War in Lebanon Takes a Heavy Toll on Young People With Autism and ADHD

FROM LEBANON – After her husband died of COVID-19 in 2020, Lena Kouyoumjian moved back in with her parents in the village of Mazraat Yachouh, about a 20-minute drive from Beirut. For an active, outgoing woman like her, the change of address was not easy, but she accepted it because she needed help caring for her 20-year-old daughter Vana, who is autistic and cannot communicate verbally.

Lena first noticed her daughter's symptoms when Vana was two. To this day, Vana still cannot put her feelings into words, and her mother does everything she can to understand her. Like many autistic people – and people with neurodevelopmental disorders more broadly – Vana needs a stable, supportive environment and structured routines to feel comfortable.

Lebanon has been at war since October 2023, with airstrikes across the country and an economic crisis that continues to hit the entire population, especially people with neurodevelopmental disorders. When Israel escalated its attacks on southern Lebanon in March, Lena – a coach for children with disabilities – understood that this could affect her autistic daughter.

“Any sudden change in routine, loud noises, fear or uncertainty can increase anxiety and make them feel unsafe,” Lena said. “I see this in my daughter. Since the situation became more difficult, she has become more anxious and more sensitive to changes around her.”

Challenging social stigma

The symptoms of autism and attention-deficit/hyperactivity disorder (ADHD) vary from person to person and condition to condition, but often include sensory issues and emotional dysregulation. ADHD and autism frequently co-occur, forming AuDHD, when traits of both conditions present together.

People with these neurodevelopmental conditions often face social stigma, including in Lebanon, because of limited understanding. While the pressures of war and mass displacement cause psychological problems for many, people with neurodevelopmental disorders are more vulnerable because of their need for support and stable routines.

“Being the parent of an autistic child is not something anyone can do. The challenge I often face is deciding how much time and energy to give my child,” Lena said.

The Lebanese Autism Awareness Association (AAA) has supported both mother and daughter. Vana has attended AAA – a nonprofit in Antelias, a suburb of Beirut, that operates as an alternative school for young autistic people – for the past six years. But soaring costs in wartime mean Vana cannot attend class regularly.

“Even getting to the center has become very difficult, especially as financial hardship grows. There are times when she cannot go and has to stay home,” Lena said.

Ghada Hayek Makhoul, who co-founded AAA with other parents in 2015, said the organization has worked tirelessly to raise awareness of autism in Lebanon. “Many people don't know what autism really is. They don't know about the autism spectrum, from mild to moderate to severe,” she said.

Sensory overload

Ghada's son Anthony, 27, is non-speaking and autistic, calm in temperament and heavily dependent on caregivers. Although he cannot speak, his mother says it is easy to tell when he is stressed: he puts his hands over his ears when discomfort from sensory overload becomes painful.

Autistic people can be more sensitive to noise than others. In wartime, Lebanon's population endures a barrage of terrifying sounds, from Israeli bombs exploding on the ground to the sonic booms of fighter jets overhead.

“Imagine [for autistic people] drones all day, the sound of bombs, and even the vibration of bombs… everything we hear, of course, affects him a great deal,” Ghada said. “My son can no longer watch TV because of the news. He turns the TV off and hides the remote. It is too much for him.”

Anthony's mother said he picks up on tension and anxiety even when his understanding of what is being said or what is happening is limited. “[It affects] every sense, everything. He doesn't want to go down to the pool anymore. He used to love the water. Now he doesn't want to get in,” she said. “I don't know what changed. Because of being outside? Because of the sound? I don't know.”

Mental health support as a luxury

Israel's war in Lebanon has direct economic consequences for AAA and other organizations that provide psychological support or services for people with neurodevelopmental disorders. Lebanon's economic crisis, with inflation possibly reaching 17% this year, has also fueled a brain drain of the professionals who could support this group.

AAA is a vital lifeline for families with autistic children, but costs reach up to $700 a month for a child attending five days a week. With 80% of the population living in poverty, few can afford such a service.

“We need more trained staff, and we also need to keep those who are leaving the country. So we need to pay better salaries, but we cannot afford it, because that would increase the burden on parents,” Ghada said. “Everything is in a state of crisis for everyone in wartime.”

The same is true of other mental health services. Many NGOs offer free therapy, but private counseling can cost more than $100 for a 50-minute session.

Nour Toukan, a public health researcher at Enmaeya, a media platform on sustainable development, said care for autistic people or even those with ADHD is “largely out-of-pocket.” Lebanon's government launched a National Disability Allowance in 2023 with funding from the European Union and the United Nations Children's Fund (UNICEF), but the $40 a month falls far short of covering even the most basic needs. Autistic people can obtain a personal disability card issued by the Ministry of Social Affairs, which makes them eligible for support, but people with ADHD cannot.

Lebanon's National Mental Health Program, established by the Ministry of Public Health in 2014, is trying to close the support gap caused by economic and geographic factors. Dr. Rabih El Chammay, the program's founder and director, said a national mental health strategy for children and adolescents is being finalized.

“National studies on autism and ADHD have also been conducted, providing evidence to guide this work. We are meeting with many organizations, especially those representing families of autistic people, to understand priorities and build momentum for coordinated action,” he said. “The war makes this work harder because it can increase the need for support while disrupting the services people depend on.”

Developmental regression

Displaced people are the hardest hit, but everyone in Lebanon whose education and routines have been disrupted is affected. Adham Faraj, 23, a psychology student at the American University of Beirut who was diagnosed with ADHD in 2024, said that when classes moved online because of the war, he found himself at home more often.

“Less interaction, especially if you struggle with focus. You have less motivation to go out, so you just study from your bed,” Adham said. He said the intensity of Israel's airstrikes in Lebanon left him uneasy, along with worries about rising medication prices.

“There is always a cheaper alternative, but that depends on your social class. Maybe an $11 box of medication works for some people, but not for everyone,” he said.

Rim Ajjour, a psychologist and psychotherapist in Beirut who specializes in working with young autistic people, has seen many of the skills that people with neurodevelopmental disorders learned before the war erode. “With limited resources in Lebanon and people's shifting priorities, access to therapy is increasingly restricted,” she said.

Rim said her clinic and others are doing their best to keep therapy accessible by holding consultation fees steady, even as their own costs rise. As Israeli attacks continue in southern Lebanon – where Israeli forces remain in occupation, violating a US-brokered ceasefire in June – many worry about the impact on their work if the conflict returns to full scale.

“I don't know whether we will be able to endure another time,” Rim said.