When the ground shakes: Psychosocial impacts of earthquakes on children with autism and a call for neuro-inclusive disaster response.

BACKGROUND: Natural disasters pose disproportionate challenges for children with autism spectrum disorder and co-occurring intellectual disability (ASD + ID), whose sensory sensitivities and reliance on routines heighten vulnerability in crisis situations. OBJECTIVE: This qualitative study examines the psychosocial impacts of the February 6, 2023 earthquakes in Türkiye, focusing on children with ASD + ID and their families across the preparedness, response, and recovery phases of disaster management. METHOD: Data were collected through focus group interviews with 28 parents residing in the three most severely affected provinces (Kahramanmaraş, Hatay, and Adıyaman) and analyzed using reflexive thematic analysis in NVivo 14. RESULTS: The findings reveal substantial gaps in disaster preparedness, emergency shelter conditions that failed to accommodate sensory needs, and the collapse of essential support services, all of which intensified psychological distress for both children and caregivers. Behavioral regression, heightened anxiety, and sleep disturbances were among the most frequently reported outcomes. CONCLUSIONS: The trauma experienced by children with ASD + ID cannot be explained solely by earthquake exposure; it is closely linked to structural deficiencies in disaster response systems. The risk of diagnostic shadowing, whereby trauma responses are misattributed to pre-existing disability, poses a significant clinical concern. Findings support the urgent integration of disability-inclusive, sensory-informed approaches into national disaster management frameworks.