The teacher was halfway through explaining a lesson when she suddenly stopped. A piece of chalk slipped from her fingers and clattered to the floor as her eyes fixed on a child sitting in the corner of the classroom. The boy had begun rocking his chair back and forth, his hands pressed tightly over his ears, whispering to himself as the rising noise of the classroom and his chair rocking began to overwhelm him.

A few students turned to look. Some whispered. A couple laughed. To many in the room, it appeared as if the child was being disruptive or disobedient. In reality, he was experiencing sensory overload — a silent distress response common in children with autism.

The teacher felt panic rise within her. She had no training to recognise autism, no support staff to assist her, and no guidance on how to adjust her lesson for a child whose brain processed sound, movement, and stress differently. Faced with a crowded classroom and constant pressure to maintain control, she was left to manage the situation alone.

By the end of the day, exhaustion had replaced panic. Sitting alone in the staff room, she wondered how long she could continue. For the first time, the thought of leaving her job crossed her mind — not because she lacked compassion, but because she felt unequipped to teach children with needs she had never been trained to understand.

As her frustration deepened, an uncomfortable question emerged — one now confronting schools and families across Pakistan: should autistic children be placed in mainstream classrooms when the education system itself is unprepared to support them?

This is not an isolated incident. It is a daily reality unfolding in classrooms, homes, and school offices, where inclusion is promised but preparation is missing, and where autistic children are caught between good intentions and harsh realities. Across Pakistan, autism is frequently misunderstood, stigmatised, and inadequately supported, making education decisions fraught with emotion, confusion, and conflicting interests. Even highly educated parents struggle to accept a proper autism diagnosis, often attributing their child’s behaviour to vaccines or other external factors.

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition that affects a person’s behaviour, communication, and social skills. It is most commonly diagnosed in children between the ages of three to 12. Autism is a spectrum disorder, meaning that every individual exhibits different symptoms and levels of severity, which can range from mild challenges to significant needs for support.

Estimates suggest over 350,000 children in Pakistan are affected by ASD, with prevalence rates showing approximately 1 in 89 to 1 in 100 children. Studies indicate a 1.3 percent to 1.45 percent prevalence rate in major cities like Karachi and Lahore. The condition, which has rising diagnosis rates, shows a 4.4:1 male-to-female ratio.

Despite growing awareness, many people still rely on myths and misconceptions. One common myth is that autism is a disease that can be cured, when in reality it is simply a different way the brain functions, manageable through therapies. Another misconception is that autism is a mental illness; while individuals with ASD may develop conditions like schizophrenia or anxiety later in life, autism itself is not a mental disorder.

Some believe only boys can have autism, but recent data shows a male-to-female ratio of approximately 3:1, and girls are often underdiagnosed because they mask symptoms or are misdiagnosed. Others blame bad parenting or childhood vaccines. Autism is also often confused with speech delays or other behavioural challenges. Autistic children may use robotic speech, echolalia, avoid eye contact, struggle with social cues, display repetitive behaviour, and have sensory sensitivities to sound, light, and textures. These symptoms vary widely; some children face mild challenges, while others require extensive support from parents and caregivers.

Many people mistakenly assume that autistic individuals are unintelligent or incapable, but in reality, they are often highly intelligent, with unique learning styles. Popular culture, such as Korean dramas, has shown characters with high IQs and photographic memory struggling with social interactions and empathy, reflecting real-life challenges faced by autistic individuals.

Yet, Pakistan’s education system continues to operate on a one-size-fits-all model, leaving autistic children either misplaced in mainstream classrooms or isolated in institutions that often prioritises profit over care.

In many classrooms, such children are misunderstood and treated harshly. Teachers label them as weak or lazy students, scold them for not paying attention, and in some cases even resort to physical punishment.

The idea of admitting autistic children into normal schools is rooted in good intentions. Inclusion promises social exposure, reduced stigma, and equal opportunity. However, inclusion without preparation becomes neglect disguised as progress. Most mainstream schools in Pakistan lack trained special educators, classroom aides, behavioural therapists, or even basic awareness about autism. Teachers are expected to manage large classes, rigid curricula, and exam pressures, adding special needs without support overwhelms them emotionally and professionally.

Teachers are rarely at fault. Many want to help but simply do not know how. They are not trained to recognise sensory overload, communication difficulties, or meltdowns. When an autistic child cries, refuses to sit still, avoids eye contact, or reacts aggressively, it is often labelled as misbehaviour rather than distress.

During an interview, Isha Shaikh, principal of a school in Islamabad, discussed the challenges faced by children on the autism spectrum in mainstream education. “Autism exists on a spectrum, and higher-functioning cases may not be immediately noticeable,” she says. “Our school primarily admits children with mild autism, who have some verbal skills, and medium to high functionality, with careful attention to classroom balance so teachers can support all students.”

Shaikh emphasised the urgent need for trained teachers and support staff, noting that children who initially show aggression or social difficulties often improve with proper counselling and guidance. “Developmental delays such as poor handwriting, speech delays, or retained reflexes are sometimes mistaken for autism,” she explains. “While factors like excessive screen time can affect development without causing autism.”

She stressed the importance of professional evaluation. “Some children struggle due to late schooling rather than autism,” says Shaikh. “Teachers are often the first to notice developmental concerns, which should be referred for assessment. Early diagnosis, parental involvement, and collaboration between trained educators and professionals are essential for successful inclusion of autistic children in mainstream schools.”

Moreover, parents face a painful dilemma. Fearing rejection, discrimination, or lowered expectations, many hide their child’s diagnosis when enrolling them in school. Some hope their child will eventually cope if treated like everyone else.

This secrecy harms everyone. Schools remain unable to respond appropriately, systems avoid responsibility, and the child suffers the most; misunderstood, unfairly punished, and emotionally exhausted from constantly masking their needs in an environment that offers no accommodation.

Psychologist Erum Khan raised serious concerns about placing autistic children especially those with moderate to severe needs in mainstream schools without proper support. “It is emotionally harmful for children and overwhelming for teachers,” she says. She noted that most teachers in Pakistan lack training in autism awareness, behaviour management, and sensory needs, making inclusion unrealistic.

She criticised some private schools for exploiting “inclusive education” as a business model without having trained staff or systems in place. While stressing that mainstream schooling should not be the default, Khan emphasised the need for autism awareness training for all teachers to reduce stigma and mislabelling. “We need special schools, early intervention, and better-equipped therapy centres, with mainstream inclusion considered only when the child is ready.”

At the same time, a troubling reality exists within private education. Many schools admit autistic children but fail to provide the support such students require. Although they do not refuse admission or charge higher fees, there is often a lack of trained staff, classroom accommodations, and structured assistance. Consequently, parents are forced to arrange shadow teachers, while children remain excluded from activities, left unattended, or quietly pressured to leave when their needs become more visible.

In many cases, shadow teachers are untrained individuals with no background in psychology or special education. They are underpaid, unsupported, and expected to manage complex needs without guidance. Inclusion becomes a marketing slogan rather than a genuine educational commitment.

The emotional toll on parents is immense. Mothers, especially, carry the burden of guilt, blame, and exhaustion. “It is difficult for me to provide answers to all kinds of questions, people ask me,” says Rehana Vakeel*. “They relentlessly question me about vaccines, parenting styles, and family history as if autism is a personal failure of mine. It is this kind of social stigma that isolates families, forcing them into silence and self-doubt.”

One of the most persistent and damaging myths surrounding autism is the belief that vaccines cause the condition. Shansay Khan*, a mother of two autistic children, is deeply concerned that when she was living in the United States, a particular vaccine might have caused autism in her children. “Both my children appeared developmentally typical before the vaccination, which makes me think that the diagnosis has something to do with immunisation.” Such beliefs are common and stem from fear, grief, and the human need to find answers.

However, decades of large-scale, high-quality scientific studies conducted across multiple countries have conclusively found no link between vaccines and autism. Medical experts confirm that autism is influenced by genetic and biological factors that begin before birth. Promoting vaccine myths not only misinforms parents but also endangers public health by discouraging essential immunisation.

Instead of chasing false causes, society must focus on real solutions early diagnosis, teacher training, family support, and policy reform.

In recent years, there have been encouraging signs of state-level recognition. The establishment of the Maryam Nawaz School and Resource Centre for Autism marks a significant milestone. It is Pakistan’s first government-run school dedicated exclusively to autism, launched under the leadership of Punjab Chief Minister Maryam Nawaz. The centre caters to children aged three to 16 years and offers structured treatment, education, and therapeutic support under one roof.

The school provides age-appropriate learning environments, sensory gardens, speech and sound therapy, vocational training, and IT skill development. More importantly, it represents a shift in state responsibility — acknowledging autism not as a private burden but as a public concern. Such initiatives set a precedent for other provinces, demonstrating that inclusive education requires investment, expertise, and long-term commitment.

At the federal level, autism has also begun to enter policy discussions. Under various social welfare and health programmes, government initiatives have emphasised disability inclusion, early screening, and rehabilitation services. While implementation remains uneven, recognition at the highest level of governance is a necessary first step. Without political will, inclusion remains a hollow promise.

Yet, specialised schools alone cannot be the answer. The real question is not whether autistic children should attend mainstream schools or special institutions but under what conditions. For some children, mainstream classrooms with trained teachers, flexible curricula, and support staff can be empowered. For others, specialised settings offer safety, routine, and dignity.

Parents play a crucial role in developing their child’s confidence and helping them navigate daily life. They should not rely solely on schools, as many mainstream institutions remain unprepared, overburdened, or more focused on managing numbers than providing genuine support. Parents must also closely observe and understand their child’s behaviour, seek professional guidance, and avoid hiding concerns or assuming that challenges will disappear once the child reaches college or university. Early diagnosis is essential, ideally between 18 and 24 months, as timely intervention and appropriate therapies can significantly improve the quality of life for children with ASD.

While no medicine or vaccine exists to cure autism, therapies like speech therapy, occupational therapy, and behavioural interventions can make a meaningful difference.

In Pakistan, autism is increasingly recognised, and several NGOs, including the Autism Society of Pakistan, Pakistan Centre for Autism, and ASD Welfare Trust are working hard to support affected children. The government has also taken steps, establishing centres of excellence, specialised schools, and awareness programmes to provide world-class education, therapy, professional training, and transportation for autistic children, aiming to give them the support and confidence they need to thrive.

Pakistan stands at a crossroads. Autism can no longer remain hidden behind closed doors, mislabelled as bad behaviour, or exploited for profit. Teachers must be properly trained, parents must be supported, and schools must be regulated, with regular seminars and awareness programmes conducted to build understanding at every level. Inclusion should not be a privilege for those who can pay extra, but a right grounded in dignity, empathy, and informed practice.

The child rocking his chair in the classroom corner is not a disruption. He is a reminder of a system that has yet to learn how to listen. Until classrooms become spaces of empathy rather than endurance, the debate over inclusion will remain incomplete. Autism does not demand special treatment; it demands informed humanity.

All facts and information are the sole responsibility of the writer

Rabia Khan covers social issues, literature, and cultural values of Pakistan. She can be reached at rabiayousufsai26@gmail.com

Eisha Anwar is a microbiology graduate and writer focused on social, education and neurodiversity issues. She can be reached at eishaa165@gmail.com