doctors are limited when it comes to
diagnosing the disease.

Based on the findings this report recommends three things. First, rising awareness among the
families of these children as well as the society. Second, building a school to educate the
children. Third, training the local doctors and teachers.

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 Executive Summary
The following recommendation report uses a Mercy Corps as a foundation for this
recommendation. In the report, I want to inform the readers about the problems that autistic
children face in Iraq Specifically in Kurdistan. I want to improve the lives of these children by
recommending three things. The first is rising awareness among the families that have autistic
children, and the society in general. Second, building a school for these kids to educate them.
Third, training the local doctors and teachers to know how to deal with these kids.

Unfortunately, in this report I was only able to use secondary data because there was
limited time to write this report, and not enough information available in Sulaimani about the
children who are fighting this disease. After I analyzed the data, I think the report is ready to be
put into consideration.

For instance, from Rami Institute “74% of families with autistic children suffer from difficulties
in social relations as well as 92% of the sample in which the brothers suffer from psychological
and social burden the existence of an autistic problem” (p. 26). However, this data is not from
this region but we can see that lack of awareness of how to behave with the children that have
ASD (Autism Spectrum Disorder) is a common problem around the world. From the report that
was done by Kameran in Erbil and Sulaimani for 76 Families that have autistic children. He
showed that among 76 children 69 of them were not able to read and write and only 3 of them
graduated from primary school which is the only degree that they can get. This can clearly show
that these kids are ignored in the society. Hafiz “discovered that significant numbers of the
children listed as autistic proved to have other psychological disturbances upon new examination
in his center in Baghdad. He also noticed that the children had been taking medication for years,
dramatically worsening their brain and negatively affected their mental and physical growth”.
This means we do need to train the doctors that are going to aid these kids.

Therefore, we should take care of these children and give them the right that other kids have. If
we rise awareness, build a school to educate them, and train our Doctors and teachers, we will
make their lives and the society better.

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 Recommendation Report:
We Should Care About Autistic Children

Prepared for: Mercy Corps Organization

Prepared by: Lanya Ali Ahmed

November 27th,2017

III

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 Table of Contents
List of Transmittal .....................................................................................................I
Executive Summary …………………………………………...............…………. II
Title Page .............................................................................................................. III
Table of Content .......................................................................................................................... IV
Table of Figures .................................................................................................... ...V

Introduction …………………………………………………................……..…...1
Method ………………………………………………………................…..……..2
Results …………………………………………………………..................…..(3-9)
1. Lack of Awareness: .................................…………………..................……..3

2. School for Autistic children ............................................……….................….…..4

3. Training courses for the Kurdish doctors and teacher ........……….................….9

Conclusion
1. How to behave with these Children .................................…………………10
2. Educating the Children .................................................................................11
3. Collecting money for a school……………………...........................…...…12
4. Searching for specialists...............................................................................12

Recommendations ..................................................................................................14
References ..............................................................................................................15

IV

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 Table of Figures
Page 1/ Figure 1.1: the common behavior of Autistic children.

Page 6/ Figure 1.2: The Public School in Sulaimani

Page 7/ Figure 1.3: Private School in Stkholm, Sweden.

Page 16/ Figure 1.4: primary, Secondary, and Tertiary audience for
the recommendation report of Blue Organization to open a school for autistic children.

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Introduction:

As a former member of Mercy corps I decided to present a recommendation report to

Mercy Corps regarding the issues that Autistic children face in Iraq, specifically in Kurdistan and

that we should care about autistic children in this region.

ASD (autism spectrum disorder) is a developmental disorder that appears from the early

childhood. Dr. Anderson talked about the behaviors of autistic children. He provided a picture

that shows the most common signs of autism. As seen below:

Figure 1.1: the common behavior of Autistic children.

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He talked about the importance of understanding the behavior of these kids as seen in Figure 1.1.

Understanding the behaviors of these kids decreases the stress of the families that have autistic

children about how to deal with them.

I have three relatives in my family that are autistic. I went to the school and the autistic

center within here in Sulaimani. From the experiences that I have had the school is only for 47

students. It is a public school which there are 25 or more students at each classes. The autistic

kids are mixed with the other students despite the fact that, they find it very difficult to be social.

As Hafiz talked about it the doctors, who have limited capabilities, most of the time

diagnose the disease in a wrong way and provide unnecessary medicine that effects the health of

these children. Moreover, we need to train some teachers who are interested in Helping them

because working with these kids is not an easy task.

Because of what I talked about above we should care about autistic children and make

their lives better. We need to rise awareness about the disease as well as educate these kids and

open training course for our doctors and teachers. I recommend this report to the Mercy Corps

organization since they are one of the best organization at helping people.

Method:

For this report I only used secondary resources some of the researches were from

Kurdistan and Iraq, and others were articles from websites. At first, I found out whom I should

recommend as a foundation of this report. After that, I made an inquiry about which questions I

should answer in the report.

Also, I made an Ishikawa diagram to find out what are the root causes of this problem as

well as how to solve these problems. By the time, I considers the three main factors that caused

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this problem I have started to search for valuable sources. Lastly, I wanted to show why my data

are important, so I wanted to give some examples to show the lives of some autistic children in

Kurdistan. Finally, I recommend three things to make the lives of these children better.

Result:

Lack of Awareness:

A child with autism needs to be treated differently than other children. Parents must put

their main focus on helping their child with autistic spectrum disorder (ASD). As well as finding

good relationship between their child with ASD with their siblings. The families need to be

aware of their siblings on how to behave around a kid with ASD, and help them to understand

the situation (Autism Society, 2006). For instance, from Rami Institute “74% of families with

autistic children suffer from difficulties in social relations as well as 92% of the sample in which

the brothers suffer from psychological and social burden the existence of an autistic problem” (p.

26).

However Iraqi government and Kurdistan Regional Government fails to address the rise

in autism. One of the reasons is because there is a lack of awareness about the disease among the

families that have a child with ASD. For instance, in 2012, Gilford University published an

article that counted 5, 000 children in Iraq including Kurdistan are fighting with ASD (Sakr,

2014). Moreover, the autism research center at Cambridge university showed that post 2003 was

recorded at high level of autism in Iraq. “According to the study, autism affected 75 out of every

1,000 children 5 to 10 years old” (Sakr, 2014). The latest data as Dr. Taha Jazza from the center

for educational and psychological research addressed the problem in one of his articles that was

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about autism. He found out that there are 7,000 autistic children in Iraq and Kurdistan in 2014

(Sakr, 2014).

Ali is a psychologist. he talked about the issue for lack of awareness in this county about

a how the families of children with ASD do not know how to deal with their children. He gave

an example about an autistic child that lived in Baghdad. The child was beaten constantly by his

mother, and he was put into an empty room whenever he made noise. Ali mentioned that

physical abuses were visible on his body. Moreover, it became clear to him that lack of familial

awareness toward autistic children is widespread and it is not easy to address (Sakr, 2014).

I want to give another example about my cousin’s daughter who is autistic. Her name is

Nma. Nma is 22 years old. Sometimes she faces physical abuse by her family or by her relatives.

She still faces violence although we are all aware that she is autistic, but most of the people in

the family do not know how to behave with her because they lack of awareness.

School for Autistic children

Sulaimani has a population of 1, 783, 270 in 2017. Unfortunately, accurate data is not

accessible about how many children among that number of the population are fighting with

autism. Despite these heartbreaking news there is only one school for autistic children in the city.

The school is public and only fulfilled 47 students. Only those children can be accepted that have

a very low disorder. Unfortunately, I cannot cite any of these information because I didn’t get

these from an article or a book. I got this information because I went to the school many times

with by cousin’s daughter even she was not accepted because of high disorder in her brain. The

table below was taken from Kameran’s research that shows the rate of education for these

children.

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Table 1: Background Characteristics for 76 Autistic Children in Erbil and Sulaimani

Items N %

Gender of Child male 57 75.0

Female 19 25.0

Age of Child 4 8 10.5

(Yesrs) 5 13 17.1

6 14 18.4

7 15 19.7

8 11 14.5

9 6 7.9

10 5 6.6

11 2 2.6

12 2 2.6

Child level of Unable to read/ write 69 90.8

Education Able to read/ write 4 5.3

Primary School Graduate 3 3.9

Date Diagnosed 2005 1 1.3

2007 3 3.9

2008 2 2.6

2009 6 7.9

2010 9 11.8

2011 14 18.4

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 2012 12 15.8

2013 19 25.0

2014 9 11.8

2015 1 1.3

N: is the number of the children.

After doing some research I want to talk about the pros and cons of Public school for

Autistic children. Public school provide free education for all of the children which means the

children with ASD that are from poor families can get education as well however, most of the

time public school struggle to find an appropriate setting and provide meaningful education

program. There will be no different with a high functioning autism with low functioning autism.

They are going to be in the same class and they study the same material despite the fact that

autistic children find it very difficult to communicate with other people even ones that are

autistic (Rudy). Unfortunately, the public school in Sulaimani mix the autistic children with the

normal students and both of them are in the same class.

Figure 1.2: The Public School in Sulaimani

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 On the other hand, private school can provide specialized environment for autistic

children. The school offer strong therapeutic interventions. It ado provide individual class room

and meaning full education for individual child. In contract of public school, each student is

treated based the high or low functioning autism. although, private school is really expensive

because it is a specialized school. Each family approximately needs to pay more than $5,000

dollars each year to educate their child. That amount of money is beyond the means of most of

the families (Rudy). Furthermore, more than $14 billion dollars is needed for building a school

that provides the best education for these children (SPM).

Figure 1.3: Private School in Stkholm, Sweden.

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Table 2: Family Socioeconomic Status

Demographics f %

Family Urban 78 100

housing Total 78 100%

Property Property 59 75.6

of housing Rent 19 24.4

Total 78 100%

Family Solitary 52 67.5

type Extended 26 32.5

Total 78 100%

Monthly Insufficient 13 16.7

income Barely 35 44.8

sufficient

Sufficient 30 38.5

Total 78 100%

Number 1-3 63 80.8%

of children children

4-6 15 19.2%

children and more

Total 78 100%

F= Frequency, represent the number of the families included in the research.

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 As it is seen on the table 44.8%t of the families’ monthly incomes are barely sufficient

which means they cannot pay that amount of money to educate their child. Mercy Corps spent

$114,476 cash money for making two programs for need able people. As a result, this

organization can be a power to believe that we can make this world a better world and it is

possible if we all work together.

Training course for the Kurdish doctors and teachers

Doctors in Iraq have limited capabilities when it comes to diagnosing autism. Hafiz

discovered that many of the children classified as autistic proved to have other psychological

disturbances upon new examination in his clinic in Baghdad. He also noted that these children

had been taking medication for years, dramatically worsening their brain and negatively affected

their mental and physical growth.

At the universities of Kurdistan there is not any specific department about neurological

disorder so the abilities of the expertise are limited. Furthermore, there is not any training course

for the teachers to be aware of how to behave with them. Just like what was mentioned by Hill,

the teachers need to have understanding of autism and be very interested in teaching autistic

children. Moreover, they need to put helpful and appropriate strategies at teaching them. Having

interests is really essential for this job. Sutton explained this very well on the interview about

how to find good autistic experts. He first talked about the topic of interests because if the

teachers love the thing they are doing they can help the children more. He also mentioned that

“the real experts are available directly from autonomous press, as well as he mentioned the

names of some professors around the world that are willing to help autistic children round the

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world like professor Simon and Professor Julie from universities of Cambridge and Kent

respectively.

Conclusion:

Looking at the data I collected, there is no positivity among talking about children with

ASD in Iraq and Kurdistan region. For this section I want to mostly talked about my experiences

with autistic children that live in Sulaimani and other European countries. Moreover, I want to

answer the question why we should care about autistic children.

At the paragraph lets talk about the importance of raising awareness among the families

that have autistic children and the society. As it was explored on the data 74% of families suffer

from finding social relationship with their child as well as 92% of the siblings suffer from

psychological and social burden difference of their autistic child. Even unfortunately, Iraq and

Kurdistan fail to address the accurate number of these children. I can say these children are not

counted as a part of this society and this dangerous disease is not considered as an essential

disease. We have more than 7,000 autistic children in Iraq (Sakr, 2014), but most of the families

still do not know how to communicate with their children.

As Ali said, autistic children face physical abuses by their families because of behaving

differently than normal people. I also talked about Nma, my cosin’s daughter, that also face

abuses because of not understanding her. Lets is talk about what I meant by behaving differently

than us. They are poor speech or some of them are lack of speech which means it is hard for us to

understand then easily. Moreover, they have strange attachment to subjects and finds it difficult

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to deal with changes to routine (the conversation). As I found out because there children are

behaving differently and their families as well as the society are lack of autistic awareness as a

result of these issues the children face physical abuses or sometimes they will be put into an

empty room to separate them from everyone. The solution of this problem is a simple goal. It is

just about making the families and their relatives aware about the behavior and the interactions

of these kids.

We do need to educate these kids

Sadly, from the first table that data had been collected from 76 Kurdish families in

Sulaimani and Erbil that have autistic children. 90.8% of the autistic children are not able to read

and write and only 4% which means 3 out of 76 children just graduated from primary school.

Primary school is the highest school degree that autistic children in Iraq can get (Kameran

Abdullah). It is feasible to say these kids are not considered as a part of the society and they do

not have human rights. We are all be able to educate and get as high degree as we want to, but

the highest degree that they can get is primary school and there is only one public school in

Sulaimani that accepts just 47 students. Furthermore, they have to sit at a class of 25 students

despite their social interaction problems.

Let’s give two example about two autistic children one lives in Baghdad the other one

lives in Sulaimani. Ali is an autistic child that his mother found out that her child was in the other

world when he become 18 months. Unfortunately, there was only one doctor in Baghdad in 2008

that had information about ASD, but he fled the county because of war in Baghdad. As a result

of that Ali left alone and his mother was the only that must take care of him. His mother (Rahna)

said: she really need someone to teach her how to practice with her son. She also talked about

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how heartbroken was it when she saw Ali has no chance to contribute to the society never in his

life and cannot have a normal life just because he was autistic. At the end of her talking, Ranha

said almost every time I am thinking about what would happen to Ali if I die? (CBS).

The second example is Nma “my cousin’s daughter”. She lives in Sulaimani and she is 22

years old, but she is among those children that cannot read and write. She was not accepted in the

public school because of high functioning disorder in her brain, so her mother quitted herself

from job to take care of her. Nma has no place to go expect her house and most of our relatives

cannot understand her. Sometimes I asked myself, I am 21 years old and soon I will get my

bachelorette degree, but Nma cannot even read or write a word. I ask myself why is it like that?

Or do they deserve this life? I only have one answer is because we do not care about them and

we do not consider them as a part of the society.

Some may think because children with ASD have brain disorder that is why they cannot

be educated however this is not true. Here is an example of an autistic child, his name is Curtin.

He lives in California and he graduated in 2014 at law department in California University as

well he got the second highest degree among all of the students in his department (Almendraia,

2014).

As I found out the monthly income for most of the families that have children with ASD

are barely sufficient (Salman Dawood and Kareem Khudhiar) and I mentioned on the result

section that public school is not a good idea for these children however private school is really

expensive. Moreover, building a private school also needs huge amount of money and Kurdistan

is facing economical issues. So it is not feasible to ask the government for any of these, so

donation from an organization that helps need able people is really needed for this project that I

use Mercy Corps.

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Training course for the Kurdish doctors and teachers

As I found out there is no neurological department in Sulaimani University or other

Universities in Kurdistan. This is limited the capabilities of the doctors to diagnosis the child

with ASD properly. As Hafiz indicated that most of the time these kids get wrong examination

and take wrong medicine that effect their health. So definitely the Kurdish doctors needs to get

training to know how to diagnose the disease properly.

Another issue is the teachers that teach these kids. They have to be very interested in

teaching the kids, and they need to put helpful and appropriate strategies at teaching them

because of behavior differences. I read some articles that there are real experts from university of

Cambridge specifically that are welling to train the doctors and the teachers as well.

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Recommendation:

After what I just saw you, I want to say it is time help these children because they really

need our help. I want to recommend first, we need to rise awareness among the families that

have children with ASD to know how to behave with their children. Second, a school is needed

to educate them and give them the feeling that they are also the part of this society and they have

the same rights that we have. Third, we do need experts both doctors and teachers for diagnosing

the disease in the right way and teachers to teach them in a professional way.

My first audience will be Mercy Corps. After that I will recommend this recommendation to the

ministry of Education and health in Sulaimani. Lastly, I will give it to the families and relatives

of these kids.

1. Program 2.Ministry of
Offfcer of
Education,
Mercy
Corps Sulaimani
3. Families
and
relatives of
the autistic
children

Figure 1.4 : primary, Secondary, and Tertiary audience for the

recommendation report of Blue Organization to open a school for autistic children.

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 References:

Almendraia, Anna. More Children with Autism are Going to College than Ever Before (And
5 other key Finding). “Huffpost”. March 11th, 2014.
https://www.huffingtonpost.com/2014/03/11/research-autism-spectrum_n_4939200.html.

Autism Society. “Family Issues”. Understanding Autism for Dummies. 2006.

http://www.autism-society.org/living-with-autism/family-issues/. November 19th, 2017.

CBS. No Help for Autistic Children in Baghdad. “CBS”. August 10th, 2008.
https://www.cbsnews.com/news/no-help-for-autistic-children-in-baghdad/.

Hill, Amelia. “Supporting Students with Autism in the Classroom: What Teachers Need
to Know.” The conversation, September 8, 2016. https://theconversation.com/supporting-
students- with-autism-in-the-classroom-what-teachers-need-to-know-64814.
October 28th, 2017.

Harvard Researchers. “Costs of Autism: Study Tallies Kid’s Higher Health and
Education Need”. Autism Speaks, February 10th, 2014.

Kameran, Goran. Life Quality of Families Having Autism with Spectrum Disorder in
Kurdistan Region of Iraq. “Near East University, Graduated School of Social Sciences,
General Psychology Master Program”. June 2015.

Mercy Corps. “Financial Information and Annual Reports”. Mercy Corps, 2016.
https://www.mercycorps.org/about-us/financials. October 16, 2017.

Rudy, Lisa Jo. “Should My Autistic Child Attend Public School?” Verywell, May 31, 2017.
https://www.verywell.com/public-school-and-autism-education-pros-and-cons-260395.
October 28th, 2017.

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Rudy, Lisa Jo. “Pros and Cons of Private School for Autistic Children.” Verywell,
September 26th, 2016. https://www.verywell.com/private-school-pros-and-cons-for-
autism-260429. October 29th, 2017.

Rumi Institute. “The Most Important Social Problems Faced by Families in Caring for
Children with Autism and Ways of Treatment and Rehabilitation”. Iraqi Academic
Scientific Journals, 2016. https://www.iasj.net/iasj?func=article&aId=113184.
October 31, 2017.

Sakr, Amal. “Iraqi Government Fails to Address Rise in Autism. AL-MONITOR, march
4th, 2014. https://www.al-monitor.com/pulse/originals/2014/03/iraq-autism-increase-
government-neglect.html. October 17th, 2017.

Salman Dawood, Kawther and Kareem Khudhiar, Ali. Assessment of Quality of Life for
Parents of Autistic Child. “Iraqi National Journal of Nursing Specialties”, Vol.29 (1),
2016.
https://www.autismspeaks.org/science/science-news/costs-autism-study-tallies-kids’-
higher-health-and-education-needs. October 31, 2017.

School planning and management. “School Costs: Did You Know…..” School Planning
& Management, July 1st, 2015. https://webspm.com/Articles/2015/07/01/School-
Costs.aspx. October 28th, 2017.

The conversation. Children with autism shouldn’t be forced to socialize. “The conversation”.
July 24th, 2015. https://theconversation.com/children-with-autism-shouldnt-be-forced-
to-socialise-44585. October 17th, 2017.

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