Skills compound
A child who cannot yet ask for what they want finds another way to be understood, and that way is usually harder to live with.
1 · The cost of waiting
A year of waiting is not a year paused
Development does not hold still while a child waits for a place, a diagnosis, or the money. It carries on, just along a different path.
1 in 31
Children identified with autism in the United States in 2022. This is not a rare condition.
CDC, ADDM Network, 2025 [1]
Age 2
Autism can be reliably identified from around this age. Most children are diagnosed years later.
ADDM surveillance [1]
21%
Of children who left ABA within two years had met their goals. Four in five stopped for other reasons.
J Dev Behav Pediatr, 2022 [2]
“Research shows that early intervention services can greatly improve a child’s development and result in better outcomes.”
Centers for Disease Control and Prevention [8]
What a delay actually costs
Behaviour hardens
A pattern that has worked for three years takes longer to change than one that is three months old.
School gets harder to enter
The gap between a child and their classroom widens with time, and inclusion gets harder to arrange.
The family pays too
Stress rises with unmet need, and a stressed household is a harder place to practise new skills.
And the part that should give you hope
Children who completed two years of therapy made clinically significant gains, including those who began with the greatest needs [2]. Families are not losing therapy because it failed them. They lose it when they run out of money, or time, or hope.
2 · The gap in Pakistan
Help exists. Reaching it is the hard part.
Pakistan has never run a national prevalence study. The Pakistan Autism Society estimates 350,000 to 400,000 children, and nobody knows the real number. A child who is never counted is never planned for.
1 in 127
People worldwide are autistic. In 2021 that was an estimated 61.8 million people.
Global Burden of Disease 2021 [4]
240 million
Children live with a disability. That is 1 in 10 children worldwide.
UNICEF, 2021 [9]
49%
More likely never to have attended school, for a child with a disability.
UNICEF, 2021 [9]
1 year
The average wait, in one Pakistani study, between a first consultation and a specialist centre.
J Coll Physicians Surg Pak, 2019 [5]
564
Psychiatrists for more than 231 million people. That is 0.24 for every 100,000.
Int J Ment Health Syst, 2024 [6]
2
Outpatient mental health facilities for children and adolescents, reported for the whole country.
WHO Mental Health Atlas 2020, in [6]
In the Pakistani study of 76 children, half came from affluent families. Reaching a specialist should not depend on that.
3 · What it costs a family
Therapy is not a luxury. It is only priced like one.
In Islamabad a therapy session starts at around PKR 1,500 and runs past PKR 3,000. A child with high support needs often needs five or six sessions a week.
The cheapest month5 sessions a week at PKR 1,500
PKR 30,00074% of the minimum wage
A month at the intensity many children need6 sessions a week at PKR 3,000
PKR 72,000177% of the minimum wage
The dashed line is the monthly minimum wage, PKR 40,700 [7]
None of that includes transport five or six days a week, the assessment, school, or equipment. Nor does it count the parent who gives up paid work to make the schedule possible.
13%
Of children referred for ABA never started it.
J Dev Behav Pediatr, 2022 [2]
$2.4 million
Estimated lifetime cost of support for an autistic person with an intellectual disability in the United States.
JAMA Pediatrics, 2014 [3]
Far more
Parenting stress, reported by parents of autistic children than by parents of other children.
Meta-analysis, 2013 [10]
A study of 334 children referred for ABA found that 13% never started, a third had stopped within a year, and more than half were gone by two years. Only 21% of those departures happened because a child had met their goals [2]. Figures are calculated at four weeks to a month, which understates a real month. Session rates and intensity are from The Project Hope’s own knowledge of the Islamabad market, August 2026.
4 · How you can help
They arrive exhausted. Not dramatic, not weeping, just tired in a way that has become ordinary to them.
A mother who has stopped being invited places because outings end badly.
A father who has stopped asking what the plan is because nobody has given him one.
Parents who have been made to feel that their child’s difficulty is a verdict on their parenting, and who have started to believe it.
So parents ration it. They go fortnightly instead of twice a week, then monthly, then they stop and do not tell anyone why.
Muhammad Farooq E Azam Awan, founder, in Why The Project Hope exists
You can be the reason a child does not wait
A number of places here are funded rather than charged for (therapy or schooling, whichever a child needs) and they are awarded on need. Every one of them is paid for by someone. It could be you.
Help fund a place
Therapy fees and training income cover part of the cost. Donations cover the rest. Talk to us and we will tell you what is needed and where it goes.
Ask about fundingGive a few hours
A few hours a month, at our centres or beyond them. You do not need a clinical background.
Volunteer with usBring your company
Team volunteering days, CSR partnerships, or sponsoring a therapy place or a classroom’s materials.
Partner with usTell a family who is waiting
Send them to the page that helps parents work out where to start. The first conversation costs nothing.
Share Start hereHope is not a feeling you hand to a family. It is a path you show them, and then walk with them.
Sources
- Shaw KA, Williams S, Patrick ME, et al. Prevalence and Early Identification of Autism Spectrum Disorder Among Children Aged 4 and 8 Years, Autism and Developmental Disabilities Monitoring Network, 16 Sites, United States, 2022. MMWR Surveill Summ. 2025;74(2):1–22. cdc.gov
- Choi KR, Bhakta B, Knight EA, et al. Patient Outcomes After Applied Behavior Analysis for Autism Spectrum Disorder. J Dev Behav Pediatr. 2022;43(1):9–16. pubmed.gov
- Buescher AVS, Cidav Z, Knapp M, Mandell DS. Costs of Autism Spectrum Disorders in the United Kingdom and the United States. JAMA Pediatr. 2014;168(8):721–728. pubmed.gov
- GBD 2021 Autism Spectrum Collaborators. The global epidemiology and health burden of the autism spectrum: findings from the Global Burden of Disease Study 2021. Lancet Psychiatry. 2025;12(2):111–121. pmc.ncbi.nlm.nih.gov
- Nadeem G, Bibi A, Suhaib B, Ahmed S, Ahmed S, Ali S. Clinical and Demographic Features of 76 Children with Autism Spectrum Disorders at a Centre in Pakistan. J Coll Physicians Surg Pak. 2019;29(4):390–391. pubmed.gov
- Dayani K, Zia M, Qureshi O, Baig M, Sabri T. Evaluating Pakistan’s mental healthcare system using the WHO assessment instrument for mental health systems (WHO-AIMS). Int J Ment Health Syst. 2024;18:32. Table 1 reports WHO Mental Health Atlas 2020 figures. doi.org
- Federal Budget 2026–27: minimum monthly wage for unskilled workers raised from PKR 37,000 to PKR 40,700. Daily Pakistan, 12 June 2026. dailypakistan.com.pk
- Centers for Disease Control and Prevention. Accessing Services for Autism Spectrum Disorder. Updated 15 April 2025. cdc.gov
- UNICEF. Nearly 240 million children with disabilities around the world, UNICEF’s most comprehensive statistical analysis finds. 10 November 2021. unicef.org.uk
- Hayes SA, Watson SL. The impact of parenting stress: a meta-analysis of studies comparing the experience of parenting stress in parents of children with and without autism spectrum disorder. J Autism Dev Disord. 2013;43(3):629–642. pubmed.gov
When you are ready
Start with a conversation
Tell us about your child, or ask how to help fund a place. The first conversation costs nothing.