The Impact of War on Children with Special Needs and Evidence based coping strategies - השפעות מלחמה על ילדים עם צרכים מיוחדים ודרכי התמודדות מבוססות מדע
- motim51
- 13 hours ago
- 8 min read
Most of the current scientific knowledge regarding how children with special needs cope during war comes from two countries, Ukraine and Israel.
Recently several studies have been published that examined the impact of war on children, with an emphasis on children with special needs and the effective ways of coping in this complex situation, as well as ways to protect the mental well being of children.
Children with special needs in war zones
Children with special needs in war zones show higher rates of distress and mental health disorders compared to their peers, but there are evidence based ways to reduce risks and support coping for both children and caregivers.
What do we know about the impact?
Autistic children in Israel after October 7 2023:
A study from 2025 examined 228 Israeli children (134 autistic, 94 non autistic) within 30 days of the October 7 2023 attack and the war that followed.
Almost all children had some form of war related exposure, but autistic children showed greater worsening in anxiety, especially fear of physical injury, panic attacks and agoraphobia, fear of public places.
Parents of autistic children reported depression, anxiety and stress significantly higher than parents of non autistic children, at levels 2–4 times higher than groups of parents of autistic children before the war, highlighting the need for early identification and targeted support for this group.
In another Israeli study from 2024 of parents of autistic children (ages 3–17 years), 81%-88% scored above the clinical cutoff for post traumatic stress on a child and adolescent trauma screening questionnaire, with autistic preschool children showing significantly higher symptoms than their non autistic peers.
Disruptions such as school closures (23% of autistic children were not in an educational setting) and interruptions in therapies (47%) increased vulnerability, highlighting the importance of maintaining routine and providing adapted support.
Information from around the world:
Across different wars exposure has been consistently associated with post traumatic stress disorder anxiety depression aggressiveness anger physical or verbal violence and increased attention symptoms similar to ADHD among children and adolescents.
Data from conflict zones indicate that PTSD rates among children exposed to war can reach 30%–70% especially under conditions of repeated exposure and displacement from their homes.
Children with developmental disabilities including autism are described as a particularly vulnerable subgroup.
A mapping study on the Russia Ukraine war highlights that children with disabilities living in institutions are at very high risk of exclusion from services and basic protections which requires active identification and adapted support.
Why are children with special needs particularly vulnerable?
Autistic children often have increased sensory sensitivity a strong need for routine and communication challenges. These characteristics make sirens explosions crowding and displacement from home factors that disrupt regulation in these children.
Children’s reliance on structured routines familiar caregivers and specialized educational settings means that school closures evacuation and staff turnover remove key regulatory supports exactly at the moment when stress is at its peak.
Children with disabilities living in institutions are at particular risk when institutions suffer from shortages of resources are evacuated chaotically or become disconnected from supply chains (from research conducted in Ukraine).
What helps? Evidence based principles
Several important principles have been identified in order to maintain children’s mental health during war:
Safety - refers both to physical safety and emotional safety:
Physical safety:
A protected and accessible place that the child knows and understands where to go during a siren who is responsible for them and where there is no immediate danger such as shooting violence or neglect.
For example in many cases children sleeping in the protected room greatly contributes to their sense of physical safety.
Emotional safety:
As much as possible familiar figures such as parents caregivers and familiar staff create emotional safety.
The adults around the children should as much as possible convey relative control consistency and a calming stance. Not denying fear but also not collapsing in front of it.
It is important to provide protection from information overload difficult images background news and disturbing videos on WhatsApp and similar sources.
For autistic children safety also includes sensory protection reducing noise as much as possible for example lowering the alert sound on the phone visual overload or unexpected touch.
Predictable routine -
A child’s mind and emotional state are calmer when the child knows what is going to happen especially during war situations in which everything feels chaotic.
Here are several principles for a daily routine at home or in a residential setting:
- A fixed time for waking up changing clothes not staying in pajamas and eating breakfast.
- Studying in Israel learning during emergency periods takes place on Zoom. Although the learning is not always effective from a didactic perspective the regular and stable meeting in which children see familiar faces of friends and educational staff has very important psychological value. It is an event that creates an island of stability during a chaotic event such as war.
For autistic children continuity of educational and therapeutic frameworks even in a reduced form or remotely has been found to be critical for maintaining family quality of life.
- Board games or shared movement activities can reduce tension and improve mood.
- Screen time is a sensitive issue in routine and even more so during emergencies. Children will spend more time than usual on screens this is okay natural and human and parents also need quiet and rest. At the same time it is recommended to set fixed times even if they are longer than usual. Screen time can also be divided into defined periods in the morning at noon and in the evening.
- It is recommended to maintain the regular bedtime routine including a shower dinner and if customary reading a story or in the case of older children reading a book independently before sleep.
The goal is to create stability within chaos even if there are sirens and evacuation there are parts of the day that are predictable and consistent.
Responsive and sensitive parents -
The child needs an adult who notices signals of distress understands their needs and responds to them in a timely and adapted way.
This is one of the central components in maintaining children’s psychological resilience during war and these are the recommended principles and emphases:
Recognizing the signs: identifying that the child is overwhelmed distressed withdrawn struggling to regulate not only when they already explode.
Interpreting the signs: understanding whether it is anxiety sensory overload difficulty with change hunger or fatigue. Parents know their children best!!
Responding in an adapted way: sitting next to the child speaking calmly and quietly touching only if it helps them.
Offering choices such as "do you want to lie down with a blanket or sit next to me?", "do you want headphones or to put on quiet music?".
Regulating together: breathing a familiar game or a transitional object.
For children with communication difficulties:
Use alternative communication methods (pictures a communication board gestures) to understand what the child feels and wants.
Pay special attention to changes in behavior as a sign of distress such as increased aggression avoidance or an increase in repetitive movements.
The goal: that the child does not feel alone with the anxiety. There is a consistent figure who responds to them and does not ignore collapse or become frightened by them.
Health and nutrition as a foundation for mental health in emergencies
This may sound technical and obvious but for developing brains and especially in situations of trauma it is a foundation for mental health.
Health:
- Access to regular medications ADHD epilepsy psychiatric medications and maintaining treatment continuity as much as possible in order not to add further difficulties in regulation.
- Treatment of acute illnesses such as tooth pain stomach pain asthma. Physical pain can mix with anxiety.
- Sleep is very important for mental health therefore as much as possible it is recommended to maintain fixed sleep times a bedtime routine and reduce screens about two hours before sleep.
Nutrition:
- Regular meals as balanced as possible with fluids even if the menu is limited.
- For children who are selective in eating it is recommended to prepare in advance foods that the children are willing to eat even in an emergency.
- Avoiding as much as possible excessive consumption of sugar and caffeine which may increase hyperactivity and anxiety.
If the child does not sleep is hungry is sick or without medication any emotional intervention will be much less effective.
Protecting parents -
- Reviews show that parents mental health and quality of caregiving are key protective factors that buffer between exposure to war and child symptoms.
- Receiving psychosocial support maintaining social connections and economic security are the factors found to be most important in protecting parents mental health.
References:
Barbic, S., Lochman, J. E., Tol, W. A., Jordans, M. J. D., et al. (2026). Evidence-based mental health interventions for children in fragile and humanitarian settings: An individual participant data meta-analysis. Evidence-Based Mental Health. Advance online publication.
Doron, G., Gordon, I., Tenenbaum, E. J., & colleagues. (2025). Psychological distress in autistic and non-autistic Israeli children following terrorism and war. European Child & Adolescent Psychiatry. Advance online publication.
Hunt, X., Betancourt, T., Pacione, L., Elsabbagh, M., & Servili, C. (2021). Commentary: children with developmental disorders in humanitarian settings: a call for evidence and action. DOI: https://doi.org/10.33682/6vgm-5n34
Karni-Visel, Y., Roth, D., Lev, S., & Werbeloff, N. (2025). Quality of life and mental health in families of children with developmental disabilities during wartime. Psychological Trauma: Theory, Research, Practice, and Policy, 17(7), 1434–1442. https://doi.org/10.1037/tra0001941
Kovacs, M., Dovbysh, S., & colleagues. (2023). Change in child mental health during the Ukraine war. European Child & Adolescent Psychiatry, 32(7).
McElroy, E., Hyland, P., Shevlin, M., Karatzias, T., Vallières, F., Ben-Ezra, M., ... & Martsenkovskyi, D. (2024). Change in child mental health during the Ukraine war: evidence from a large sample of parents. European child & adolescent psychiatry, 33(5), 1495-1502. doi: 10.1007/s00787-023-02255-z
Rachamim, L., Aloni, R., Mualem-Taylor, H., Glickman, O., Goodman, A., & Laor, N. (2025). “Children of war”: examining the associations between war exposure, maternal PTSD, and continuous traumatic stress on Israeli children’s PTSD. Research on Child and Adolescent Psychopathology, 53(7), 1047-1059. doi: 10.1007/s10802-025-01321-1
Rozenblat, S., Nitzan, T., Matz Vaisman, T., Shusel, R., Rum, Y., Ashtamker, M., Golan, O., Dinstein, I., & Koller, J. (2024). Autistic children and their parents in the context of war: Preliminary findings. Stress and Health, 40(5), e3442. https://doi.org/10.1002/smi.3442
Sennersten, F., Frogh, S., Påhlsson, S., Wladis, A., Alvinius, A., & Bäckström, D. (2025). The Russo-Ukrainian War’s toll on paediatric health during the first two years and future research directions: a scoping review. Communications Medicine, 5(1), 431. doi: 10.1038/s43856-025-01190-1
Shaked-Ashkenazi, S., Bar, I., Oliver-Aronson, L., Horesh, D., Eden, S., & Golan, O. (2025). Psychological distress in autistic and non-autistic Israeli children exposed to war and terrorism. Journal of Psychiatric Research, 188, 266-270. DOI: 10.1016/j.jpsychires.2025.05.073
Yildirim, S., Gutierrez-Torres, M. A., Byansi, W., Ventevogel, P., Bosqui, T., & Betancourt, T. S. (2026). Evidence based mental health interventions for children in fragile and conflict affected settings: expanding reach and system strengthening. bmj, 392. doi: 10.1136/bmj-2025-086043
🟢 For all updates on autism and events at our center, join our quiet WhatsApp group 🟢
Comments