Difficulties Faced by Children with Autism Spectrum Disorders after an Earthquake: A Study from Parents' Perspectives

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This research aims to examine the difficulties that children diagnosed with Autism Spectrum Disorder (ASD) face in education, health, and social support services from the parental perspective following the earthquakes centered in Kahramanmaraş on February 6, 2023. Materials and Methods The research used a basic qualitative research method and semi-structured interviews were conducted with 22 parents residing in Malatya, which was affected by the earthquake. The data obtained were examined with content analysis method. Results It was determined that children diagnosed with ASD experienced serious regressions in their education, health, and basic skills. At the same time, parents faced difficulties in accessing health and social services. As a result of the research, it was determined that the interruption of the daily routines of children diagnosed with ASD and their alienation from their social environments after the disaster increased behavioral and emotional problems. Conclusions It was emphasized that alternative education models should be developed for children diagnosed with ASD during disaster periods and families should be encouraged to take an active role in this process. Health sciences/Health care Biological sciences/Psychology Social science/Psychology Autism Spectrum Disorder Child Disaster Earthquake Parent Purpose of Study This study aims to evaluate the difficulties faced by children with ASD in the fields of education, health, and social support after the earthquake centered in Kahramanmaraş on February 6, 2023, from the perspective of parents and to comprehensively present their experiences in this process. Introduction Special education is provided to individuals with special needs by specially trained personnel through special education programs. The ability of children with special needs to acquire independent living skills depends on determining their needs and providing educational opportunities appropriate to these needs [ 1 , 2 ]. For this reason, individual programs are carried out in line with the needs and deficiencies of individuals with special needs through special education practices [ 3 – 5 ]. Through these programs, individuals with inadequate development in psychomotor, mental, communication, social, and emotional areas are supported by an expert team with personalized individual planning. As with all educational practices, there may be unintentional situations that interrupt the continuity of special education. One of these situations, disasters, can disrupt educational services, which poses significant challenges, especially for children with special needs. The loss of school infrastructure and educational opportunities can delay children's return to education and hinder their academic and social progress [ 6 ]. Because disasters are considered sudden events that disrupt the normal flow of life, cause loss of life and property, and cannot be controlled by people after they begin [ 7 ]. Disasters are difficult periods when social norms are temporarily suspended and the basic order of daily life is seriously shaken. Earthquakes, in particular, can deepen such difficulties and cause social systems to become dysfunctional in a short time [ 8 ]. Children, in particular, cannot tolerate the negativities brought by disasters as well as adults. They are more sensitive to conditions such as malnutrition, dehydration, and respiratory failure. Disasters can disrupt children's social lives and lead to psychological problems such as depression and stress disorder in the long term. Children are largely dependent on their parents or caregivers for basic needs such as food, housing, hygiene, health care, and general safety. Children who are separated from their parents during disasters are socially disadvantaged [ 9 ]. During this period, individuals with special needs who have difficulty meeting their own needs experience significant difficulties [ 8 ]. Because individuals with special needs who try to adapt to the society they live in before the disaster may be disadvantaged by encountering problems such as movement and access restrictions as a result of the disruption of the existing environmental and social order. Disasters can worsen the psychological problems of children with special needs, who already rely heavily on their parents for support. The trauma experienced by parents can affect children more, leading to increased rates of depression and post-traumatic stress disorder (PTSD) [ 6 ]. If individuals with special needs are not taken into account in the planning and risk reduction processes before the disaster and do not participate in the process as stakeholders, greater problems may be experienced during the disaster and in the following processes [ 10 ]. Children with special needs may have difficulty in evacuating and taking protective action during sudden-onset disasters due to their mobility or cognitive impairments. They may also face difficulties in receiving timely warnings and have difficulty accessing shelters and necessary medical support [ 6 ]. Interruption of access to treatment can have long-term negative effects on children with developmental problems. Children with ASD in particular experience significant difficulties when their daily routines are disrupted. Failure to understand the effects of the problems experienced by children with ASD can lead to situations such as resistance to change, inability to adapt to innovations, and behavioral problems [ 11 , 12 ]. Children with ASD have inadequately developed skills in leisure activities [ 11 ]. Children diagnosed with ASD may face great difficulties in accessing and benefiting from health services, and this access may become even more difficult, especially in emergencies such as earthquakes [ 13 ]. Families of children with ASD also face psychological, social, and financial difficulties during and after earthquakes. These difficulties include issues such as meeting the needs of their children, providing emotional support, and rearranging routines [ 14 ]. Loud noises, vibrations, and crowded environments experienced during and after earthquakes can cause sensory problems and increased anxiety in children with ASD. This situation, along with the disruption of their daily routines, can trigger sleep problems and behavioral disorders [ 15 ]. It was stated that behaviors such as communication, daily living, socialization, and motor skills of individuals with ASD decreased significantly in the months immediately after the earthquake [ 16 ]. On February 6, 2023, two earthquakes of magnitude 7.7 and 7.6 occurred in the Kahramanmaraş province of Türkiye. More than 50 thousand people died and more than 107 thousand people were injured in this earthquake. The earthquake significantly affected and destroyed 11 cities with a population of approximately 14 million. It is known that more than half a million buildings were damaged due to the earthquakes, leaving millions of people homeless [ 17 ]. Individuals with special needs were deeply affected by this earthquake in Türkiye [ 18 ]. In the studies conducted, when examining the stress, depression, and maladjustment levels of children diagnosed with ASD [ 19 ], it was seen that multi-faceted examinations regarding health services, social and academic support, language and communication problems, and difficulties in self-care skills were not included. In addition, most studies investigating the effects of natural disasters tend to focus only on the immediate aftermath of these events. As a result, the long-term effects of such disasters were often neglected [ 20 ]. This study aims to evaluate the difficulties faced by children with ASD in the fields of education, health, and social support after the earthquake centered in Kahramanmaraş on February 6, 2023, from the perspective of parents and to comprehensively present their experiences in this process. This study, which reveals the difficulties experienced by children with ASD in the post-disaster processes, contributes to a better understanding of the needs of children with ASD and their families by increasing social awareness. Method This study investigates the difficulties experienced by parents of children with ASD after a disaster and the effects of this process on children from the parent's perspective. The study uses a basic qualitative research approach to reveal parental experiences in detail. Basic qualitative research aims to understand how people experience events and phenomena and how they comprehend this experience [ 21 ]. Participants and procedure The participants of the study consisted of 22 parents of children diagnosed with ASD residing in Malatya province of Türkiye, which was significantly affected by the earthquake. The participants were selected for the study using criterion sampling, a purposive sampling method. Criterion sampling involves selecting individuals who have certain characteristics and who have experienced the phenomenon that is important for the research topic [ 22 ]. Our criteria for sample selection in this study were as follows: (1) having a child diagnosed with ASD, (2) being affected by the earthquake centered in Kahramanmaraş on February 6, 2023, and (3) volunteering to participate in the study. The characteristics of the participants are presented in Table 1 . The study included 14 mothers and 8 fathers. The ages of the parents ranged from 24 to 54. 14 of the participants had low-level income, 6 had moderate-level income, and 2 had high-level income. 5 of the children with ASD were girls and 17 were boys. The ages of the children ranged from 4 to 18. While one child had no siblings, 4 children (n = 1) had 1 sibling, 11 children had 2 siblings, 5 children had 3 siblings, and 1 child had 5 siblings. 3 of the children with ASD attended a special education and rehabilitation center, 1 child attended a special education class, and 18 children attended a separate special education school. After the earthquake, 9 families did not relocate, 9 families moved to a different residence within the province, and 4 families migrated out of the province for a short time or permanently. While 4 children with ASD were separated from their fathers only after the earthquake, 18 families did not separate. Table 1 Information on participants Parent Child Status after the earthquake Gender Age Income Gender Age Number of siblings Type of school attended Relocation status after the earthquake The separation status of the child with ASD from his/her parents after the earthquake Female 24 Moderate Female 6 1 Special education and rehabilitation center No No Female 34 Low Male 4 0 Special education and rehabilitation center Moving to a different residence within the province No Male 54 High Male 18 3 Special education class No No Male 44 Moderate Female 5 2 Special education and rehabilitation center Migrating out of province for a short time or permanently Separation from only father Male 38 Low Male 8 2 Separate Special Education School No Separation from only father Female 45 Moderate Male 12 5 Separate Special Education School No No Male 46 Moderate Male 13 3 Separate Special Education School Moving to a different residence within the province No Female 36 Low Male 11 3 Separate Special Education School Moving to a different residence within the province No Male 47 Low Male 15 2 Separate Special Education School Migrating out of province for a short time or permanently No Male 48 Low Male 17 1 Separate Special Education School No No Female 50 Low Female 13 2 Separate Special Education School Moving to a different residence within the province No Female 38 Low Male 12 2 Separate Special Education School No No Male 46 Moderate Male 8 2 Separate Special Education School No No Female 35 Low Male 10 2 Separate Special Education School Moving to a different residence within the province No Female 35 Low Male 12 2 Separate Special Education School Migrating out of province for a short time or permanently Separation from only father Female 39 Low Male 13 1 Separate Special Education School Moving to a different residence within the province Separation from only father Female 44 Low Female 15 2 Separate Special Education School Moving to a different residence within the province No Male 41 High Male 13 2 Separate Special Education School Migrating out of province for a short time or permanently No Female 42 Low Male 14 1 Separate Special Education School No No Female 39 Low Male 14 2 Separate Special Education School No No Female 43 Low Female 14 0 Separate Special Education School Moving to a different residence within the province No Male 50 Moderate Male 14 1 Separate Special Education School Moving to a different residence within the province No Note: Income status was determined according to the minimum wage paid in Türkiye. Before collecting the data, ethics committee permission was obtained. In this context, the study was approved by Batman University’s Ethics Committee (Decision no: 2024/01–44). ABK, one of the researchers, participated in a series of seminars at the provincial level for families with children with special needs after the earthquake as a special education specialist. During this process, he had the opportunity to meet families diagnosed with ASD. In addition, efforts were made to reach parents of children with ASD through teachers working in special education. In this context, information about the purpose of the study was provided to parents who met the inclusion criteria by face-to-face and telephone interviews. Data collection The interview technique was used with a semi-structured interview form to collect data. An interview is a form of data collection method that allows in-depth information to be collected about a specific topic, conducted face-to-face or via technological/digital tools such as telephone, etc. [ 23 ]. The researchers prepared a draft form containing questions appropriate to the research purpose based on the disaster literature. This draft form was shared with four academics who are experts in qualitative research, in the field of special education, guidance and psychological counseling, and child development. The interview form was finalized in line with the opinions received. The semi-structured interview form includes eight questions. Before the interviews, the participants were called and the date, place, and time of the interview were determined by asking the participants. The interviews were conducted at school and in private settings. Two researchers participated in the interviews. Three participants allowed audio recording, and notes were taken in the interviews with the other participants. The interviews lasted an average of 45–55 minutes. Data analysis The content analysis method was used in the analysis of the data. Content analysis is the process of systematically examining qualitative data and revealing certain themes, patterns, and meanings based on the data by the researchers. The following steps were followed in the content analysis as suggested by Hsieh & Shannon : (1) transcription of the data, (2) coding, (3) identification of themes, and (4) interpretation. Transcripts were created by transcribing the notes and audio recordings taken during the interviews and recorded electronically [ 24 ]. The transcripts were detailed to include the emotional reactions and intonations of the participants. These transcripts were shared with the participants and feedback was received. In the second stage, two researchers coded the data manually. The transcripts were read several times by the same researchers and new codes were determined if there were. After the codes were reviewed in a joint meeting attended by all researchers, they were deleted or renamed. In addition, the codes were assigned to a logical category with a common opinion. Thus, the codes were brought together under themes. Researcher triangulation was performed for the accuracy of the results. By doing so, individual biases were prevented and different perspectives were brought. Additionally, direct quotes from participant statements were used during the presentation and interpretation of the findings to ensure validity and reliability. Results In line with the views expressed by the parents, the difficulties that emerged after the earthquake and the negative effects of the earthquake on the development of children were divided into themes and presented in detail. The socio-economic difficulties experienced by the parents are presented in Table 2 . Accordingly, parents have difficulties in accessing social services and the lack of financial assistance stands out as a significant problem. In addition to these socio-economic difficulties, it is seen that families faced housing problems, and some families even had to cope with situations such as temporary residence and frequent moves. In addition, alienation from the social environment emerges as another difficulty faced by the families. Direct quotes from the parents' statements are presented below. "When our house was damaged after the earthquake, we stayed in the container for a long time. Since the container space was small, we could not do any social activities. Since there were no children in our environment, the child was extremely uneasy" (Parent 20). "We lived in a period when money had no power. Afterward, we made a living with the means of the state. However, we had financial problems because we could not do our jobs. We were in frequent contact with social services" (Parent 19). "We had transportation problems, we had difficulties in getting support. We lived in a village, our special education class teacher Ali helped us despite all the difficulties, he brought tablets, materials and provided diapers and food aid, God bless him" (Parent 5). "We had a lot of trouble with housing, we had to stay in the car for a while" (Parent 12). Table 2 Socio-economic difficulties experienced after the earthquake Theme Codes Socio-economic difficulties Access to social services Lack of financial assistance Housing problems Away from the social environment Temporary residence and relocation The difficulties experienced by parents of children diagnosed with ASD in accessing health services are presented in Table 3 . The difficulties in this area begin with the problems of making appointments and finding specialist doctors. In addition, parents have also experienced difficulties in finding medication. Other important problems encountered in accessing health services include the lack of regular check-ups for their children and inadequate diagnosis and treatment processes. Various problems experienced in using medication after the earthquake are also added to these difficulties. Direct quotes regarding parents' views are presented below. "We had difficulties in getting health services after the earthquake. The child had to get treatment in another city because he had epilepsy. We went there" (Parent 12). "We stayed in tents for months after the earthquake, they took us out because the house was damaged. Afterward, we lived in a container given by the state, the child constantly had the flu, there was a stove, and it was cold. Earthquake houses were built by our state. Now we are moving into our own house'" (Parent 1). " The child preferred to withdraw and not talk because there were many deaths in the social circle. The appointments we made at the hospital were canceled due to the busyness after the earthquake. The appointment system was closed for a while. Since the child has epilepsy, we could not use the medicines in the first weeks because we could not obtain them. After a while, we obtained the medicines through the aid of the Ministry of Health. The child's behavior and emotions deteriorated in the post-earthquake process, after a while we started taking medicines and he recovered as he got used to the social environment in time" (Parent 2). Table 3 Difficulties experienced in accessing health services after the earthquake Theme Codes Difficulties experienced in accessing health services Appointment Problems Problems Finding Specialist Doctors Problems Finding Medicines Lack of Regular Check-ups Inadequate Diagnosis and Treatment Problems in Medication Use The codes related to the theme of difficulties experienced by parents of children diagnosed with ASD regarding education are presented in Table 4 . The closure of schools and access to education are the main difficulties. When attendance problems in education are combined with the lack of appropriate educational environments, it is seen that this process becomes even more complicated. In addition, problems such as interruption of educational support, difficulties in accessing educational materials, and children forgetting lessons are also prominent. In addition, problems such as not being able to focus on education and falling behind in school are also part of these difficulties. Direct quotes related to this theme are presented below. "My child was very bored because our school was closed after the earthquake. I think this situation caused significant regressions for my child with ASD. My child was going to school before the earthquake, so the child was spending time with his peers" (Parent 7). "There was no education for 4 months due to the earthquake, there was a change of location for 3 months, the child had difficulty a lot after starting school, and we had to take all the education from the beginning again. I need privacy education for my child after the earthquake. The disruptions in education and difficulty in attendance make it difficult for us to get help in this regard" (Parent 3). "We were deprived of everything for 4.5 months, there was nothing in the village, and the child only concentrated on toys and phones. Later, AFAD and Tohum Autism Foundation brought educational cards, materials, and tablets, but after 5 months he became quite withdrawn" (Parent 18). "Since the child's academic life did not continue during that time, the progress we made was in vain because he forgot most of it and we could not focus on education because we were struggling to survive. There was a decline in literacy" (Parent 7). "Yes, the interruption of education caused a lot of setbacks, our house was destroyed in the earthquake and not having a house or a school affected the child a lot. He could not do many things he could do independently after the earthquake" (Parent 15). Table 4 Difficulties experienced in education after the earthquake Theme Codes Difficulties experienced in education Closure of the Schools Difficulties in Accessing Education Attendance Issues in Education Lack of Appropriate Educational Environment Interruption of Educational Support Difficulty in Finding Educational Materials Forgetting Lessons Inability to Focus on Education Falling behind in school In the theme of emotional and behavioral problems that occur in children diagnosed with ASD (see Table 5 ), emotional reactions such as social isolation, fear, and anxiety are observed. Children's withdrawal, fear of earthquakes, and crying spells are among the frequently observed problems. Problems such as agrypnia, acousticophobia, and delirium are also among the emotional difficulties experienced in this process. In addition, behavioral problems such as excessive interest in the opposite sex and not preferring to talk are prominent. Increased use of repetitive words (echolalia), feeling uneasiness due to not being understood, irritability, and increased obsessions are also frequently observed behaviors in children. Direct quotes regarding parents' views are presented below. "Yes, he became very afraid of swimming pools, shopping malls, and horse riding, he constantly withdrew himself from such environments. His crying fits increased, he did not want to go to crowded places, and when he did he would cry a lot. He distanced himself from social circles, he spent more time on the phone" (Parent 9). "There was a decrease in perception and eye contact, but when the child started education, some skills were recovered over time. Of course, there is fear and anxiety" (Parent 12). "After the earthquake, we had problems such as excessive crying and not being able to sleep at night. Apart from this, some behaviors that were limited to home, such as taking off all clothes when coming home, started to be done everywhere we went, but over time we got these things back on track" (Parent 11). "We could not use medication because she had epilepsy. Her behavior and emotions deteriorated. After a while, we started taking medication and she recovered because she got used to the environment" (Parent 2). "In the post-earthquake period, my child diagnosed with autism has increased his obsessions a lot. We are especially having problems with dressing. We have become obsessed with a sweater and shoes, he still goes to school with torn sneakers. His clothes are the same color, he uses the same shoes" (Parent 3). Table 5 Emotional and behavioral problems in children diagnosed with ASD after the earthquake Theme Codes Emotional and behavioral problems Social Isolation Fear and Anxiety Withdrawal Fear of earthquake Crying spells Agrypnia Acousticophobia Delirium Excessive interest in the opposite sex Prefer not to talk Increase in repetitive word use Uneasiness due to not being understood Becoming irritable Increase in obsessions The codes included in the theme of regression in basic skills in children with ASD (see Table 6 ) are manifested by regressions in toilet, eating and drinking, and psychomotor skills. In addition, regressions are observed in dressing skills and personal care habits such as brushing teeth. Problems related to language and communication, such as inadequacy in using appropriate language and difficulty in expressing oneself, are also experienced. Furthermore, regressions are observed in social skills such as decreased perception and eye contact, and difficulty in socializing. Direct quotes regarding parental views are presented below. "We had difficulty in toilet skills. After the earthquake, the toilet in the shelter allocated to us by the state was far away, there was some difficulty and regression, there was a regression in eating and drinking, he became very choosy, and he stayed in the same clothes for 2 months after the earthquake. He did not want to take them off. He almost doesn't dress himself anymore, I dress him, and his teeth brushing has regressed." (Parent 7) "Since we did not attend school, progress in basic skills was replaced by regression. Because there is a problem with motor skills, this makes it difficult for my child to perform many skills" (Parent 18) “There were regressions in her skills due to the limitations we experienced in terms of opportunities after the earthquake. Maybe if she had continued her education, her communication skills could have been much better. Unfortunately, she cannot speak now, so I cannot always understand her under all circumstances. For this reason, my child becomes uneasy” (Parent 5). “Since we did not continue with physical therapy, there were regressions in his psychomotor skills. Before the earthquake, he was going to physical therapy every week. We had made significant progress for him. However, the damage to buildings caused by the earthquake caused many institutions to close” (Parent, 18). Table 6 Areas of regression in basic skills of children diagnosed with ASD after the earthquake Theme Codes Decrease in toilet skills Eating and drinking regression Dressing regression Regression in Basic Skills Teeth brushing regression Inadequate use of appropriate language Difficulty in expressing themselves Decrease in perception and eye contact Regression in psychomotor skills Difficulty in socializing Discussion In this study, the difficulties experienced by children diagnosed with ASD following the earthquakes centered in Kahramanmaraş, Türkiye, were examined in detail in line with the views of their parents. The research findings reveal the multifaceted effects of the earthquake on these individuals. The research revealed the difficulties experienced by children diagnosed with ASD in the areas of socio-economic, health, education, emotional and behavioral, and basic skills in the post-earthquake period. It was determined that factors such as difficulties in accessing social services, interruptions in education, and inadequacies in health services have profound effects on the general development of children. As a result of the research, it is seen that individuals diagnosed with ASD experienced socio-economic difficulties after the earthquake. It is observed that children diagnosed with ASD, together with their families, experienced various difficulties in meeting basic needs in the early periods after the disaster. Disruptions in accessing social services and lack of financial assistance made it difficult to meet the needs of individuals diagnosed with ASD. Approximately 75 thousand houses were delivered to their beneficiaries 1 year after the Kahramanmaraş earthquake [ 25 ]. However, since difficulties were experienced with factors such as housing problems and temporary residence until the delivery process of the houses, the living conditions of the families became difficult. After the Kahramanmaraş earthquake, all student dormitories across the country were opened to the service of disaster-affected citizens in order to meet the housing needs of people in earthquake zones. However, the housing needs of students could not be met in this way, and education and training in Türkiye were carried out online [ 26 ]. During this process, it was determined that children diagnosed with ASD were alienated from their social environments and had difficulties in reaching support networks. In a study conducted by Luther et al. [ 27 ], parents stated that having a child diagnosed with ASD caused stress factors such as financial difficulties, loss of personal freedom, and marital disharmony. The most common strategies they used to cope with these difficulties were to seek social support. In a different study, many parents stated that the services provided were not sufficient or did not fully meet the needs of their children. In particular, in issues such as housing and social life support, parents emphasized that the existing services were not suitable for their children's situation [ 28 ]. In this context, our results underline more comprehensive and holistic approaches to the basic needs of families with children diagnosed with ASD after a disaster. Another finding of the study was related to the difficulties experienced by families with children diagnosed with ASD in healthcare services. It was revealed that individuals diagnosed with ASD had problems accessing healthcare services after the earthquake. Difficulties in making appointments and the inability to find specialist doctors caused the children's regular check-ups to be interrupted and their treatment processes to be negatively affected. It is stated that the problems experienced in obtaining medicine and the difficulties in using medicine in the first weeks of the earthquake made the treatment process difficult. This situation shows that institutions may be inadequate after large-scale disasters such as the Kahramanmaraş earthquake. In this respect, institutions that were not damaged should be identified and rehabilitation interventions should be provided quickly with the coordination of physicians, physiotherapists, psychologists, and other health professionals in order to protect and improve the health of earthquake victims. In Türkiye, primary health care services are developing. Primary health care services, which provide easy access to individuals in need, are advantageous in this respect. Primary care is at a very important point in terms of accessing rehabilitation services for earthquake victims in natural disasters such as earthquakes, which have widespread effects on individuals, and reducing the intensity so that more people can access treatment without losing time. It is emphasized that the employment of these health professionals in primary care should be increased and earthquake victims should be supported biopsychosocially with appropriate rehabilitation strategies. To achieve this, it is stated that rehabilitation rooms should be established in family health centers and the necessary equipment support should be provided [ 29 ]. In a study conducted by Wilson & Peterson, families with children diagnosed with ASD may experience many difficulties in the healthcare process. Parents expressed the problems they experienced in making medical appointments, communicating with doctors, and complex healthcare environments. Communication problems and insufficient knowledge of healthcare professionals about ASD are among the important obstacles [ 30 ]. In different studies, parents have expressed the problems experienced by their children in accessing health services [ 31 ], finding specialist doctors, and obtaining medicine [ 32 ]. It is understood that individuals diagnosed with ASD experienced more serious problems in accessing health services in the period after the Kahramanmaraş earthquake. It is thought that this situation may be due to various reasons. Healthcare professionals' lack of sufficient knowledge about ASD may reduce the quality of services provided to these groups. Especially in the post-disaster period, when healthcare professionals work under an intense workload, the time and attention allocated to special needs groups may decrease. This situation may cause parents to have difficulty communicating with healthcare professionals and not benefit sufficiently from health services. To increase the quality of services for individuals with special needs, especially during major disaster periods such as earthquakes, the knowledge and awareness levels of healthcare professionals about ASD should be increased. The study concluded that children with ASD have difficulties in their education. Schools, especially in earthquake zones, were damaged and closed for long periods. Such interruptions in access to education have negatively affected both the academic and social development of children. This situation reveals the importance of parents' competence in providing support for the education of their children with ASD [ 33 ]. In a study conducted by Gray & Donnelly [ 34 ], it was determined that families with children with ASD experience significant differences in access to education and support services. While traveling families had great difficulty finding suitable schools for their children, settled families were able to receive more support. However, both groups had difficulty accessing educational opportunities that were appropriate for their children's needs. In a similar study, families of individuals with special needs affected by the earthquake experienced great difficulties in meeting their basic needs, especially hygiene, health, nutrition, and housing. However, it was observed that these families had high psychological resilience and were more resistant than other families in coping with difficulties. This situation was explained as the families already had a difficult life and developed various coping mechanisms and competencies to cope with such traumatic situations [ 35 ]. Studies conducted in Hatay and Şanlıurfa found an increase in autism symptoms and increased levels of irritability after the earthquake. This increase was especially evident in regions that had to suspend special education for longer periods [ 19 ]. Another study reported that the routine education processes of children with special needs were interrupted after the earthquake, and this caused negative changes in the children's behavior. It has been reported that the disruption of the routines of children with ASD, in particular, caused behavioral problems to reoccur. Although these children have a high desire to continue their education, this demand may be insufficient under current conditions [ 35 ]. In this context, strategies that include the educational needs of children with special needs should be added to crisis and disaster management policies to prevent interruptions in educational services during disasters. The negative effects of educational interruptions on children's development become even more apparent after traumatic events such as earthquakes. The educational needs of children with special needs can often be inadequate during disasters and wars. These children may be deprived of education due to both physical and mental disabilities and have problems in being included in the education system in the long term [ 36 ]. Restructuring schools and training teachers in the post-disaster period can be a long process. Therefore, alternative education models should be developed to ensure the sustainability of education services. Solutions such as homeschooling can prevent children with ASD from being disconnected from the education process. Including parents in the education process more and creating structured education plans in the home environment can increase children's participation in the education process. Our research results have revealed that children diagnosed with ASD experienced anxiety, acousticophobia, fear of earthquakes, and sleep disorders after the earthquake and that these individuals also exhibited crying spells and irritable behavior. In a study on the COVID-19 pandemic process conducted by Arıcı-Doğan & Görgü [ 37 ], it was found that interruptions in access to special education negatively affected the social interaction skills and problematic behaviors of children diagnosed with ASD. Our research findings reveal that social isolation and psychological regression lead to significant declines in the general health and well-being of these children. This situation has led to children forgetting what they had learned and experiencing negative changes in their behavior. A bibliometric study conducted in the field shows that individuals diagnosed with ASD are most commonly exposed to traumatic events such as accidents, disasters, violent acts, and sexual abuse. Such traumas cause an increase in symptoms such as deterioration in social and communication skills, aggression, distraction, sleep disorders, hyperactivity, and self-harm in individuals diagnosed with ASD [ 38 ]. Nguyen & Minh Pham [ 39 ] state that natural disasters affect children's educational processes through various channels and that these effects negatively affect not only academic success but also children's psychosocial development. It has been stated that the condition of individuals diagnosed with ASD with psychological disorders may worsen after the disaster. This situation shows how critical post-disaster psychological support services are for individuals with special needs [ 40 ]. After the earthquakes in Nepal in 2015, individuals with special needs faced higher risks and difficulties in disasters. Individuals with special needs encountered problems such as access problems, lack of information, and social exclusion during and after the disaster [ 41 ]. Similarly, after the Christchurch earthquakes, children with special needs faced serious difficulties in preparing for and coping with disasters [ 42 ]. Studies show that psychiatric disorders such as depression, anxiety, and behavioral disorders may increase in individuals diagnosed with ASD after the earthquake [ 43 ]. In the study conducted by Aslan & Şahinöz (2023), the difficulties encountered by individuals with special needs during the evacuation process and the inadequacies of disaster management systems during the Izmir earthquake were emphasized. This situation shows that individuals with special needs are more vulnerable during disasters and can be more affected psychologically [ 44 ]. In addition, the social interaction and communication difficulties experienced by these individuals further increase the difficulties they experience after the earthquake. Especially after the disaster, sudden changes, loud noises, and encounters with people they do not know can have more negative effects on these children [ 45 ]. As a result of the research, it was determined that children diagnosed with ASD experienced significant regressions in their basic skills after the earthquake. Regressions in daily life skills such as toilet skills, eating and drinking, and dressing negatively affect children's self-care skills, and the loss of routine habits such as brushing teeth has further deepened this situation. In addition, deficiencies in language use and difficulties in expressing oneself limit children's communication capacities; difficulties in perception, eye contact, and socialization negatively affect social adaptation processes. Families play a critical role in providing emotional support and developing self-care skills for children and adolescents with special needs. The extent to which families of children with special needs are affected by natural disasters has a direct impact on the difficulties these children face and the traumatic reactions they show. The trauma and stress experienced by families can negatively affect the psychosocial adaptation and general development processes of children with special needs [ 46 ]. A study has shown that individuals with ASD show symptoms such as deterioration in social interaction and communication skills, increased stereotypical behaviors, aggression, distraction, sleep disorders, agitation, hyperactivity, and loss of self-care skills when exposed to trauma. The most common type of trauma among children with a history of trauma was found to be witnessing accidents or violent events or being a victim of such events [ 47 ]. In a similar study, after the 2023 Kahramanmaraş earthquakes, parents experienced serious difficulties in accessing basic needs such as self-care, medication, personal hygiene, and food. This situation negatively affected the health and nutritional status of both parents and individuals with mental disabilities [ 48 ]. The effectiveness of post-earthquake intervention and rehabilitation programs plays a critical role in the recovery process of individuals diagnosed with ASD. However, earthquake-related damage in physical therapy centers is associated with such regressions. In a study conducted by Valenti et al., it was stated that intensive rehabilitation programs implemented after the earthquake partially improved the adaptive functions of children diagnosed with ASD, but longer-term interventions were needed for full recovery [ 49 ]. Similarly, access to physical activity is of great importance for both the physical and mental health of individuals diagnosed with ASD. Yarımkaya et al. emphasized that the difficulties experienced by individuals diagnosed with ASD in accessing physical activity after the earthquake have negative effects on the health and social skills of these individuals [ 50 ]. It is thought that the regressions in the psychomotor skills of children diagnosed with ASD after the earthquake may arise from the disruption of their routines, stress and trauma, and deficiencies in their social support networks. Because children diagnosed with ASD may experience regressions in their skills due to disruptions in their routines [ 51 ], the trauma experienced by children diagnosed with ASD may affect their physical functions [ 52 ], and it is emphasized that there is a relationship between the social environment of these children and their psychomotor skills [ 53 ]. Although post-disaster periods pose significant challenges for families of children with ASD, parents' abilities to adapt and find effective solutions are known to play an important role in alleviating these challenges. Findings highlight the importance of parent-focused support programs to optimize coping strategies and resilience during times of significant life disruption [ 54 ]. Another study has shown that the participation of parents and family members in the education process increases the participation and success of children with ASD in the education process. Parental support has enabled children to take a more active role in education [ 55 ]. Therefore, psychosocial support programs and training should be organized for parents in the post-disaster period, and families should be encouraged to take an active role in the education process. The participation of parents in the education process supports children's social interactions and can be effective in reducing problematic behaviors. Conclusions This study comprehensively examines the multifaceted effects of earthquakes on children with ASD and emphasizes the need for long-term, sustainable solutions to the needs of these children. The continuity of education, health, and social support services is of critical importance in maintaining the well-being of individuals with ASD. In this context, it is of great importance that disaster preparedness and intervention strategies are designed to meet the special needs of individuals with special needs and that these individuals are actively involved in disaster management processes. This study was conducted within the first year after the earthquake, and the long-term changes and developments could not be observed. Since the effects of disasters may change over time, a longer follow-up study may allow for a more comprehensive evaluation of the findings. Abbreviations ASD: Autism Spectrum Disorder Declarations Acknowledgements We would like to thanks, our patients who participated in our study for their contribution to the studies. Funding This study was not financially supported by any funding. Conflict of interest The authors report no conflict of interest. Ethical Approval The ethical committee approval was obtained from the Ethics Committee of Batman University (Decision no: 2024/01-44). All methods were carried out by the 1964 Helsinki Declaration. Informed consent was obtained from all the participants. Data availability Not applicable. Author contributions MeAK, MuAK, OTC and CK designed the study; MeAK and MuAK collected the data; MeAK and MuAK drafted the manuscript; OTC conducted the analysis and interpreted the results; MeAK, MuAK, OTC and CK reviewed the final manuscript and gave their consent. References Özdoğru M. Özel gereksinimli öğrencilerin okul öncesi eğitiminde karşılaşılan sorunlar. Temel Eğitim. 2021;(11):6-16. Şahbaz Ü, Kalay G. Okulöncesi eğitimi öğretmen adaylarının kaynaştırmaya ilişkin görüşlerinin belirlenmesi. Mehmet Akif Ersoy Üniversitesi Eğitim Fakültesi Dergisi. 2010;(19):116-35. Cook BG, Schirmer BR. What Is Special About Special Education?:Overview and Analysis. The Journal of Special Education. 2003;37(3):200-5; doi: 10.1177/00224669030370031001. Francisco MPB, Hartman M, Wang Y. Inclusion and Special Education. Education Sciences. 2020;10(9):238. Ünlü E. Özel eğitime gereksinim duyan çocuklar ve özel eğitim. In: Diken İH, editor. Özel eğitime gereksinimi olan öğrenciler ve özel eğitim. Pegem Akademi Yayıncılık; 2022. p. 3-17. Peek L, Stough LM. Children With Disabilities in the Context of Disaster: A Social Vulnerability Perspective. Child Development. 2010;81(4):1260-70; doi: https://doi.org/10.1111/j.1467-8624.2010.01466.x. Espejo R. Are Natural Disasters Increasing? : Greenhaven Publishing LLC; 2014. Bilik MB, Akdağ M. Özel gereksinimli bireyler ve ebeveynleri açısından afet Zorlukları: 2011 Van depremi örneği. Afet ve Risk Dergisi. 2023;6(1):243-56. Bouton M, Cooper A. Children and Disaster. In: Ciottone G, editor. Ciottone's Disaster Medicine (3rd Ed). New Delhi: Elsevier; 2024. p. 58-67. Arslan K. Afetlerin engelli bireylere etkisi. In: Sosyal Bilimler Üzerine Araştırmalar-II. Özgür Yayın Dağıtım; 2023. p. 197-209. Akcay E, Başgül ŞS. Pandemi ve özel gereksinimi olan/risk altındaki çocuklar. Covid-19 pandemisi ve çocuk ve ergen ruh sağlığı. 2020;1:55-61. Ben-Pazi H, Beni-Adani L, Lamdan R. Accelerating Telemedicine for Cerebral Palsy During the COVID-19 Pandemic and Beyond. Frontiers in Neurology. 2020;11; doi: 10.3389/fneur.2020.00746. Scarpinato N, Bradley J, Kurbjun K, Bateman X, Holtzer B, Ely B. Caring for the Child With an Autism Spectrum Disorder in the Acute Care Setting. Journal for Specialists in Pediatric Nursing. 2010;15(3):244-54; doi: https://doi.org/10.1111/j.1744-6155.2010.00244.x. Ahmad ESN. The Challenges Faced by the Parents of Autistic Children in Jordan. Journal of Education and Practice. 2020;11(28):74-82. Eroğlu M, Yakşi N. Changes in Symptom Severity and Sleeping Habits After Earthquake in Children and Adolescents with Autism Spectrum Disorder: The Case of the Kahramanmaras Earthquake in 2023, Turkey. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi. 2023;14(4):577-86. Valenti M, Di Giovanni C, Mariano M, Pino MC, Sconci V, Mazza M. Autism after an earthquake: the experience of L'Aquila (Central Italy) as a basis for an operative guideline. Epidemiologia e Prevenzione. 2016;40(2):49-52. Republic of Turkey Presidency Strategy and Budget Presidency. Kahramanmaraş and Hatay Earthquakes Report. https://www.sbb.gov.tr/wpcontent/uploads/2023/03/%202023-Kahramanmaras-ve-Hatay-Depremleri-Raporu.pdf (2023). Accessed. Koç M, Yalçın S. Afetlerde Krize Müdahale: Kahramanmaraş Depremi’nde Aile ve Sosyal Hizmetler Bakanlığı’nın Çalışmaları. Uluslararası Sosyal Hizmet Araştırmaları Dergisi. 2023;3(2):93-105. Eroglu M, Efendi GY, Temelturk RD, Yaksi N. Living on with autism after a devastating earthquake: experiences of children and adolescents in Turkey. International Journal of Developmental Disabilities. 2024;70(4):766-76; doi: 10.1080/20473869.2023.2301184. Blanc J, Eugene D, Louis EF, Cadichon JM, Joseph J, Pierre A, et al. Mental Health Among Children Older than 10 Years Exposed to the Haiti 2010 Earthquake: a Critical Review. Current Psychiatry Reports. 2020;22(11):57; doi: 10.1007/s11920-020-01178-9. Merriam SB, Tisdell EJ. Qualitative research: A guide to design and implementation. John Wiley & Sons; 2015. Patton MQ. Qualitative research & evaluation methods: Integrating theory and practice. Sage publications; 2014. Kvale S. Interviews: Learning the craft of qualitative research interviewing. Sage; 2009. Hsieh H-F, Shannon SE. Three approaches to qualitative content analysis. Qualitative health research. 2005;15(9):1277-88. Republic of Türkiye Ministry of Environment Urbanization and Climate Change. Deprem bölgesinde kalıcı konutların teslimi. https://csb.gov.tr/deprem-bolgesinde-kalici-konutlarin-teslimi-devam-ediyor-bakanlik-faaliyetleri-40087 (2024). Accessed. Telli SG, Altun D. Türkiye'de deprem sonrası çevrimiçi öğrenmenin vazgeçilmezliği. Üniversite Araştırmaları Dergisi. 2023;6(2):125-36; doi: https://doi.org/10.32329/uad.1268747. Luther EH, Canham DL, Cureton VY. Coping and Social Support for Parents of Children with Autism. The Journal of School Nursing. 2005;21(1):40-7; doi: 10.1177/10598405050210010901. Marsack-Topolewski CN, Weisz AN. Parents’ Perceptions of Access to Services for Their Adult Children Diagnosed With Autism Spectrum Disorder. Families in Society. 2020;101(2):190-204; doi: 10.1177/1044389419881273. Yılmaz RC, Kocamaz D. Yıkıcı Deprem Sonrasında Erken Rehabilitatif Müdahaleler İle Sakatlık Önlenebilir: Kahramanmaraş-Pazarcık Depremi Sonrası Rehabilitasyon Çalışanlarına Mektup. Turkish Journal of Family Medicine and Primary Care. 2019;17(1):1-5. Wilson SA, Peterson CC. Medical care experiences of children with autism and their parents: A scoping review. Child: Care, Health and Development. 2018;44(6):807-17; doi: https://doi.org/10.1111/cch.12611. Nicholas DB, Zwaigenbaum L, Muskat B, Craig WR, Newton AS, Kilmer C, et al. Experiences of emergency department care from the perspective of families in which a child has autism spectrum disorder. Social Work in Health Care. 2016;55(6):409-26; doi: 10.1080/00981389.2016.1178679. Lajonchere C, Jones N, Coury DL, Perrin JM. Leadership in Health Care, Research, and Quality Improvement for Children and Adolescents With Autism Spectrum Disorders: Autism Treatment Network and Autism Intervention Research Network on Physical Health. Pediatrics. 2012;130(Supplement_2):S62-S8; doi: 10.1542/peds.2012-0900C. Karaca MA, Sarı H. The educational skills self-competence scale for parents of children with autism spectrum disorder: A validity and reliability study. Anatolian Journal of Health Research. 2024;5(1):57-64; doi: https://doi.org/10.61534/anatoljhr.1428323. Gray C, Donnelly J. Unheard voices: the views of traveller and non-traveller mothers and children with ASD. International Journal of Early Years Education. 2013;21(4):268-85; doi: 10.1080/09669760.2013.842160. Söğüt DA, Kaya A. ‘In order not to cry, we averted our eyes from each other:’experiences of special education professionals working in the field during the Turkey earthquake. International Journal of Developmental Disabilities. 2024:1-11. Battle DE. Persons With Communication Disabilities in Natural Disasters, War, and/or Conflict. Communication Disorders Quarterly. 2014;36(4):231-40; doi: 10.1177/1525740114545980. Arıcı-Doğan D, Görgü E. Investigation of the Views' of the Mothers of Children with Autism Spectrum Disorder on Suspending Special Education during the Covid-19 Pandemic Process. Journal of Qualitative Research in Education. 2022;(30); doi: https://doi.org/10.14689/enad.30.5. Hernández-González O, Fresno-Rodríguez A, Spencer-Contreras RE, Tárraga-Mínguez R, González-Fernández D, Sepúlveda-Opazo F. Research Mapping of Trauma Experiences in Autism Spectrum Disorders: A Bibliometric Analysis. Healthcare. 2023. doi: 10.3390/healthcare11091267. Nguyen CV, Minh Pham N. The impact of natural disasters on children's education: Comparative evidence from Ethiopia, India, Peru, and Vietnam. Review of Development Economics. 2018;22(4):1561-89; doi: https://doi.org/10.1111/rode.12406. Stough LM, Kelman I. People with disabilities and disasters. Handbook of disaster research. 2018:225-42. Lord A, Sijapati B, Baniya J, Chand O, Ghale T. Disaster, disability, & difference: a study of the challenges faced by persons with disabilities in post-earthquake Nepal. Kathmandu: United Nations Development Programme. 2016. Ronan KR, Alisic E, Towers B, Johnson VA, Johnston DM. Disaster Preparedness for Children and Families: a Critical Review. Current Psychiatry Reports. 2015;17(7):58; doi: 10.1007/s11920-015-0589-6. Kerns CM, Newschaffer CJ, Berkowitz SJ. Traumatic Childhood Events and Autism Spectrum Disorder. Journal of Autism and Developmental Disorders. 2015;45(11):3475-86; doi: 10.1007/s10803-015-2392-y. Aslan R, Şahinöz S. The experiences of people with disabilities in the 2020 Izmir earthquake: A phenomenological research. International Journal of Disaster Risk Reduction. 2023;95:103868; doi: https://doi.org/10.1016/j.ijdrr.2023.103868. Edmonds CO. Designing Emergency Preparedness Resources for Children with Autism. International Journal of Disability, Development and Education. 2017;64(4):404-19; doi: 10.1080/1034912X.2016.1264577. Altun A, Erdur Baker Ö, Yıldırım Z. Afetlerde Psikolojik Destek İçin Psikolojik Danışmanlara Yönelik Çevirimiçi Eğitim Geliştirilmesi. https://open.metu.edu.tr/handle/11511/49947 (2018). Accessed. Mehtar M, Mukaddes NM. Posttraumatic Stress Disorder in individuals with diagnosis of Autistic Spectrum Disorders. Research in Autism Spectrum Disorders. 2011;5(1):539-46; doi: https://doi.org/10.1016/j.rasd.2010.06.020. Yarımkaya E, Bakkaloğlu H. Experiences of parents of individuals with intellectual disabilities after the 2023 Kahramanmaraş earthquakes in Türkiye: a phenomenological study. International Journal of Developmental Disabilities.1-15; doi: 10.1080/20473869.2024.2363009. Valenti M, Ciprietti T, Egidio CD, Gabrielli M, Masedu F, Tomassini AR, et al. Adaptive Response of Children and Adolescents with Autism to the 2009 Earthquake in L’Aquila, Italy. Journal of Autism and Developmental Disorders. 2012;42(6):954-60; doi: 10.1007/s10803-011-1323-9. Yarımkaya E, Şenlik ZA, Demir M, Töman U, Kul M, Türkmen M. Barriers to physical activity in individuals with autism spectrum disorders after the 2023 Kahramanmaraş Earthquakes in Türkiye. International Journal of Developmental Disabilities. 2024:1-13. Siracusano M, Segatori E, Riccioni A, Emberti Gialloreti L, Curatolo P, Mazzone L. The Impact of COVID-19 on the Adaptive Functioning, Behavioral Problems, and Repetitive Behaviors of Italian Children with Autism Spectrum Disorder: An Observational Study. Children. 2021. doi: 10.3390/children8020096. Michna GA, Trudel SM, Bray MA, Reinhardt J, Dirsmith J, Theodore L, et al. Best practices and emerging trends in assessment of trauma in students with autism spectrum disorder. Psychology in the Schools. 2023;60(2):479-94; doi: https://doi.org/10.1002/pits.22769. Renobell V. La mejora de la sociabilidad y las habilidades sociales mediante el uso de la psicomotricidad relacional en menores con síntomas de autismo. Revista de Psicoterapia. 2023;34(125):33-46; doi: 10.5944/rdp.v34i125.37819. Tokatly Latzer I, Leitner Y, Karnieli-Miller O. Core experiences of parents of children with autism during the COVID-19 pandemic lockdown. Autism. 2021;25(4):1047-59; doi: 10.1177/1362361320984317. Indriasari FN, Daniyati K P, Widyarani L. Disaster Risk Reduction and Emergency Preparedness for Children With Autism in Facing Earthquake Disaster in Yogyakarta. Jurnal Medicoeticolegal dan Manajemen Rumah Sakit. 2024;7(1):52-9; doi: 10.18196/jmmr.7156. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7185490","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":500738168,"identity":"bfca0634-e3db-47d4-a78c-f8f7e2ea5fd8","order_by":0,"name":"Mehmet Akif KAY","email":"","orcid":"","institution":"Batman University","correspondingAuthor":false,"prefix":"","firstName":"Mehmet","middleName":"Akif","lastName":"KAY","suffix":""},{"id":500738170,"identity":"ecca8019-5d57-49c3-aa20-54a279a7087b","order_by":1,"name":"Muhammed Abdulbaki KARACA","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA+UlEQVRIiWNgGAWjYDACHhiDmYHhAEMFiMHcQKwWZqCWMyAGI7FaQNYwtoEYBLTw9xx+9uFHjZ2cvDv/wUM359VG87cDtfyo2IZTi8TZNuOZPceSjQ0PMzMczt12PHfGYcYGxp4zt3Fbc57BmIG3gTlxYzNYy7HcBqAWZsY23Frkz7N/ZvzbUF8P0TLnWO58QloMzvYYM/M2HE6QZwZpaajJ3UBIi+GZM8XMMseOG25gZjY4nHPsQO5GoJaD+PwidyZ9M+Obmmp5+f6Djz/n1NTlzjt/+OCDHxV4vA934QEwdRhMHiCsHgjkG8BUHVGKR8EoGAWjYGQBAMijXHjydUQBAAAAAElFTkSuQmCC","orcid":"","institution":"Inonu University","correspondingAuthor":true,"prefix":"","firstName":"Muhammed","middleName":"Abdulbaki","lastName":"KARACA","suffix":""},{"id":500738172,"identity":"0db2d019-a265-4d9a-b395-6e76f40d9ebd","order_by":2,"name":"Osman Tayyar ÇELİK","email":"","orcid":"","institution":"Inonu University","correspondingAuthor":false,"prefix":"","firstName":"Osman","middleName":"Tayyar","lastName":"ÇELİK","suffix":""},{"id":500738174,"identity":"e65ba134-d886-4e13-a551-5cac56803692","order_by":3,"name":"Cihangir KAÇMAZ","email":"","orcid":"","institution":"Kayseri University","correspondingAuthor":false,"prefix":"","firstName":"Cihangir","middleName":"","lastName":"KAÇMAZ","suffix":""}],"badges":[],"createdAt":"2025-07-22 09:53:18","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7185490/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7185490/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1038/s41598-025-23025-8","type":"published","date":"2025-11-10T15:57:40+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":96105355,"identity":"83946084-d92e-4b4b-a8c2-5c4e14428b58","added_by":"auto","created_at":"2025-11-17 16:11:18","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":747546,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7185490/v1/92ecd54c-81f1-478b-a462-78cbeddb7cf1.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Difficulties Faced by Children with Autism Spectrum Disorders after an Earthquake: A Study from Parents' Perspectives","fulltext":[{"header":"Purpose of Study","content":"\u003cp\u003eThis study aims to evaluate the difficulties faced by children with ASD in the fields of education, health, and social support after the earthquake centered in Kahramanmaraş on February 6, 2023, from the perspective of parents and to comprehensively present their experiences in this process.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e"},{"header":"Introduction","content":"\u003cp\u003eSpecial education is provided to individuals with special needs by specially trained personnel through special education programs. The ability of children with special needs to acquire independent living skills depends on determining their needs and providing educational opportunities appropriate to these needs [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. For this reason, individual programs are carried out in line with the needs and deficiencies of individuals with special needs through special education practices [\u003cspan additionalcitationids=\"CR4\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e–\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Through these programs, individuals with inadequate development in psychomotor, mental, communication, social, and emotional areas are supported by an expert team with personalized individual planning.\u003c/p\u003e\u003cp\u003eAs with all educational practices, there may be unintentional situations that interrupt the continuity of special education. One of these situations, disasters, can disrupt educational services, which poses significant challenges, especially for children with special needs. The loss of school infrastructure and educational opportunities can delay children's return to education and hinder their academic and social progress [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Because disasters are considered sudden events that disrupt the normal flow of life, cause loss of life and property, and cannot be controlled by people after they begin [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eDisasters are difficult periods when social norms are temporarily suspended and the basic order of daily life is seriously shaken. Earthquakes, in particular, can deepen such difficulties and cause social systems to become dysfunctional in a short time [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Children, in particular, cannot tolerate the negativities brought by disasters as well as adults. They are more sensitive to conditions such as malnutrition, dehydration, and respiratory failure. Disasters can disrupt children's social lives and lead to psychological problems such as depression and stress disorder in the long term. Children are largely dependent on their parents or caregivers for basic needs such as food, housing, hygiene, health care, and general safety. Children who are separated from their parents during disasters are socially disadvantaged [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eDuring this period, individuals with special needs who have difficulty meeting their own needs experience significant difficulties [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Because individuals with special needs who try to adapt to the society they live in before the disaster may be disadvantaged by encountering problems such as movement and access restrictions as a result of the disruption of the existing environmental and social order. Disasters can worsen the psychological problems of children with special needs, who already rely heavily on their parents for support. The trauma experienced by parents can affect children more, leading to increased rates of depression and post-traumatic stress disorder (PTSD) [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. If individuals with special needs are not taken into account in the planning and risk reduction processes before the disaster and do not participate in the process as stakeholders, greater problems may be experienced during the disaster and in the following processes [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eChildren with special needs may have difficulty in evacuating and taking protective action during sudden-onset disasters due to their mobility or cognitive impairments. They may also face difficulties in receiving timely warnings and have difficulty accessing shelters and necessary medical support [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Interruption of access to treatment can have long-term negative effects on children with developmental problems. Children with ASD in particular experience significant difficulties when their daily routines are disrupted. Failure to understand the effects of the problems experienced by children with ASD can lead to situations such as resistance to change, inability to adapt to innovations, and behavioral problems [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eChildren with ASD have inadequately developed skills in leisure activities [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Children diagnosed with ASD may face great difficulties in accessing and benefiting from health services, and this access may become even more difficult, especially in emergencies such as earthquakes [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Families of children with ASD also face psychological, social, and financial difficulties during and after earthquakes. These difficulties include issues such as meeting the needs of their children, providing emotional support, and rearranging routines [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Loud noises, vibrations, and crowded environments experienced during and after earthquakes can cause sensory problems and increased anxiety in children with ASD. This situation, along with the disruption of their daily routines, can trigger sleep problems and behavioral disorders [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. It was stated that behaviors such as communication, daily living, socialization, and motor skills of individuals with ASD decreased significantly in the months immediately after the earthquake [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eOn February 6, 2023, two earthquakes of magnitude 7.7 and 7.6 occurred in the Kahramanmaraş province of Türkiye. More than 50 thousand people died and more than 107 thousand people were injured in this earthquake. The earthquake significantly affected and destroyed 11 cities with a population of approximately 14\u0026nbsp;million. It is known that more than half a million buildings were damaged due to the earthquakes, leaving millions of people homeless [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Individuals with special needs were deeply affected by this earthquake in Türkiye [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eIn the studies conducted, when examining the stress, depression, and maladjustment levels of children diagnosed with ASD [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e], it was seen that multi-faceted examinations regarding health services, social and academic support, language and communication problems, and difficulties in self-care skills were not included. In addition, most studies investigating the effects of natural disasters tend to focus only on the immediate aftermath of these events. As a result, the long-term effects of such disasters were often neglected [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThis study aims to evaluate the difficulties faced by children with ASD in the fields of education, health, and social support after the earthquake centered in Kahramanmaraş on February 6, 2023, from the perspective of parents and to comprehensively present their experiences in this process. This study, which reveals the difficulties experienced by children with ASD in the post-disaster processes, contributes to a better understanding of the needs of children with ASD and their families by increasing social awareness.\u003c/p\u003e"},{"header":"Method","content":"\u003cp\u003e This study investigates the difficulties experienced by parents of children with ASD after a disaster and the effects of this process on children from the parent's perspective. The study uses a basic qualitative research approach to reveal parental experiences in detail. Basic qualitative research aims to understand how people experience events and phenomena and how they comprehend this experience [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].\u003c/p\u003e\u003cp\u003e\u003cb\u003eParticipants and procedure\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe participants of the study consisted of 22 parents of children diagnosed with ASD residing in Malatya province of Türkiye, which was significantly affected by the earthquake. The participants were selected for the study using criterion sampling, a purposive sampling method. Criterion sampling involves selecting individuals who have certain characteristics and who have experienced the phenomenon that is important for the research topic [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Our criteria for sample selection in this study were as follows: (1) having a child diagnosed with ASD, (2) being affected by the earthquake centered in Kahramanmaraş on February 6, 2023, and (3) volunteering to participate in the study. The characteristics of the participants are presented in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. The study included 14 mothers and 8 fathers. The ages of the parents ranged from 24 to 54. 14 of the participants had low-level income, 6 had moderate-level income, and 2 had high-level income. 5 of the children with ASD were girls and 17 were boys. The ages of the children ranged from 4 to 18. While one child had no siblings, 4 children (n = 1) had 1 sibling, 11 children had 2 siblings, 5 children had 3 siblings, and 1 child had 5 siblings. 3 of the children with ASD attended a special education and rehabilitation center, 1 child attended a special education class, and 18 children attended a separate special education school. After the earthquake, 9 families did not relocate, 9 families moved to a different residence within the province, and 4 families migrated out of the province for a short time or permanently. While 4 children with ASD were separated from their fathers only after the earthquake, 18 families did not separate.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eInformation on participants\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"9\"\u003e\u003c/colgroup\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e\u003cp\u003eParent\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"4\" nameend=\"c7\" namest=\"c4\"\u003e\u003cp\u003eChild\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e\u003cp\u003eStatus after the earthquake\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGender\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eIncome\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eGender\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eAge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eNumber of siblings\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eType of school attended\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eRelocation status after the earthquake\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eThe separation status of the child with ASD from his/her parents after the earthquake\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eModerate\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eSpecial education and rehabilitation center\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eLow\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eSpecial education and rehabilitation center\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eMoving to a different residence within the province\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eHigh\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eSpecial education class\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e44\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eModerate\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eSpecial education and rehabilitation center\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eMigrating out of province for a short time or permanently\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eSeparation from only father\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eLow\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eSeparate Special Education School\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eSeparation from only father\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eModerate\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eSeparate Special Education School\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eModerate\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eSeparate Special Education School\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eMoving to a different residence within the province\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eLow\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eSeparate Special Education School\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eMoving to a different residence within the province\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e47\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eLow\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eSeparate Special Education School\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eMigrating out of province for a short time or permanently\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eLow\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eSeparate Special Education School\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eLow\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eSeparate Special Education School\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eMoving to a different residence within the province\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eLow\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eSeparate Special Education School\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eModerate\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eSeparate Special Education School\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eLow\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eSeparate Special Education School\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eMoving to a different residence within the province\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eLow\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eSeparate Special Education School\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eMigrating out of province for a short time or permanently\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eSeparation from only father\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eLow\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eSeparate Special Education School\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eMoving to a different residence within the province\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eSeparation from only father\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e44\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eLow\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eSeparate Special Education School\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eMoving to a different residence within the province\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eHigh\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eSeparate Special Education School\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eMigrating out of province for a short time or permanently\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e42\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eLow\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eSeparate Special Education School\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eLow\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eSeparate Special Education School\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eLow\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eSeparate Special Education School\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eMoving to a different residence within the province\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eModerate\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eSeparate Special Education School\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eMoving to a different residence within the province\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"9\"\u003eNote: \u003cem\u003eIncome status was determined according to the minimum wage paid in Türkiye.\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eBefore collecting the data, ethics committee permission was obtained. In this context, the study was approved by Batman University’s Ethics Committee (Decision no: 2024/01–44). ABK, one of the researchers, participated in a series of seminars at the provincial level for families with children with special needs after the earthquake as a special education specialist. During this process, he had the opportunity to meet families diagnosed with ASD. In addition, efforts were made to reach parents of children with ASD through teachers working in special education. In this context, information about the purpose of the study was provided to parents who met the inclusion criteria by face-to-face and telephone interviews.\u003c/p\u003e\u003cp\u003e\u003cb\u003eData collection\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe interview technique was used with a semi-structured interview form to collect data. An interview is a form of data collection method that allows in-depth information to be collected about a specific topic, conducted face-to-face or via technological/digital tools such as telephone, etc. [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. The researchers prepared a draft form containing questions appropriate to the research purpose based on the disaster literature. This draft form was shared with four academics who are experts in qualitative research, in the field of special education, guidance and psychological counseling, and child development. The interview form was finalized in line with the opinions received. The semi-structured interview form includes eight questions. Before the interviews, the participants were called and the date, place, and time of the interview were determined by asking the participants. The interviews were conducted at school and in private settings. Two researchers participated in the interviews. Three participants allowed audio recording, and notes were taken in the interviews with the other participants. The interviews lasted an average of 45–55 minutes.\u003c/p\u003e\u003ch2\u003eData analysis\u003c/h2\u003e\u003cp\u003eThe content analysis method was used in the analysis of the data. Content analysis is the process of systematically examining qualitative data and revealing certain themes, patterns, and meanings based on the data by the researchers. The following steps were followed in the content analysis as suggested by Hsieh \u0026amp; Shannon : (1) transcription of the data, (2) coding, (3) identification of themes, and (4) interpretation. Transcripts were created by transcribing the notes and audio recordings taken during the interviews and recorded electronically [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. The transcripts were detailed to include the emotional reactions and intonations of the participants. These transcripts were shared with the participants and feedback was received. In the second stage, two researchers coded the data manually. The transcripts were read several times by the same researchers and new codes were determined if there were. After the codes were reviewed in a joint meeting attended by all researchers, they were deleted or renamed. In addition, the codes were assigned to a logical category with a common opinion. Thus, the codes were brought together under themes. Researcher triangulation was performed for the accuracy of the results. By doing so, individual biases were prevented and different perspectives were brought. Additionally, direct quotes from participant statements were used during the presentation and interpretation of the findings to ensure validity and reliability.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eIn line with the views expressed by the parents, the difficulties that emerged after the earthquake and the negative effects of the earthquake on the development of children were divided into themes and presented in detail. The socio-economic difficulties experienced by the parents are presented in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. Accordingly, parents have difficulties in accessing social services and the lack of financial assistance stands out as a significant problem. In addition to these socio-economic difficulties, it is seen that families faced housing problems, and some families even had to cope with situations such as temporary residence and frequent moves. In addition, alienation from the social environment emerges as another difficulty faced by the families. Direct quotes from the parents' statements are presented below.\u003c/p\u003e\u003cp\u003e\u003cem\u003e\"When our house was damaged after the earthquake, we stayed in the container for a long time. Since the container space was small, we could not do any social activities. Since there were no children in our environment, the child was extremely uneasy\" (Parent 20).\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003e\"We lived in a period when money had no power. Afterward, we made a living with the means of the state. However, we had financial problems because we could not do our jobs. We were in frequent contact with social services\" (Parent 19).\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003e\"We had transportation problems, we had difficulties in getting support. We lived in a village, our special education class teacher Ali helped us despite all the difficulties, he brought tablets, materials and provided diapers and food aid, God bless him\" (Parent 5).\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003e\"We had a lot of trouble with housing, we had to stay in the car for a while\" (Parent 12).\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eSocio-economic difficulties experienced after the earthquake\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"2\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTheme\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCodes\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003eSocio-economic difficulties\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAccess to social services\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLack of financial assistance\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHousing problems\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAway from the social environment\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTemporary residence and relocation\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe difficulties experienced by parents of children diagnosed with ASD in accessing health services are presented in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e. The difficulties in this area begin with the problems of making appointments and finding specialist doctors. In addition, parents have also experienced difficulties in finding medication. Other important problems encountered in accessing health services include the lack of regular check-ups for their children and inadequate diagnosis and treatment processes. Various problems experienced in using medication after the earthquake are also added to these difficulties. Direct quotes regarding parents' views are presented below.\u003c/p\u003e\u003cp\u003e\u003cem\u003e\"We had difficulties in getting health services after the earthquake. The child had to get treatment in another city because he had epilepsy. We went there\" (Parent 12).\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003e\"We stayed in tents for months after the earthquake, they took us out because the house was damaged. Afterward, we lived in a container given by the state, the child constantly had the flu, there was a stove, and it was cold. Earthquake houses were built by our state. Now we are moving into our own house'\" (Parent 1).\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003e\" The child preferred to withdraw and not talk because there were many deaths in the social circle. The appointments we made at the hospital were canceled due to the busyness after the earthquake. The appointment system was closed for a while. Since the child has epilepsy, we could not use the medicines in the first weeks because we could not obtain them. After a while, we obtained the medicines through the aid of the Ministry of Health. The child's behavior and emotions deteriorated in the post-earthquake process, after a while we started taking medicines and he recovered as he got used to the social environment in time\" (Parent 2).\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eDifficulties experienced in accessing health services after the earthquake\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"2\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTheme\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCodes\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e\u003cp\u003eDifficulties experienced in accessing health services\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAppointment Problems\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eProblems Finding Specialist Doctors\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eProblems Finding Medicines\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLack of Regular Check-ups\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eInadequate Diagnosis and Treatment\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eProblems in Medication Use\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe codes related to the theme of difficulties experienced by parents of children diagnosed with ASD regarding education are presented in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e. The closure of schools and access to education are the main difficulties. When attendance problems in education are combined with the lack of appropriate educational environments, it is seen that this process becomes even more complicated. In addition, problems such as interruption of educational support, difficulties in accessing educational materials, and children forgetting lessons are also prominent. In addition, problems such as not being able to focus on education and falling behind in school are also part of these difficulties. Direct quotes related to this theme are presented below.\u003c/p\u003e\u003cp\u003e\u003cem\u003e\"My child was very bored because our school was closed after the earthquake. I think this situation caused significant regressions for my child with ASD. My child was going to school before the earthquake, so the child was spending time with his peers\" (Parent 7).\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003e\"There was no education for 4 months due to the earthquake, there was a change of location for 3 months, the child had difficulty a lot after starting school, and we had to take all the education from the beginning again. I need privacy education for my child after the earthquake. The disruptions in education and difficulty in attendance make it difficult for us to get help in this regard\" (Parent 3).\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003e\"We were deprived of everything for 4.5 months, there was nothing in the village, and the child only concentrated on toys and phones. Later, AFAD and Tohum Autism Foundation brought educational cards, materials, and tablets, but after 5 months he became quite withdrawn\" (Parent 18).\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003e\"Since the child's academic life did not continue during that time, the progress we made was in vain because he forgot most of it and we could not focus on education because we were struggling to survive. There was a decline in literacy\" (Parent 7).\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003e\"Yes, the interruption of education caused a lot of setbacks, our house was destroyed in the earthquake and not having a house or a school affected the child a lot. He could not do many things he could do independently after the earthquake\" (Parent 15).\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eDifficulties experienced in education after the earthquake\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"2\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTheme\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCodes\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"8\" rowspan=\"9\"\u003e\u003cp\u003eDifficulties experienced in education\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eClosure of the Schools\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDifficulties in Accessing Education\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAttendance Issues in Education\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLack of Appropriate Educational Environment\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eInterruption of Educational Support\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDifficulty in Finding Educational Materials\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eForgetting Lessons\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eInability to Focus on Education\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFalling behind in school\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eIn the theme of emotional and behavioral problems that occur in children diagnosed with ASD (see Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e), emotional reactions such as social isolation, fear, and anxiety are observed. Children's withdrawal, fear of earthquakes, and crying spells are among the frequently observed problems. Problems such as agrypnia, acousticophobia, and delirium are also among the emotional difficulties experienced in this process. In addition, behavioral problems such as excessive interest in the opposite sex and not preferring to talk are prominent. Increased use of repetitive words (echolalia), feeling uneasiness due to not being understood, irritability, and increased obsessions are also frequently observed behaviors in children. Direct quotes regarding parents' views are presented below.\u003c/p\u003e\u003cp\u003e\u003cem\u003e\"Yes, he became very afraid of swimming pools, shopping malls, and horse riding, he constantly withdrew himself from such environments. His crying fits increased, he did not want to go to crowded places, and when he did he would cry a lot. He distanced himself from social circles, he spent more time on the phone\" (Parent 9).\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003e\"There was a decrease in perception and eye contact, but when the child started education, some skills were recovered over time. Of course, there is fear and anxiety\" (Parent 12).\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003e\"After the earthquake, we had problems such as excessive crying and not being able to sleep at night. Apart from this, some behaviors that were limited to home, such as taking off all clothes when coming home, started to be done everywhere we went, but over time we got these things back on track\" (Parent 11).\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003e\"We could not use medication because she had epilepsy. Her behavior and emotions deteriorated. After a while, we started taking medication and she recovered because she got used to the environment\" (Parent 2).\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003e\"In the post-earthquake period, my child diagnosed with autism has increased his obsessions a lot. We are especially having problems with dressing. We have become obsessed with a sweater and shoes, he still goes to school with torn sneakers. His clothes are the same color, he uses the same shoes\" (Parent 3).\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eEmotional and behavioral problems in children diagnosed with ASD after the earthquake\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"2\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTheme\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCodes\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"13\" rowspan=\"14\"\u003e\u003cp\u003eEmotional and behavioral problems\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSocial Isolation\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFear and Anxiety\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eWithdrawal\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFear of earthquake\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCrying spells\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAgrypnia\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAcousticophobia\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDelirium\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eExcessive interest in the opposite sex\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePrefer not to talk\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIncrease in repetitive word use\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eUneasiness due to not being understood\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eBecoming irritable\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIncrease in obsessions\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe codes included in the theme of regression in basic skills in children with ASD (see Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e) are manifested by regressions in toilet, eating and drinking, and psychomotor skills. In addition, regressions are observed in dressing skills and personal care habits such as brushing teeth. Problems related to language and communication, such as inadequacy in using appropriate language and difficulty in expressing oneself, are also experienced. Furthermore, regressions are observed in social skills such as decreased perception and eye contact, and difficulty in socializing. Direct quotes regarding parental views are presented below.\u003c/p\u003e\u003cp\u003e\u003cem\u003e\"We had difficulty in toilet skills. After the earthquake, the toilet in the shelter allocated to us by the state was far away, there was some difficulty and regression, there was a regression in eating and drinking, he became very choosy, and he stayed in the same clothes for 2 months after the earthquake. He did not want to take them off. He almost doesn't dress himself anymore, I dress him, and his teeth brushing has regressed.\" (Parent 7)\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003e\"Since we did not attend school, progress in basic skills was replaced by regression. Because there is a problem with motor skills, this makes it difficult for my child to perform many skills\" (Parent 18)\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;There were regressions in her skills due to the limitations we experienced in terms of opportunities after the earthquake. Maybe if she had continued her education, her communication skills could have been much better. Unfortunately, she cannot speak now, so I cannot always understand her under all circumstances. For this reason, my child becomes uneasy\u0026rdquo; (Parent 5).\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;Since we did not continue with physical therapy, there were regressions in his psychomotor skills. Before the earthquake, he was going to physical therapy every week. We had made significant progress for him. However, the damage to buildings caused by the earthquake caused many institutions to close\u0026rdquo; (Parent, 18).\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eAreas of regression in basic skills of children diagnosed with ASD after the earthquake\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"2\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTheme\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCodes\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDecrease in toilet skills\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEating and drinking regression\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDressing regression\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRegression in Basic Skills\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTeeth brushing regression\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eInadequate use of appropriate language\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDifficulty in expressing themselves\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDecrease in perception and eye contact\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRegression in psychomotor skills\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDifficulty in socializing\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn this study, the difficulties experienced by children diagnosed with ASD following the earthquakes centered in Kahramanmaraş, T\u0026uuml;rkiye, were examined in detail in line with the views of their parents. The research findings reveal the multifaceted effects of the earthquake on these individuals. The research revealed the difficulties experienced by children diagnosed with ASD in the areas of socio-economic, health, education, emotional and behavioral, and basic skills in the post-earthquake period. It was determined that factors such as difficulties in accessing social services, interruptions in education, and inadequacies in health services have profound effects on the general development of children.\u003c/p\u003e\u003cp\u003eAs a result of the research, it is seen that individuals diagnosed with ASD experienced socio-economic difficulties after the earthquake. It is observed that children diagnosed with ASD, together with their families, experienced various difficulties in meeting basic needs in the early periods after the disaster. Disruptions in accessing social services and lack of financial assistance made it difficult to meet the needs of individuals diagnosed with ASD. Approximately 75 thousand houses were delivered to their beneficiaries 1 year after the Kahramanmaraş earthquake [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. However, since difficulties were experienced with factors such as housing problems and temporary residence until the delivery process of the houses, the living conditions of the families became difficult. After the Kahramanmaraş earthquake, all student dormitories across the country were opened to the service of disaster-affected citizens in order to meet the housing needs of people in earthquake zones. However, the housing needs of students could not be met in this way, and education and training in T\u0026uuml;rkiye were carried out online [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. During this process, it was determined that children diagnosed with ASD were alienated from their social environments and had difficulties in reaching support networks. In a study conducted by Luther et al. [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e], parents stated that having a child diagnosed with ASD caused stress factors such as financial difficulties, loss of personal freedom, and marital disharmony. The most common strategies they used to cope with these difficulties were to seek social support. In a different study, many parents stated that the services provided were not sufficient or did not fully meet the needs of their children. In particular, in issues such as housing and social life support, parents emphasized that the existing services were not suitable for their children's situation [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. In this context, our results underline more comprehensive and holistic approaches to the basic needs of families with children diagnosed with ASD after a disaster.\u003c/p\u003e\u003cp\u003eAnother finding of the study was related to the difficulties experienced by families with children diagnosed with ASD in healthcare services. It was revealed that individuals diagnosed with ASD had problems accessing healthcare services after the earthquake. Difficulties in making appointments and the inability to find specialist doctors caused the children's regular check-ups to be interrupted and their treatment processes to be negatively affected. It is stated that the problems experienced in obtaining medicine and the difficulties in using medicine in the first weeks of the earthquake made the treatment process difficult. This situation shows that institutions may be inadequate after large-scale disasters such as the Kahramanmaraş earthquake. In this respect, institutions that were not damaged should be identified and rehabilitation interventions should be provided quickly with the coordination of physicians, physiotherapists, psychologists, and other health professionals in order to protect and improve the health of earthquake victims. In T\u0026uuml;rkiye, primary health care services are developing. Primary health care services, which provide easy access to individuals in need, are advantageous in this respect. Primary care is at a very important point in terms of accessing rehabilitation services for earthquake victims in natural disasters such as earthquakes, which have widespread effects on individuals, and reducing the intensity so that more people can access treatment without losing time. It is emphasized that the employment of these health professionals in primary care should be increased and earthquake victims should be supported biopsychosocially with appropriate rehabilitation strategies. To achieve this, it is stated that rehabilitation rooms should be established in family health centers and the necessary equipment support should be provided [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eIn a study conducted by Wilson \u0026amp; Peterson, families with children diagnosed with ASD may experience many difficulties in the healthcare process. Parents expressed the problems they experienced in making medical appointments, communicating with doctors, and complex healthcare environments. Communication problems and insufficient knowledge of healthcare professionals about ASD are among the important obstacles [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. In different studies, parents have expressed the problems experienced by their children in accessing health services [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e], finding specialist doctors, and obtaining medicine [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. It is understood that individuals diagnosed with ASD experienced more serious problems in accessing health services in the period after the Kahramanmaraş earthquake. It is thought that this situation may be due to various reasons. Healthcare professionals' lack of sufficient knowledge about ASD may reduce the quality of services provided to these groups. Especially in the post-disaster period, when healthcare professionals work under an intense workload, the time and attention allocated to special needs groups may decrease. This situation may cause parents to have difficulty communicating with healthcare professionals and not benefit sufficiently from health services. To increase the quality of services for individuals with special needs, especially during major disaster periods such as earthquakes, the knowledge and awareness levels of healthcare professionals about ASD should be increased.\u003c/p\u003e\u003cp\u003eThe study concluded that children with ASD have difficulties in their education. Schools, especially in earthquake zones, were damaged and closed for long periods. Such interruptions in access to education have negatively affected both the academic and social development of children. This situation reveals the importance of parents' competence in providing support for the education of their children with ASD [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. In a study conducted by Gray \u0026amp; Donnelly [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e], it was determined that families with children with ASD experience significant differences in access to education and support services. While traveling families had great difficulty finding suitable schools for their children, settled families were able to receive more support. However, both groups had difficulty accessing educational opportunities that were appropriate for their children's needs. In a similar study, families of individuals with special needs affected by the earthquake experienced great difficulties in meeting their basic needs, especially hygiene, health, nutrition, and housing. However, it was observed that these families had high psychological resilience and were more resistant than other families in coping with difficulties. This situation was explained as the families already had a difficult life and developed various coping mechanisms and competencies to cope with such traumatic situations [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eStudies conducted in Hatay and Şanlıurfa found an increase in autism symptoms and increased levels of irritability after the earthquake. This increase was especially evident in regions that had to suspend special education for longer periods [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Another study reported that the routine education processes of children with special needs were interrupted after the earthquake, and this caused negative changes in the children's behavior. It has been reported that the disruption of the routines of children with ASD, in particular, caused behavioral problems to reoccur. Although these children have a high desire to continue their education, this demand may be insufficient under current conditions [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. In this context, strategies that include the educational needs of children with special needs should be added to crisis and disaster management policies to prevent interruptions in educational services during disasters. The negative effects of educational interruptions on children's development become even more apparent after traumatic events such as earthquakes. The educational needs of children with special needs can often be inadequate during disasters and wars. These children may be deprived of education due to both physical and mental disabilities and have problems in being included in the education system in the long term [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]. Restructuring schools and training teachers in the post-disaster period can be a long process. Therefore, alternative education models should be developed to ensure the sustainability of education services. Solutions such as homeschooling can prevent children with ASD from being disconnected from the education process. Including parents in the education process more and creating structured education plans in the home environment can increase children's participation in the education process.\u003c/p\u003e\u003cp\u003eOur research results have revealed that children diagnosed with ASD experienced anxiety, acousticophobia, fear of earthquakes, and sleep disorders after the earthquake and that these individuals also exhibited crying spells and irritable behavior. In a study on the COVID-19 pandemic process conducted by Arıcı-Doğan \u0026amp; G\u0026ouml;rg\u0026uuml; [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e], it was found that interruptions in access to special education negatively affected the social interaction skills and problematic behaviors of children diagnosed with ASD. Our research findings reveal that social isolation and psychological regression lead to significant declines in the general health and well-being of these children. This situation has led to children forgetting what they had learned and experiencing negative changes in their behavior. A bibliometric study conducted in the field shows that individuals diagnosed with ASD are most commonly exposed to traumatic events such as accidents, disasters, violent acts, and sexual abuse. Such traumas cause an increase in symptoms such as deterioration in social and communication skills, aggression, distraction, sleep disorders, hyperactivity, and self-harm in individuals diagnosed with ASD [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. Nguyen \u0026amp; Minh Pham [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e] state that natural disasters affect children's educational processes through various channels and that these effects negatively affect not only academic success but also children's psychosocial development. It has been stated that the condition of individuals diagnosed with ASD with psychological disorders may worsen after the disaster. This situation shows how critical post-disaster psychological support services are for individuals with special needs [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e]. After the earthquakes in Nepal in 2015, individuals with special needs faced higher risks and difficulties in disasters. Individuals with special needs encountered problems such as access problems, lack of information, and social exclusion during and after the disaster [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e]. Similarly, after the Christchurch earthquakes, children with special needs faced serious difficulties in preparing for and coping with disasters [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]. Studies show that psychiatric disorders such as depression, anxiety, and behavioral disorders may increase in individuals diagnosed with ASD after the earthquake [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e]. In the study conducted by Aslan \u0026amp; Şahin\u0026ouml;z (2023), the difficulties encountered by individuals with special needs during the evacuation process and the inadequacies of disaster management systems during the Izmir earthquake were emphasized. This situation shows that individuals with special needs are more vulnerable during disasters and can be more affected psychologically [\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e]. In addition, the social interaction and communication difficulties experienced by these individuals further increase the difficulties they experience after the earthquake. Especially after the disaster, sudden changes, loud noises, and encounters with people they do not know can have more negative effects on these children [\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eAs a result of the research, it was determined that children diagnosed with ASD experienced significant regressions in their basic skills after the earthquake. Regressions in daily life skills such as toilet skills, eating and drinking, and dressing negatively affect children's self-care skills, and the loss of routine habits such as brushing teeth has further deepened this situation. In addition, deficiencies in language use and difficulties in expressing oneself limit children's communication capacities; difficulties in perception, eye contact, and socialization negatively affect social adaptation processes. Families play a critical role in providing emotional support and developing self-care skills for children and adolescents with special needs. The extent to which families of children with special needs are affected by natural disasters has a direct impact on the difficulties these children face and the traumatic reactions they show. The trauma and stress experienced by families can negatively affect the psychosocial adaptation and general development processes of children with special needs [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e]. A study has shown that individuals with ASD show symptoms such as deterioration in social interaction and communication skills, increased stereotypical behaviors, aggression, distraction, sleep disorders, agitation, hyperactivity, and loss of self-care skills when exposed to trauma. The most common type of trauma among children with a history of trauma was found to be witnessing accidents or violent events or being a victim of such events [\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e]. In a similar study, after the 2023 Kahramanmaraş earthquakes, parents experienced serious difficulties in accessing basic needs such as self-care, medication, personal hygiene, and food. This situation negatively affected the health and nutritional status of both parents and individuals with mental disabilities [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe effectiveness of post-earthquake intervention and rehabilitation programs plays a critical role in the recovery process of individuals diagnosed with ASD. However, earthquake-related damage in physical therapy centers is associated with such regressions. In a study conducted by Valenti et al., it was stated that intensive rehabilitation programs implemented after the earthquake partially improved the adaptive functions of children diagnosed with ASD, but longer-term interventions were needed for full recovery [\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e]. Similarly, access to physical activity is of great importance for both the physical and mental health of individuals diagnosed with ASD. Yarımkaya et al. emphasized that the difficulties experienced by individuals diagnosed with ASD in accessing physical activity after the earthquake have negative effects on the health and social skills of these individuals [\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e]. It is thought that the regressions in the psychomotor skills of children diagnosed with ASD after the earthquake may arise from the disruption of their routines, stress and trauma, and deficiencies in their social support networks. Because children diagnosed with ASD may experience regressions in their skills due to disruptions in their routines [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e], the trauma experienced by children diagnosed with ASD may affect their physical functions [\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e], and it is emphasized that there is a relationship between the social environment of these children and their psychomotor skills [\u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eAlthough post-disaster periods pose significant challenges for families of children with ASD, parents' abilities to adapt and find effective solutions are known to play an important role in alleviating these challenges. Findings highlight the importance of parent-focused support programs to optimize coping strategies and resilience during times of significant life disruption [\u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e]. Another study has shown that the participation of parents and family members in the education process increases the participation and success of children with ASD in the education process. Parental support has enabled children to take a more active role in education [\u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e]. Therefore, psychosocial support programs and training should be organized for parents in the post-disaster period, and families should be encouraged to take an active role in the education process. The participation of parents in the education process supports children's social interactions and can be effective in reducing problematic behaviors.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThis study comprehensively examines the multifaceted effects of earthquakes on children with ASD and emphasizes the need for long-term, sustainable solutions to the needs of these children. The continuity of education, health, and social support services is of critical importance in maintaining the well-being of individuals with ASD. In this context, it is of great importance that disaster preparedness and intervention strategies are designed to meet the special needs of individuals with special needs and that these individuals are actively involved in disaster management processes.\u003c/p\u003e\u003cp\u003eThis study was conducted within the first year after the earthquake, and the long-term changes and developments could not be observed. Since the effects of disasters may change over time, a longer follow-up study may allow for a more comprehensive evaluation of the findings.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eASD: Autism Spectrum Disorder\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe would like to thanks, our patients who participated in our study for their contribution to the studies.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was not financially supported by any funding.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interest\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors report no conflict of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical Approval\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe ethical committee approval was obtained from the Ethics Committee of Batman University\u0026nbsp;(Decision no: 2024/01-44). All methods were carried out by the 1964 Helsinki Declaration. Informed consent was obtained from all the participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMeAK, MuAK, OTC and CK designed the study; MeAK and MuAK collected the data; MeAK and MuAK drafted the manuscript; OTC conducted the analysis and interpreted the results; MeAK, MuAK, OTC and CK reviewed the final manuscript and gave their consent.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003e\u0026Ouml;zdoğru M. \u0026Ouml;zel gereksinimli \u0026ouml;ğrencilerin okul \u0026ouml;ncesi eğitiminde karşılaşılan sorunlar. Temel Eğitim. 2021;(11):6-16.\u003c/li\u003e\n\u003cli\u003eŞahbaz \u0026Uuml;, Kalay G. Okul\u0026ouml;ncesi eğitimi \u0026ouml;ğretmen adaylarının kaynaştırmaya ilişkin g\u0026ouml;r\u0026uuml;şlerinin belirlenmesi. Mehmet Akif Ersoy \u0026Uuml;niversitesi Eğitim Fak\u0026uuml;ltesi Dergisi. 2010;(19):116-35.\u003c/li\u003e\n\u003cli\u003eCook BG, Schirmer BR. What Is Special About Special Education?:Overview and Analysis. The Journal of Special Education. 2003;37(3):200-5; doi: 10.1177/00224669030370031001.\u003c/li\u003e\n\u003cli\u003eFrancisco MPB, Hartman M, Wang Y. Inclusion and Special Education. Education Sciences. 2020;10(9):238.\u003c/li\u003e\n\u003cli\u003e\u0026Uuml;nl\u0026uuml; E. \u0026Ouml;zel eğitime gereksinim duyan \u0026ccedil;ocuklar ve \u0026ouml;zel eğitim. In: Diken İH, editor. \u0026Ouml;zel eğitime gereksinimi olan \u0026ouml;ğrenciler ve \u0026ouml;zel eğitim. Pegem Akademi Yayıncılık; 2022. p. 3-17.\u003c/li\u003e\n\u003cli\u003ePeek L, Stough LM. Children With Disabilities in the Context of Disaster: A Social Vulnerability Perspective. Child Development. 2010;81(4):1260-70; doi: https://doi.org/10.1111/j.1467-8624.2010.01466.x.\u003c/li\u003e\n\u003cli\u003eEspejo R. Are Natural Disasters Increasing? : Greenhaven Publishing LLC; 2014.\u003c/li\u003e\n\u003cli\u003eBilik MB, Akdağ M. \u0026Ouml;zel gereksinimli bireyler ve ebeveynleri a\u0026ccedil;ısından afet Zorlukları: 2011 Van depremi \u0026ouml;rneği. Afet ve Risk Dergisi. 2023;6(1):243-56.\u003c/li\u003e\n\u003cli\u003eBouton M, Cooper A. Children and Disaster. In: Ciottone G, editor. Ciottone\u0026apos;s Disaster Medicine (3rd Ed). New Delhi: Elsevier; 2024. p. 58-67.\u003c/li\u003e\n\u003cli\u003eArslan K. Afetlerin engelli bireylere etkisi. In: Sosyal Bilimler \u0026Uuml;zerine Araştırmalar-II. \u0026Ouml;zg\u0026uuml;r Yayın Dağıtım; 2023. p. 197-209.\u003c/li\u003e\n\u003cli\u003eAkcay E, Başg\u0026uuml;l ŞS. Pandemi ve \u0026ouml;zel gereksinimi olan/risk altındaki \u0026ccedil;ocuklar. Covid-19 pandemisi ve \u0026ccedil;ocuk ve ergen ruh sağlığı. 2020;1:55-61.\u003c/li\u003e\n\u003cli\u003eBen-Pazi H, Beni-Adani L, Lamdan R. Accelerating Telemedicine for Cerebral Palsy During the COVID-19 Pandemic and Beyond. Frontiers in Neurology. 2020;11; doi: 10.3389/fneur.2020.00746.\u003c/li\u003e\n\u003cli\u003eScarpinato N, Bradley J, Kurbjun K, Bateman X, Holtzer B, Ely B. Caring for the Child With an Autism Spectrum Disorder in the Acute Care Setting. Journal for Specialists in Pediatric Nursing. 2010;15(3):244-54; doi: https://doi.org/10.1111/j.1744-6155.2010.00244.x.\u003c/li\u003e\n\u003cli\u003eAhmad ESN. The Challenges Faced by the Parents of Autistic Children in Jordan. Journal of Education and Practice. 2020;11(28):74-82.\u003c/li\u003e\n\u003cli\u003eEroğlu M, Yakşi N. Changes in Symptom Severity and Sleeping Habits After Earthquake in Children and Adolescents with Autism Spectrum Disorder: The Case of the Kahramanmaras Earthquake in 2023, Turkey. Acıbadem \u0026Uuml;niversitesi Sağlık Bilimleri Dergisi. 2023;14(4):577-86.\u003c/li\u003e\n\u003cli\u003eValenti M, Di Giovanni C, Mariano M, Pino MC, Sconci V, Mazza M. Autism after an earthquake: the experience of L\u0026apos;Aquila (Central Italy) as a basis for an operative guideline. Epidemiologia e Prevenzione. 2016;40(2):49-52.\u003c/li\u003e\n\u003cli\u003eRepublic of Turkey Presidency Strategy and Budget Presidency. Kahramanmaraş and Hatay Earthquakes Report. https://www.sbb.gov.tr/wpcontent/uploads/2023/03/%202023-Kahramanmaras-ve-Hatay-Depremleri-Raporu.pdf (2023). Accessed.\u003c/li\u003e\n\u003cli\u003eKo\u0026ccedil; M, Yal\u0026ccedil;ın S. Afetlerde Krize M\u0026uuml;dahale: Kahramanmaraş Depremi\u0026rsquo;nde Aile ve Sosyal Hizmetler Bakanlığı\u0026rsquo;nın \u0026Ccedil;alışmaları. Uluslararası Sosyal Hizmet Araştırmaları Dergisi. 2023;3(2):93-105.\u003c/li\u003e\n\u003cli\u003eEroglu M, Efendi GY, Temelturk RD, Yaksi N. Living on with autism after a devastating earthquake: experiences of children and adolescents in Turkey. International Journal of Developmental Disabilities. 2024;70(4):766-76; doi: 10.1080/20473869.2023.2301184.\u003c/li\u003e\n\u003cli\u003eBlanc J, Eugene D, Louis EF, Cadichon JM, Joseph J, Pierre A, et al. Mental Health Among Children Older than 10 Years Exposed to the Haiti 2010 Earthquake: a Critical Review. Current Psychiatry Reports. 2020;22(11):57; doi: 10.1007/s11920-020-01178-9.\u003c/li\u003e\n\u003cli\u003eMerriam SB, Tisdell EJ. Qualitative research: A guide to design and implementation. John Wiley \u0026amp; Sons; 2015.\u003c/li\u003e\n\u003cli\u003ePatton MQ. Qualitative research \u0026amp; evaluation methods: Integrating theory and practice. Sage publications; 2014.\u003c/li\u003e\n\u003cli\u003eKvale S. Interviews: Learning the craft of qualitative research interviewing. Sage; 2009.\u003c/li\u003e\n\u003cli\u003eHsieh H-F, Shannon SE. Three approaches to qualitative content analysis. Qualitative health research. 2005;15(9):1277-88.\u003c/li\u003e\n\u003cli\u003eRepublic of T\u0026uuml;rkiye Ministry of Environment Urbanization and Climate Change. Deprem b\u0026ouml;lgesinde kalıcı konutların teslimi. https://csb.gov.tr/deprem-bolgesinde-kalici-konutlarin-teslimi-devam-ediyor-bakanlik-faaliyetleri-40087 (2024). Accessed.\u003c/li\u003e\n\u003cli\u003eTelli SG, Altun D. T\u0026uuml;rkiye\u0026apos;de deprem sonrası \u0026ccedil;evrimi\u0026ccedil;i \u0026ouml;ğrenmenin vazge\u0026ccedil;ilmezliği. \u0026Uuml;niversite Araştırmaları Dergisi. 2023;6(2):125-36; doi: https://doi.org/10.32329/uad.1268747.\u003c/li\u003e\n\u003cli\u003eLuther EH, Canham DL, Cureton VY. Coping and Social Support for Parents of Children with Autism. The Journal of School Nursing. 2005;21(1):40-7; doi: 10.1177/10598405050210010901.\u003c/li\u003e\n\u003cli\u003eMarsack-Topolewski CN, Weisz AN. Parents\u0026rsquo; Perceptions of Access to Services for Their Adult Children Diagnosed With Autism Spectrum Disorder. Families in Society. 2020;101(2):190-204; doi: 10.1177/1044389419881273.\u003c/li\u003e\n\u003cli\u003eYılmaz RC, Kocamaz D. Yıkıcı Deprem Sonrasında Erken Rehabilitatif M\u0026uuml;dahaleler İle Sakatlık \u0026Ouml;nlenebilir: Kahramanmaraş-Pazarcık Depremi Sonrası Rehabilitasyon \u0026Ccedil;alışanlarına Mektup. Turkish Journal of Family Medicine and Primary Care. 2019;17(1):1-5.\u003c/li\u003e\n\u003cli\u003eWilson SA, Peterson CC. Medical care experiences of children with autism and their parents: A scoping review. Child: Care, Health and Development. 2018;44(6):807-17; doi: https://doi.org/10.1111/cch.12611.\u003c/li\u003e\n\u003cli\u003eNicholas DB, Zwaigenbaum L, Muskat B, Craig WR, Newton AS, Kilmer C, et al. Experiences of emergency department care from the perspective of families in which a child has autism spectrum disorder. Social Work in Health Care. 2016;55(6):409-26; doi: 10.1080/00981389.2016.1178679.\u003c/li\u003e\n\u003cli\u003eLajonchere C, Jones N, Coury DL, Perrin JM. Leadership in Health Care, Research, and Quality Improvement for Children and Adolescents With Autism Spectrum Disorders: Autism Treatment Network and Autism Intervention Research Network on Physical Health. Pediatrics. 2012;130(Supplement_2):S62-S8; doi: 10.1542/peds.2012-0900C.\u003c/li\u003e\n\u003cli\u003eKaraca MA, Sarı H. The educational skills self-competence scale for parents of children with autism spectrum disorder: A validity and reliability study. Anatolian Journal of Health Research. 2024;5(1):57-64; doi: https://doi.org/10.61534/anatoljhr.1428323.\u003c/li\u003e\n\u003cli\u003eGray C, Donnelly J. Unheard voices: the views of traveller and non-traveller mothers and children with ASD. International Journal of Early Years Education. 2013;21(4):268-85; doi: 10.1080/09669760.2013.842160.\u003c/li\u003e\n\u003cli\u003eS\u0026ouml;ğ\u0026uuml;t DA, Kaya A. \u0026lsquo;In order not to cry, we averted our eyes from each other:\u0026rsquo;experiences of special education professionals working in the field during the Turkey earthquake. International Journal of Developmental Disabilities. 2024:1-11.\u003c/li\u003e\n\u003cli\u003eBattle DE. Persons With Communication Disabilities in Natural Disasters, War, and/or Conflict. Communication Disorders Quarterly. 2014;36(4):231-40; doi: 10.1177/1525740114545980.\u003c/li\u003e\n\u003cli\u003eArıcı-Doğan D, G\u0026ouml;rg\u0026uuml; E. Investigation of the Views\u0026apos; of the Mothers of Children with Autism Spectrum Disorder on Suspending Special Education during the Covid-19 Pandemic Process. Journal of Qualitative Research in Education. 2022;(30); doi: https://doi.org/10.14689/enad.30.5.\u003c/li\u003e\n\u003cli\u003eHern\u0026aacute;ndez-Gonz\u0026aacute;lez O, Fresno-Rodr\u0026iacute;guez A, Spencer-Contreras RE, T\u0026aacute;rraga-M\u0026iacute;nguez R, Gonz\u0026aacute;lez-Fern\u0026aacute;ndez D, Sep\u0026uacute;lveda-Opazo F. Research Mapping of Trauma Experiences in Autism Spectrum Disorders: A Bibliometric Analysis. Healthcare. 2023. doi: 10.3390/healthcare11091267.\u003c/li\u003e\n\u003cli\u003eNguyen CV, Minh Pham N. The impact of natural disasters on children\u0026apos;s education: Comparative evidence from Ethiopia, India, Peru, and Vietnam. Review of Development Economics. 2018;22(4):1561-89; doi: https://doi.org/10.1111/rode.12406.\u003c/li\u003e\n\u003cli\u003eStough LM, Kelman I. People with disabilities and disasters. Handbook of disaster research. 2018:225-42.\u003c/li\u003e\n\u003cli\u003eLord A, Sijapati B, Baniya J, Chand O, Ghale T. Disaster, disability, \u0026amp; difference: a study of the challenges faced by persons with disabilities in post-earthquake Nepal. Kathmandu: United Nations Development Programme. 2016.\u003c/li\u003e\n\u003cli\u003eRonan KR, Alisic E, Towers B, Johnson VA, Johnston DM. Disaster Preparedness for Children and Families: a Critical Review. Current Psychiatry Reports. 2015;17(7):58; doi: 10.1007/s11920-015-0589-6.\u003c/li\u003e\n\u003cli\u003eKerns CM, Newschaffer CJ, Berkowitz SJ. Traumatic Childhood Events and Autism Spectrum Disorder. Journal of Autism and Developmental Disorders. 2015;45(11):3475-86; doi: 10.1007/s10803-015-2392-y.\u003c/li\u003e\n\u003cli\u003eAslan R, Şahin\u0026ouml;z S. The experiences of people with disabilities in the 2020 Izmir earthquake: A phenomenological research. International Journal of Disaster Risk Reduction. 2023;95:103868; doi: https://doi.org/10.1016/j.ijdrr.2023.103868.\u003c/li\u003e\n\u003cli\u003eEdmonds CO. Designing Emergency Preparedness Resources for Children with Autism. International Journal of Disability, Development and Education. 2017;64(4):404-19; doi: 10.1080/1034912X.2016.1264577.\u003c/li\u003e\n\u003cli\u003eAltun A, Erdur Baker \u0026Ouml;, Yıldırım Z. Afetlerde Psikolojik Destek İ\u0026ccedil;in Psikolojik Danışmanlara Y\u0026ouml;nelik \u0026Ccedil;evirimi\u0026ccedil;i Eğitim Geliştirilmesi. https://open.metu.edu.tr/handle/11511/49947 (2018). Accessed.\u003c/li\u003e\n\u003cli\u003eMehtar M, Mukaddes NM. Posttraumatic Stress Disorder in individuals with diagnosis of Autistic Spectrum Disorders. Research in Autism Spectrum Disorders. 2011;5(1):539-46; doi: https://doi.org/10.1016/j.rasd.2010.06.020.\u003c/li\u003e\n\u003cli\u003eYarımkaya E, Bakkaloğlu H. Experiences of parents of individuals with intellectual disabilities after the 2023 Kahramanmaraş earthquakes in T\u0026uuml;rkiye: a phenomenological study. International Journal of Developmental Disabilities.1-15; doi: 10.1080/20473869.2024.2363009.\u003c/li\u003e\n\u003cli\u003eValenti M, Ciprietti T, Egidio CD, Gabrielli M, Masedu F, Tomassini AR, et al. Adaptive Response of Children and Adolescents with Autism to the 2009 Earthquake in L\u0026rsquo;Aquila, Italy. Journal of Autism and Developmental Disorders. 2012;42(6):954-60; doi: 10.1007/s10803-011-1323-9.\u003c/li\u003e\n\u003cli\u003eYarımkaya E, Şenlik ZA, Demir M, T\u0026ouml;man U, Kul M, T\u0026uuml;rkmen M. Barriers to physical activity in individuals with autism spectrum disorders after the 2023 Kahramanmaraş Earthquakes in T\u0026uuml;rkiye. International Journal of Developmental Disabilities. 2024:1-13.\u003c/li\u003e\n\u003cli\u003eSiracusano M, Segatori E, Riccioni A, Emberti Gialloreti L, Curatolo P, Mazzone L. The Impact of COVID-19 on the Adaptive Functioning, Behavioral Problems, and Repetitive Behaviors of Italian Children with Autism Spectrum Disorder: An Observational Study. Children. 2021. doi: 10.3390/children8020096.\u003c/li\u003e\n\u003cli\u003eMichna GA, Trudel SM, Bray MA, Reinhardt J, Dirsmith J, Theodore L, et al. Best practices and emerging trends in assessment of trauma in students with autism spectrum disorder. Psychology in the Schools. 2023;60(2):479-94; doi: https://doi.org/10.1002/pits.22769.\u003c/li\u003e\n\u003cli\u003eRenobell V. La mejora de la sociabilidad y las habilidades sociales mediante el uso de la psicomotricidad relacional en menores con s\u0026iacute;ntomas de autismo. Revista de Psicoterapia. 2023;34(125):33-46; doi: 10.5944/rdp.v34i125.37819.\u003c/li\u003e\n\u003cli\u003eTokatly Latzer I, Leitner Y, Karnieli-Miller O. Core experiences of parents of children with autism during the COVID-19 pandemic lockdown. Autism. 2021;25(4):1047-59; doi: 10.1177/1362361320984317.\u003c/li\u003e\n\u003cli\u003eIndriasari FN, Daniyati K P, Widyarani L. Disaster Risk Reduction and Emergency Preparedness for Children With Autism in Facing Earthquake Disaster in Yogyakarta. Jurnal Medicoeticolegal dan Manajemen Rumah Sakit. 2024;7(1):52-9; doi: 10.18196/jmmr.7156.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Autism Spectrum Disorder, Child, Disaster, Earthquake, Parent","lastPublishedDoi":"10.21203/rs.3.rs-7185490/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7185490/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003ePurpose\u003c/strong\u003e The February 6, 2023 Kahramanmaraş earthquake severely affected 11 provinces in Türkiye, disrupting services for vulnerable groups. This research aims to examine the difficulties that children diagnosed with Autism Spectrum Disorder (ASD) face in education, health, and social support services from the parental perspective following the earthquakes centered in Kahramanmaraş on February 6, 2023.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMaterials and Methods\u003c/strong\u003e The research used a basic qualitative research method and semi-structured interviews were conducted with 22 parents residing in Malatya, which was affected by the earthquake. The data obtained were examined with content analysis method.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e It was determined that children diagnosed with ASD experienced serious regressions in their education, health, and basic skills. At the same time, parents faced difficulties in accessing health and social services. As a result of the research, it was determined that the interruption of the daily routines of children diagnosed with ASD and their alienation from their social environments after the disaster increased behavioral and emotional problems.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e It was emphasized that alternative education models should be developed for children diagnosed with ASD during disaster periods and families should be encouraged to take an active role in this process.\u003c/p\u003e","manuscriptTitle":"Difficulties Faced by Children with Autism Spectrum Disorders after an Earthquake: A Study from Parents' Perspectives","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-08-18 14:39:10","doi":"10.21203/rs.3.rs-7185490/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-09-01T12:40:08+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-08-31T07:01:09+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"333990027862964664148129518782533485415","date":"2025-08-14T21:47:08+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"331572052693472058003462157277695765390","date":"2025-08-11T20:17:50+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-08-10T14:33:08+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"124354929044683009771939495449382343459","date":"2025-08-10T06:49:26+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-08-09T20:22:37+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-07-25T06:06:48+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-07-23T05:51:04+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-07-23T03:57:22+00:00","index":"","fulltext":""},{"type":"submitted","content":"Scientific Reports","date":"2025-07-22T09:46:30+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"3e16120c-4e5d-4b6a-881f-43e756c8d97e","owner":[],"postedDate":"August 18th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[{"id":53198285,"name":"Health sciences/Health care"},{"id":53198286,"name":"Biological sciences/Psychology"},{"id":53198287,"name":"Social science/Psychology"}],"tags":[],"updatedAt":"2025-11-17T16:07:18+00:00","versionOfRecord":{"articleIdentity":"rs-7185490","link":"https://doi.org/10.1038/s41598-025-23025-8","journal":{"identity":"scientific-reports","isVorOnly":false,"title":"Scientific Reports"},"publishedOn":"2025-11-10 15:57:40","publishedOnDateReadable":"November 10th, 2025"},"versionCreatedAt":"2025-08-18 14:39:10","video":"","vorDoi":"10.1038/s41598-025-23025-8","vorDoiUrl":"https://doi.org/10.1038/s41598-025-23025-8","workflowStages":[]},"version":"v1","identity":"rs-7185490","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7185490","identity":"rs-7185490","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}