Early detection, lasting impact: Transforming autism care in the UAE

Sahil Maria, a Board-Certified Behavior Analyst (BCBA) and Senior Program Specialist at the New England Center for Children Clinic – Dubai, examines emerging diagnostic protocols and intervention efficacy for autism spectrum disorder in the UAE. This analysis highlights critical neurological markers, evidence-based therapeutic approaches, and the implementation of multidisciplinary frameworks that significantly enhance developmental trajectories when applied during key windows in early childhood.

April was marked globally as Autism Awareness Month, dedicated to building understanding, promoting inclusion, and advocating for the rights of autistic indi­viduals. In the United Arab Emirates, the importance of early diagnosis and inter­vention has gained focus in recent years, supported by inclusive care, public aware­ness campaigns, and efforts to enhance ac­cess to specialised services. These services ensure families are equipped with the tools they need to help their children thrive in society. Early detection of Autism Spec­trum Disorder (ASD) allows for timely, evidence-based interventions that can significantly improve the developmental trajectory of children.

Early signs of autism
Before exploring early diagnosis, it’s im­portant to understand the signs that may appear in a child’s first years. While symp­toms can vary widely, they typically begin to emerge between 12 and 24 months, though subtle differences in development may be observable earlier.

Research has indicated that some early indicators, such as reduced eye contact, limited social smiling, and minimal re­sponse to social cues, can be seen as early as 6 months, though not reliably diagnosed at that stage. By around 12 months, signs like a lack of response to name, absence of pointing or gesturing, and limited interest in social interaction may become more ap­parent. By 18 to 24 months, patterns in be­haviour, communication, and play often be­come clearer, prompting further evaluation.

Some common early signs include:

• Limited eye contact: difficulty in making or maintaining eye contact.
• Delayed speech and communication: delays in babbling by 12 months, speaking words by 16 months, or forming simple phrases by the age of two. Some children may also lose previously acquired language or social skills.
• Repetitive behaviours: This includes movements such as hand-flapping, rock­ing, or spinning objects.
• Unusual sensory responses: height­ened or reduced sensitivity to sound, tex­ture, or light.

There is no single behaviour that con­firms autism; rather, it’s the combination and intensity of these traits that may indi­cate the need for a professional diagnosis and evaluation.

Early diagnosis and the importance of timely intervention
Once early signs become apparent, the next essential step is obtaining a timely and accurate diagnosis. Decades of clinical research and practice have shown that the earlier a child with autism is diagnosed and begins intervention, the greater the potential for positive developmental outcomes. Early diagnosis has been associated with improvements in communication, learning, social interaction, and adaptive behaviour, when treatment is started shortly after diag­nosis. Best treatment gains have been found when intervention begins near age 2. Early intervention has also been subsequently found to reduce the cost of special educa­tion services across the lifespan.

Historically, autism diagnoses were often delayed until school age. Today, with in­creased awareness and enhanced screening tools, children are being identified earlier, sometimes before the age of two. Routine paediatric check-ups now commonly in­clude developmental milestone checklists that help healthcare providers and families detect potential concerns early on.

A formal diagnostic evaluation is con­ducted by qualified professionals such as developmental paediatricians and psy­chologists. One of the most widely used tools is the Autism Diagnostic Observa­tion Schedule, Second Edition (ADOS­2). This standardised assessment evaluates communication, social interaction, play, and repetitive behaviours through struc­tured activities. When combined with parental input and developmental history, it helps provide a comprehensive profile of the child’s strengths and needs.

In the UAE, increasing public awareness and the expansion of specialised services have improved access to early diagnosis. Paediatricians and interdisciplinary teams
– particularly within integrated healthcare ecosystems like Dubai Healthcare City (DHCC) – are now better equipped to provide multidisciplinary assessments. At centres such as the New England Center for Children (NECC) Clinic – Dubai in DHCC, early screening is directly linked to individualised intervention planning, giving families a structured and supportive path forward.

Specialised treatments and care available
Although no single treatment works for all individuals with ASD, a variety of evidence-based interventions, particularly those grounded in developmental science and behavioural approaches, have been shown to significantly improve outcomes when tailored to each child’s unique needs.

Behavioural and communication-based therapies form the foundation of autism support. These programs typically target:

• Reducing interfering or disruptive be­haviours
• Teaching daily living and self-help skills
• Supporting language and communi­cation development
• Enhancing play, social interaction, and emotional regulation
• Promoting foundational and early academic skills
  
  Among the most well-established ap­proaches is Applied Behaviour Analysis (ABA). ABA relies on structured, measur­able teaching methods to increase desired behaviours and reduce those that may in­terfere with learning and independence. Programs are individualised, data-driven, and adjusted over time to ensure meaning­ful progress. Family involvement is essen­tial. Caregivers are often trained to imple­ment strategies at home, help generalise skills across settings, and actively support their child’s long-term development.

In Dubai, centres such as the NECC Clinic – Dubai in Dubai Healthcare City offer integrated, multidisciplinary treat­ment programmes. Children may receive ABA therapy alongside speech-language therapy and occupational therapy, depend­ing on their individual needs.

For children with communication diffi­culties, speech-language therapy plays an important role in developing both verbal and nonverbal communication. Therapists use personalised strategies to help children express their wants and needs, build vo­cabulary, and enhance their ability to en­gage with others. Occupational therapy, on the other hand, supports the development of fine motor skills, daily living skills, and addresses sensory integration challenges – common areas of need for many children on the autism spectrum.

Families seeking intervention services must ensure the professionals delivering them are appropriately trained and quali­fied. For instance, in the case of ABA, services should be supervised by a Board-Certified Behaviour Analyst (BCBA) or a Qualified Behaviour Analyst (QBA), cre­dentialed by bodies such as the Behaviour Analyst Certification Board (BACB) or the Qualified Applied Behaviour Analysis Credentialing Board (QABA). This en­sures the implementation of ethical, effec­tive, and evidence-based practices. Typi­cally, treatment plans are developed and overseen by trained behaviour analysts, therapists, and technicians, who work col­laboratively to address each child’s unique strengths and challenges.

By recognising the early signs of au­tism and accessing timely, professional support, families can connect to life-changing resources that promote inde­pendence, communication, and quality of life. Early diagnosis and intervention remain key to improved long-term out­comes, and personalised care is central to that success.

In the UAE, growing public aware­ness and expanding access to specialised services are empowering more families to take action. Supported by the coun­try’s continued investment in inclusive healthcare, through ecosystems like Dubai Healthcare City and centres such as the NECC Clinic – Dubai, a more inclusive and supportive future is taking shape for autistic children and their families.

About the author
Sahil Maria is a Board-Certified Behavior Analyst (BCBA) and Senior Program Spe­cialist at the New England Center for Chil­dren Clinic – Dubai. With over ten years of experience in Canada and the UAE, he has worked across clinics, centers, schools, homes, and community settings. Sahil is pas­sionate about the science of human learn­ing and values Applied Behavior Analysis (ABA) for its evidence-based framework to understand behavior and guide meaningful, data-driven intervention.

The NECC Clinic – Dubai
The New England Center for Children (NECC) Clinic Dubai is a branch of the multinational organization helping chil­dren of determination gain skills they need to thrive. Through personalized care and education of students to research and training of staff, the clinic aims to impact as many lives as possible.

Headquartered near Boston, MA (USA), NECC runs consulting and clinic-based ser­vices in Abu Dhabi, Dubai, and Qatar for all nationalities and diagnoses as well as a school for Emirati children in Abu Dhabi. Their expertise is encapsulated in the Au­tism Curriculum Encyclopedia (ACE) ABA Software System that is commercially available to learners worldwide.

Autism in the GCC
Recent epidemiological data reveals striking variations in autism spectrum disorder (ASD) prevalence across Gulf Cooperation Council (GCC) countries, with Qatar reporting the highest rate at 151 per 10,000 individuals, followed by UAE (112), Oman (107), Bahrain
(103), Saudi Arabia (101), and Kuwait (98). These figures position several GCC nations among countries with the highest autism rates globally, surpassing even the United States.

A 2024 systematic review highlights dramatic regional variations, with Saudi Arabia showing prevalence as high as 2.51% in certain studies – a staggering 250-fold increase compared to the lowest recorded rate of 0.01% in Oman from earlier surveys. This pattern of increasing prevalence mirrors global trends, likely reflecting improved awareness and diagnostic capabilities.

This field of research, however, remains critically underdeveloped. “Despite increasing prevalence rates, research about ASD in the GCC region is still limited,” notes a 2023 UAE-focused study. Key methodological concerns include culturally inappropriate assessment tools primarily designed for Western populations and significant heterogeneity in study
methodologies.

Healthcare officials face substantial challenges in addressing this growing public health concern, including establishing culturally-appropriate screening protocols, expanding specialized services, and developing a more robust research infrastructure. Without
strategic investment in these areas, the region risks falling behind in evidence-based autism interventions despite its economic resources.

Genetic determinants of autism
Autism spectrum disorder (ASD) exhibits robust genetic etiology, with twin studies consistently demonstrating heritability estimates between 64% and 93% (Tick et al., 2016). This genetic contribution manifests through several distinct mechanisms operating
concurrently.

High-impact rare variants occur in over 100 genes, with significant contributions from mutations affecting synaptic proteins (SHANK3), chromatin regulators (CHD8), and cell adhesion molecules (NRXN1) (Satterstrom et al., 2020). De novo mutations – genetic alterations absent in parents – account for approximately 30% of simplex autism cases, typically exerting stronger phenotypic effects than inherited variants (Iossifov et
al., 2014).

Structural genomic abnormalities constitute another major contributor, with copy number variations (CNVs) identified in 5-10% of ASD cases. These chromosomal deletions or duplications disrupt multiple genes simultaneously, creating compound genetic effects (Sanders et al., 2015).

Common genetic variants with individually minimal effects collectively contribute substantially to autism risk through polygenic inheritance patterns. Research indicates these common variations may account for 40-60% of ASD liability (Gaugler
et al., 2014).

These diverse genetic factors converge on critical neurodevelopmental pathways affecting synaptic function, transcriptional regulation, and neuronal connectivity during essential developmental periods (Willsey et al., 2013). This genetic heterogeneity explains the phenotypic diversity observed clinically and informs precision medicine approaches.

Clinical applications now include chromosomal microarray analysis and next-generation sequencing panels that identify genetic contributors in approximately 25-40% of ASD cases, enabling more targeted clinical management and improved prognostic insights.