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Autistic spectrum disorders (ASDs)

Autistic spectrum disorders (ASDs) are a group of lifelong conditions that affect how a person communicates with and relates to other people.

This factsheet is relevant for both parents of children with an ASD and adults who have the condition. However, for simplicity, we will refer to your child throughout.

ASDs are a group of conditions that affect how your child develops. They include autism and Asperger’s syndrome. The word 'spectrum' is used because, although many children share similar difficulties, the way that these affect them can vary. So, your child may have mild symptoms, or they may be more severely affected.

Around one in 100 people have an ASD. Around half of people with an ASD also have a learning disability. Boys are more likely to be diagnosed with an ASD than girls.

Generally, children who have an ASD don’t develop the social and language skills that other children of the same age do. As a result, they find it difficult to relate to other people and to build relationships. Children with an ASD may also have unusual, repetitive behaviour and learning disabilities.

Autism

Children with autism have difficulty communicating and interacting with others. They also find it hard to understand what other people are thinking or feeling, or to predict what will happen next. Some children with autism may have a learning disability, such as dyslexia or dyspraxia, which affects co-ordination and movement.

Asperger syndrome

Asperger syndrome is a type of autism. Children with Asperger syndrome find it hard to read the signals that other people give, such as facial expressions, body language and tone of voice. This makes communication and interaction difficult and can make children feel anxious and confused. If your child has Asperger syndrome he or she will generally have fewer problems with talking and language than a child with autism. They will generally have average or above average intelligence.

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  • Symptoms Symptoms of autistic spectrum disorders

    If your child has an ASD, he or she will have symptoms that affect the way he or she communicates. Their social skills, interests and behaviour may also be affected. How your child is affected can vary widely. Some children are very mildly affected and need little special support, whereas other children are severely affected and need a lifetime of special support.

    You may notice some of the symptoms and behaviour of ASDs when your child is very young. However, sometimes symptoms don’t become obvious until your child experiences new social settings, such as going to school.

    Social communication

    Children with an ASD don’t develop the usual ways to communicate using speech or non-speech skills that other children of the same age do. Your child may have trouble understanding the meaning of spoken or written language. For example, your child may:

    • not respond to you when you speak to them
    • use words correctly but not really understand what they are saying
    • not make eye contact
    • not understand or use gestures

    Your child may take words exactly as they mean – that is, he or she will have a very literal sense of language and won’t be able to understand jokes or sarcasm. He or she may also find it difficult to read body language and facial expressions.

    Children with severe autism may not speak at all, but can be helped to communicate in other ways, such as through signing or using pictures.

    Social skills

    Children with autism often find it hard to recognise or understand what other people are feeling and may have trouble expressing their own feelings. Your child may find it difficult to engage with other people, make friends and get on well with their peers. They may be unable to cope with new situations. For example, if your child has an ASD he or she may:

    • not look for comfort from other people, even when distressed
    • prefer to spend time on his or her own
    • find it difficult to accept simple social rules
    • behave strangely because he or she can’t express how they are feeling

    Behaviour and interests

    Your child may have problems seeing the world from someone else’s point of view and predicting what someone might do. This makes the world feel unpredictable and your child may cope with this by developing strict routines. He or she may become distressed if these routines aren’t followed or impose those routines on other people.

    Children with an ASD may show very little or no interest in play that involves pretending. Instead, they may be more interested in repetitive behaviours, activities and interests.

    Other symptoms

    Apart from problems that affect your child’s communication, social skills, interests and behaviour, he or she may also be over- or under-sensitive to sight, sound, smell, touch and taste.

    Many children with an ASD also have other conditions such as attention deficit hyperactivity disorder (ADHD), dyspraxia (difficulty organising thoughts and movements) or dyslexia.

  • Diagnosis Diagnosis of autistic spectrum disorders

    If you notice your child might be showing signs of an ASD, contact your GP or health visitor.
    Your GP will ask about your child’s behaviour and. If your GP thinks your child may have an ASD, he or she may refer you to a specialist or child development centre. Your child may have more tests, interviews and examinations. There are a number of different assessments which can be used to assess your child’s behaviour and how they interact with other people.

    You and your child may see a number of different people including a paediatrician, child psychiatrist, speech therapist, occupational therapist and psychologist. This can mean having several appointments over several weeks.

    After the assessments you may get a detailed diagnosis report, which should state clearly what the diagnosis is.

  • Treatment Treatment of autistic spectrum disorders

    There isn’t a cure for ASDs, however, there are many different ways that your child can be helped to manage. These are called interventions and are treatments or therapies which aim to improve the quality of life for you and your child. The best treatment for your child will depend on how he or she is affected. Individual therapies can be tailored to your child.
    Some of the main approaches to managing an ASD are listed below.

    • Making adjustments to the physical environment such as the lighting, amount of noise, colour of walls and personal space available.
    • Alternative communications – this involves teaching your child to communicate using other types of communication apart from speech. They include sign language and Picture Exchange Communication System (PECS), where your child is taught to communicate with picture cards.
    • Behaviour therapies. There is a wide range of these programmes, which aim to encourage appropriate behaviour and to discourage inappropriate behaviour. They include Applied Behaviour Analysis (ABA) which improves skills by rewarding good behaviour.
    • Therapies that help with specific problems, for example speech and language therapy, physiotherapy to improve movement and co-ordination, and occupational therapy to help develop daily living skills.

    It’s important to remember that one therapy may work for one child but not for another, as all children have different needs and abilities.

    There are hundreds of different interventions available and making a choice about what is best for your child can be difficult. Talk to your specialist for information about the different approaches to managing autism.

    Medicines

    Medicines can’t treat ASDs as such, but they can help to ease some of the symptoms. Your child’s specialist may prescribe a medicine for him or her to take to reduce symptoms such as agitation, aggression, hyperactive behaviour or sleep problems. Always ask your specialist, GP or pharmacist for advice and read the patient information leaflet that comes with your child’s medicine.

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  • Causes Causes of autistic spectrum disorders

    The exact causes of ASDs aren't fully understood at present and they may be caused by a combination of factors. These include the genes inherited from our parents, being born before 35 weeks, and birth defects that affect the development of the nervous system.

  • Help and support Help and support

    Looking after a child with an ASD can be challenging and hard work at times. Health professionals involved in your child's care can provide help and support for you and your child's carers.

    For example, respite breaks give you a chance to rest while somebody else looks after your child – these may be provided by social services. Some families are entitled to benefits, such as disability living allowance to help cover the expenses involved in caring for a child with an ASD. You may also find it helpful to get information and support from local autism support groups.

    School

    If your child has an ASD, he or she is entitled to extra help at school, college and university. Your child can also get help at times of transition, when they move from one school to another. Children with an ASD often need an educational assessment and special support. Your child may go to a special school or, where possible, attend a mainstream school with extra help.

    You can find more information about living with an ASD from charities such as the National Autistic Society.

  • FAQs FAQs

    Is everyone with an autistic spectrum disorder diagnosed as a child?

    Answer

    Not everyone with an autistic spectrum disorder (ASD) is diagnosed as a child. If you're an adult and think you have the behaviours associated with an ASD, contact your GP.

    Explanation

    It’s possible that adults can have an ASD and not have been diagnosed as a child. If you think you have some of the behaviours associated with an ASD, contact your GP. He or she will usually refer you to a specialist who will have experience of diagnosing ASDs.

    Getting a diagnosis of an ASD can help you understand why you feel different to other people or why you behave in the way that you do. It can also help you to get access to some benefits and services that may help. If you're diagnosed with an ASD, you will be able to access special services for people with ASDs.

    Organisations, such as the National Autistic Society, provide information about strategies for coping with ASD symptoms, such as how to socialise and recognise your anxieties.

    What can I do if my child becomes distressed when visiting new places?

    Answer

    Try to identify what is triggering your child's anxiety and prepare him or her in advance when going to new places. Make sure that your child goes to new places with his or her usual carer, who can provide comfort, support and an explanation.

    Explanation

    Children with an ASD often prefer fixed routines and can react badly when this is disrupted. Some children may be oversensitive to certain sensory information, such as smells, lights or sounds. A trip to somewhere new with your child, such as the shops, can often be a stressful experience.

    It can be helpful to identify what triggers your child’s anxiety by keeping a diary. Also, try to prepare your child in advance. For example, show a picture of the place where you’re going (eg a shop) and explain what you will do when you get there. You may find it helps to use a timetable to explain what will happen during your trip, including how you will get there, when you will eat and when you will return home. Ending a visit to a new place on a positive note, by leaving before your child becomes anxious can also help.

    If your child still becomes distressed after you’ve tried to prepare him or her for your visit, you could try the following.

    • Use books or stories about going to new places.
    • Learn and use relaxation techniques.
    • Use earmuffs, earplugs, headphones or sunglasses if noise or bright/flickering lights cause your child to feel anxious.
    • Increase your child's tolerance to new events by gradually building up to them.

    After the visit, allow your child to have some calm time, such as winding down in the car or at home.

    What extra help will my child receive at school if he or she has an autistic spectrum disorder?

    Answer

    If your child has an ASD then his or her school should provide extra help and support. The help that your child can receive differs in each country in the UK. Check with your local authority to see what kind of help is available.

    Explanation

    If your child has an ASD, there are programmes in place at schools to provide him or her with extra support. In England and Wales these programmes are called Early Years Action and School Action. The type of help your child receives may include:

    • extra support from a learning support assistant or teaching assistant on an individual basis or in small groups
    • special learning materials and equipment
    • further specialist help from an educational psychologist, a specialist teacher and/or a speech and language therapist (a health professional who specialises in identifying and managing speech and communication problems)

    There will be a Special Educational Needs Co-ordinator (SENCO) at your child’s school who will be able to give you further information and advice.

    If the school is unable to meet your child's needs, you can request an assessment from your local authority. This leads to the development of a statement of special educational needs, which is sometimes called a statement. This will show what specialist help your child needs and how this can be provided.

    Children with an ASD may be taught at:

    • a mainstream school – your child is taught alongside other pupils, but the school may provide extra support for your child for a set number of hours a week
    • a base or unit within a mainstream school – pupils with an ASD are educated separately in the base, but are able to access the mainstream school when appropriate
    • a specialist school – these are schools specifically for children with special educational needs
    • a residential school – your child stays overnight and will be provided with support 24 hours a day
    • an independent school – these aren't maintained by the local authority, so you may need to pay for them

    The schools suitable for your child may differ between areas, so it’s a good idea to check with your local authority first. They will be able to provide you with a list of schools in your area.

    Will my child grow out of his or her autistic spectrum disorder?

    Answer

    No, ASDs aren't something that your child can grow out of – they continue to affect a person throughout his or her life. Treatment and support can help to minimise the impact an ASD has on your child's life.

    Explanation

    ASDs are lifelong conditions. They don't go away by themselves and there isn’t a cure. If your child has an ASD, he or she will still have the disorder when they become an adult.

    Your child will change as he or she matures, and may often learn to manage their condition very successfully by the time they reach adulthood.

    Adults who have an ASD can live a full and satisfying life with the right support. They may have relationships, marry and raise children, just like anyone else. However, some adults need lifelong care.

  • Resources Resources

    Further information

    Sources

    • Autism diagnosis in children and young people: recognition, referral and diagnosis of children and young people on the autism spectrum. National Institute for Health and Care Excellence (NICE), September 2011. www.nice.org.uk
    • Information about autism spectrum disorders. National Children's Bureau. www.ncb.org.uk, published 2012
    • What is Asperger Syndrome? National Autistic Society. www.autism.org.uk, published March 2013
    • What is autism? National Autistic Society. www.autism.org.uk, published March 2013
    • Assessment, diagnosis and clinical interventions for children and young people with autism spectrum disorders. Scottish Intercollegiate Guidelines Network July 2007. www.sign.ac.uk
    • Interventions for children and young people with autism. Research Autism. researchautism.net, published April 2013
    • Diagnosis: information for adults. National Autistic Society. www.autism.org.uk, published March 2013
    • Getting extra help in school: England and Wales. National Autistic Society. www.autism.org.uk, published October 2012
  • Related information Related information

  • Author information Author information

    Reviewed by Dylan Merkett, Bupa Health Information Team, October 2013.

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