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01

Why now

What a year of waiting actually costs — and what the evidence says about starting sooner.

Read this first

02

Why we fund places

What therapy costs a family in Islamabad, and why families stop before it has finished working.

Read the arithmetic

Why now — a note on waiting

A year of waiting is not a year paused

This is the part most families are never told plainly. 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 — up from 1 in 150 in 2000. This is not a rare condition. It is a common one that most systems are still built to treat as rare. CDC, ADDM Network — published April 2025 [1]
Age 2 Autism can be reliably identified by a trained clinician from around this age. In practice most children are diagnosed years later — and every one of those years is a year of support not given. Consistent finding across ADDM surveillance [1]
21% Of children who left ABA within two years had actually met their goals. The other four in five stopped for reasons that had nothing to do with whether it was working. Choi et al., J Dev Behav Pediatr, 2022 [2]

What a delay actually costs

Nothing dramatic happens on the day you decide to wait. The cost is quiet, and it accumulates.

  • Skills compound, and so does their absence. A child who cannot yet ask for what they want does not simply wait to learn — they find another way to be understood, and that way is usually harder to live with for everyone.
  • Behaviour hardens into habit. What starts as frustration becomes a pattern, and a pattern that has worked for three years takes longer to change than one that is three months old.
  • School gets harder to enter, not easier. The gap between a child and their classroom widens with time, and each year of it makes an inclusive placement more difficult to arrange.
  • The family pays too. Parenting stress rises with unmet need, and a stressed household is a harder place to practise new skills — which is precisely what makes them stick.

And the part that should give you hope

The same study that measured how many families drop out also measured what happened to those who stayed. The children who completed two years made clinically significant gains — including the children who began with the greatest needs.

Read that alongside the 21%. Families are not losing therapy because it failed them. They are losing it because they run out of money, or time, or hope, before it has finished working. Which of those three we can help with, we will.

We do not promise recovery or cure, and you should be wary of anyone who does. What we can say is that starting sooner gives us more to work with, and that the first conversation costs nothing.

Talk to someone this week

Why we give it away

Therapy is not a luxury. It is only priced like one.

Pakistan has never run a national prevalence study. The Pakistan Autism Society estimates 350,000 to 400,000 children; published research is city-specific and does not agree. Nobody knows the real number — which is not a footnote, it is the first problem. A child who is never counted is never planned for.

What we do know is what families here actually pay. In Islamabad a therapy session starts at around PKR 1,500 and runs past PKR 3,000. A child who needs intensive support does not need one session a week. Many need five or six.

PKR 30,000 A month of therapy at the cheapest end — five sessions a week at PKR 1,500. 81% of a full minimum-wage income
PKR 72,000 A month at six sessions a week at PKR 3,000. Common for a child with high support needs, not extreme. 195% — nearly twice that income
PKR 37,000 The monthly minimum wage in Islamabad. The whole household income, for many families. ICT, financial year 2025–26

Read those three numbers together, because that is how a parent reads them. At the lowest possible rate, therapy for one child costs four-fifths of an entire minimum-wage income. At the rate many children actually need, it costs roughly twice that income — and the household still has rent, food, and any other children.

None of it includes transport five or six days a week, the initial assessment, school, or the equipment some children need. Nor does it count the parent who gives up paid work to make the schedule possible, which is often the real cost and never appears on an invoice.

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 — but only 21% of those departures happened because the child had met their goals. The children who stayed made clinically significant gains. Families are not losing therapy because it failed them.

That is the gap this centre exists to close. A number of places are funded rather than charged for — therapy or schooling, whichever a child needs, awarded on need.

Figures are calculated at four weeks to a month, which understates a real month. Session rates and the five-to-six-a-week intensity are from The Project Hope’s own knowledge of the Islamabad market, August 2026. Minimum wage: Islamabad Capital Territory, financial year 2025–26.

Sources

  1. 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
  2. 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
  3. 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

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