Skip to main content

Advertisement

Log in

“On the Sidelines”: Access to Autism-Related Services in the West Bank

  • Original Paper
  • Published:
Journal of Autism and Developmental Disorders Aims and scope Submit manuscript

Abstract

We examined access to autism-related services among Palestinians (N = 24) raising children with autism spectrum disorder (ASD) in the West Bank. Using qualitative methods, we identified five primary interview themes. Poor screening, diagnostic, and psychoeducational practices were prevalent, as parents reported service providers minimized parental concerns and communicated ineffectively with the caregivers regarding treatment options. Geographic barriers and financial burdens prevented many families from seeking or maintaining services. Limited service availability was a dominant barrier: parents reported limited or denied access to education, community-based services, and ASD-specific interventions. Consequently, several families noted their children did not receive any services whatsoever. Research, practices and policies to address the shortage of services for children with ASD are urgently needed in the West Bank.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Al Jabery, M., Arabiat, D., Al Khamra, H., Betawi, I., & Abdel Jabbar, S. (2014). Parental perceptions of services provided for children with autism in Jordan. Journal of Child and Family Studies, 23(3), 475–486. doi:10.1007/s10826-012-9703-0.

    Article  Google Scholar 

  • Al-Farsi, Y., Al-Sharbati, M., Al-Farsi, O., Al-Shafaee, M., Brooks, D., & Waly, M. (2011). Brief report: Prevalence of autistic spectrum disorders in the Sultanate of Oman. Journal of Autism and Developmental Disorders, 41(6), 821–825. doi:10.1007/s10803-010-1094-8.

    Article  PubMed  Google Scholar 

  • Anastas, J. W. (2004). Quality in qualitative evaluation: Issues and possible answers. Research on Social Work Practice, 14(1), 57–65.

    Article  Google Scholar 

  • Ansari, Z. A. (2002). Parental acceptance-rejection of disabled children in non-urban Pakistan. North American Journal of Psychology, 4(1), 121.

    Google Scholar 

  • Centers for Disease Control and Prevention. (2014). Data and statistics. Retrieved from http://www.cdc.gov/ncbddd/autism/data.html

  • Corbin, J. M., & Strauss, A. L. (2008). Basics of qualitative research: Techniques and procedures for developing grounded theory. Los Angeles: Sage.

    Google Scholar 

  • Crabtree, S. A. (2007). Maternal perceptions of care-giving of children with developmental disabilities in the United Arab Emirates. Journal of Applied Research in Intellectual Disabilities, 20(3), 247–255. doi:10.1111/j.1468-3148.2006.00327.x.

    Article  Google Scholar 

  • Dababnah, S., & Parish, S. L. (2013). “At a moment, you could collapse”: Raising children with autism in the West Bank. Children and Youth Services Review, 35(10), 1670–1678. doi:10.1016/j.childyouth.2013.07.007.

    Article  Google Scholar 

  • Dardas, L. A., & Ahmad, M. M. (2014). Quality of life among parents of children with autistic disorder: A sample from the Arab world. Research in Developmental Disabilities, 35(2), 278–287. doi:10.1016/j.ridd.2013.10.029.

    Article  PubMed  Google Scholar 

  • Dukmak, S. (2009). Rehabilitation services in the United Arab Emirates as perceived by parents of children with disabilities. Journal of Rehabilitation, 75(4), 27–34.

    Google Scholar 

  • Eide, A. H. (2006). Impact of community-based rehabilitation programmes: The case of Palestine. Scandinavian Journal of Disability Research, 8(4), 199–210. doi:10.1080/15017410500466750.

    Article  Google Scholar 

  • Filipek, P. A., Accardo, P. J., Baranek, G. T., Cook, E. H. J., Dawson, G., Gordon, B., & Volkmar, F. R. (1999). The screening and diagnosis of autistic spectrum disorders. Journal of Autism and Developmental Disorders, 29(6), 439–484. doi:10.1023/A:1021943802493.

    Article  PubMed  Google Scholar 

  • Giacaman, R., Abdul-Rahim, H. F., & Wick, L. (2003). Health sector reform in the occupied Palestinian territories (OPT): Targeting the forest or the trees? Health Policy and Planning, 18(1), 59–67. doi:10.1093/heapol/18.1.59.

    Article  PubMed Central  PubMed  Google Scholar 

  • Giacaman, R., Khatib, R., Shabaneh, L., Ramlawi, A., Sabri, B., Sabatinelli, G., & Laurance, T. (2009). Health status and health services in the Occupied Palestinian Territory. The Lancet, 373, 837–849. doi:10.1016/S0140-6736(09)60107-0.

    Article  Google Scholar 

  • Gordon, N., & Halileh, S. (2013). An analysis of cross sectional survey data of stunting among Palestinian children less than five years of age. Maternal and Child Health Journal, 17(7), 1288–1296. doi:10.1007/s10995-012-1126-4.

    Article  PubMed  Google Scholar 

  • Gulliford, M., Figueroa-Munoz, J., Morgan, M., Hughes, D., Gibson, B., Beech, R., & Hudson, M. (2002). What does “access to health care” mean? Journal of Health Services Research and Policy, 7(3), 186–188.

    Article  PubMed  Google Scholar 

  • Habash, M., & Fteiha, M. (2015). Study of beliefs of parents of children with autism regarding complementary and traditional medicine in 4 Middle-East countries. Poster session at the International Meeting of Autism Research, Salt Lake City, UT.

  • Hamdan, M., & Al-Akhras, N. (2009). House-to-house survey of disabilities in rural communities in the north of the West Bank. Eastern Mediterranean Health Journal, 15(6), 1496–1503.

    PubMed  Google Scholar 

  • Harami, G., Henley, D., & Greer, C. (2010). Development of a disability programme in West Bank and Gaza strip. The Lancet. Abstract retrieved from http://www.thelancet.com/pb/assets/raw/Lancet/abstracts/palestine/S0140673610608501.pdf

  • Hastings, R., Robertson, J., & Yasamy, M. T. (2012). Interventions for children with pervasive developmental disorders in low and middle income countries. Journal of Applied Research in Intellectual Disabilities, 25(2), 119–134. doi:10.1111/j.1468-3148.2011.00680.x.

    Article  PubMed  Google Scholar 

  • Hussein, H., Taha, G. R. A., & Almanasef, A. (2011). Characteristics of autism spectrum disorders in a sample of Egyptian and Saudi patients: Transcultural cross sectional study. Child and Adolescent Psychiatry and Mental Health, 5, 1–12. doi:10.1186/1753-2000-5-34.

    Article  Google Scholar 

  • Kogan, M. D., Strickland, B. B., Blumberg, S. J., Singh, G. K., Perrin, J. M., & van Dyck, P. C. (2008). A national profile of the health care experiences and family impact of autism spectrum disorder among children in the United States, 2005–2006. Pediatrics, 122(6), e1149–e1158. doi:10.1542/peds.2008-1057.

    Article  PubMed  Google Scholar 

  • Mandell, D. S., Ittenbach, R. F., Levy, S. E., & Pinto-Martin, J. A. (2007). Disparities in diagnoses received prior to a diagnosis of autism spectrum disorder. Journal of Autism and Developmental Disorders, 37(9), 1795–1802.

    Article  PubMed Central  PubMed  Google Scholar 

  • Masri, A. T., Suluh, N. A., & Nasir, R. (2013). Diagnostic delay of autism in Jordan: Review of 84 cases. Libyan Journal of Medicine, 8, 1–2. doi:10.3402/ljm.v8i0.21725.

    Article  Google Scholar 

  • McIntyre, D. I., Thiede, M., & Birch, S. (2009). Access as a policy-relevant concept in low- and middle-income countries. Health Economics, Policy and Law, 4(2), 179.

    Article  Google Scholar 

  • Murphy, M. A., & Ruble, L. A. (2012). A comparative study of rurality and urbanicity on access to and satisfaction with services for children with autism spectrum disorders. Rural Special Education Quarterly, 31(3), 3–11.

    Google Scholar 

  • Obeid, R., & Daou, N. (2015). The effects of coping style, social support, and behavioral problems on the well-being of mothers of children with autism spectrum disorders in Lebanon. Research in Autism Spectrum Disorders, 10, 59–70. doi:10.1016/j.rasd.2014.11.003.

    Article  Google Scholar 

  • Palestinian Central Bureau of Statistics. (2011). Disability survey, 2011. Ramallah: Palestinian Ministry of Social Affairs.

    Google Scholar 

  • QSR International. (2012). NVivo (10th edn.) QSR International.

  • Samadi, S. A., & Mahmoodizadeh, A. (2014). Omid early intervention resource kit for children with autism spectrum disorders and their families. Early Child Development and Care, 184(3), 354–369. doi:10.1080/03004430.2013.788501.

    Article  Google Scholar 

  • Samadi, S. A., McConkey, R., & Bunting, B. (2014). Parental wellbeing of Iranian families with children who have developmental disabilities. Research in Developmental Disabilities, 35(7), 1639–1647. doi:10.1016/j.ridd.2014.04.001.

    Article  PubMed  Google Scholar 

  • Seif Eldin, A., Habib, D., Noufal, A., Farrag, S., Bazaid, K., Al-Sharbati, M., & Gaddour, N. (2008). Use of M-CHAT for a multinational screening of young children with autism in the Arab countries. International Review of Psychiatry, 20(3), 281–289. doi:10.1080/09540260801990324.

    Article  PubMed  Google Scholar 

  • State of Palestine Ministry of Health. (2012). Public health policy for Palestinian children. Nablus: State of Palestine Ministry of Health.

    Google Scholar 

  • State of Palestine Ministry of Health. (2014). National health strategy 2014–2016. Nablus: State of Palestine Ministry of Health.

    Google Scholar 

  • Taha, G. R. A., & Hussein, H. (2014). Autism spectrum disorders in developing countries: Lessons from the Arab world. In V. B. Patel, V. R. Preedy, & C. R. Martin (Eds.), Comprehensive guide to autism (pp. 2509–2531). New York: Springer. doi:10.1007/978-1-4614-4788-7_98.

    Chapter  Google Scholar 

  • Thomas, K. C., Ellis, A. R., McLaurin, C., Daniels, J., & Morrissey, J. P. (2007). Access to care for autism-related services. Journal of Autism and Developmental Disorders, 37(10), 1902–1912.

    Article  PubMed  Google Scholar 

  • United Nations. (2012). The humanitarian impact of Israeli settlement policies. East Jerusalem: United Nations Office for the Coordination of Humanitarian Affairs.

    Google Scholar 

  • United Nations Relief and Works Agency. (2012). Socio-economic and food security survey. Retrieved from http://www.unrwa.org/sites/default/files/Socio-Economic%20%26%20Food%20Security%20Survey.pdf

  • United Nations Relief and Works Agency (UNRWA). (2014). Where we work: West Bank. Retrieved from http://www.unrwa.org/where-we-work/west-bank

  • United States Central Intelligence Agency [CIA]. (2014). The world factbook: West Bank. Retrieved from https://www.cia.gov/library/publications/the-world-factbook/geos/we.html

  • Vohra, R., Madhavan, S., Sambamoorthi, U., & St Peter, C. (2014). Access to services, quality of care, and family impact for children with autism, other developmental disabilities, and other mental health conditions. Autism: The International Journal of Research and Practice, 18(7), 815–826. doi:10.1177/1362361313512902.

    Article  Google Scholar 

  • World Bank. (2006). The role and performance of Palestinian NGOs in health, education and agriculture. Retrieved from http://unispal.un.org/pdfs/NGOreportDec06.pdf

  • World Bank. (2013). West Bank and Gaza: Area C and the future of the Palestinian economy (No. AUS2922). Washington, DC: World Bank.

    Google Scholar 

  • World Bank. (2015). Data: West Bank and Gaza. Retrieved from http://data.worldbank.org/country/west-bank-gaza

  • World Health Organization. (2013). Right to health: Barriers to health access in the occupied Palestinian territory, 2011 and 2012 (No. WHO-EM/OPT/004/E). Geneva: World Health Organization.

    Google Scholar 

  • Young, W. C. (1997). Families and the handicapped in northern Jordan. Journal of Comparative Family Studies, 28(2), 151–169.

    Google Scholar 

  • Zeglam, A. M., & Maound, A. J. (2012). Prevalence of autistic spectrum disorders in Tripoli, Libya: The need for more research and planned services. Eastern Mediterranean Health Journal, 18(2), 184–188.

    PubMed  Google Scholar 

Download references

Acknowledgments

This research was supported in part by grants from the Anne-Linda Furstenberg Fund for Qualitative Research and UNC Center for Global Initiatives. Drs. Susan Parish, Kathleen Rounds, Allam Jarrar, and Gary Mesibov provided helpful advice on the conceptualization and implementation of this study. We also acknowledge the individuals in the West Bank who graciously contributed their time to this research.

Author Contributions

SD conceptualized the study, supervised data collection, conducted data analysis and interpretation, and drafted the manuscript. KB performed the literature search, assisted in data analysis and interpretation, and contributed to manuscript preparation. Both authors revised and approved the final version of the manuscript.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sarah Dababnah.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Dababnah, S., Bulson, K. “On the Sidelines”: Access to Autism-Related Services in the West Bank. J Autism Dev Disord 45, 4124–4134 (2015). https://doi.org/10.1007/s10803-015-2538-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10803-015-2538-y

Keywords

Navigation