Navigation

Autism spectrum disorder (ASD)


Expert reviewer, Dr Sammad Hashmi, Consultant Psychiatrist
Next review due September 2023

Autism spectrum disorder (ASD) is a condition that affects how someone develops in terms of their behaviour and how they communicate with others.

Doctors use the term ASD to include both autism and Asperger’s syndrome because both conditions are now seen as parts of one spectrum. But you'll often still hear the older terms used. On this page, we’ve used ASD throughout. ASD can be diagnosed at any age, but it’s most often noticed during childhood. This information is about ASD in children.

father and son eating breakfast in the kitchen

About autism spectrum disorder

Around one in every 100 children has autism spectrum disorder (ASD). ASD often runs in families and boys are four times more likely to be diagnosed with ASD than girls. This is thought to be partly because girls with ASD may have different behaviours from boys, which can make the signs less obvious.

If your child has ASD, they may see and respond to the world in ways different from those around them. Your child may:

  • have difficulties with social situations
  • find it hard to understand and relate to other people
  • find change difficult to manage, and prefer daily routines and sometimes strict rules
  • have intense interests in certain things which they like to focus on

ASD is a spectrum, which means children are affected in different ways and to different degrees. Some may have subtle problems with understanding, while others may need more support and care.

Many people with ASD also have other health conditions and difficulties. These include:

It’s worth knowing that many people with ASD also have other health conditions and difficulties. These include:

  • epilepsy – around two or three out of every 10 people with ASD will have this
  • mental health conditions – around seven out of 10 people with ASD will have a condition such as attention deficit hyperactivity disorder (ADHD) or anxiety
  • learning difficulties
  • difficulties sleeping
  • problems with digestion and eating – for information about how to manage, see our FAQ: Would a special diet help my child with ASD? below.

Causes of autistic spectrum disorder

No one knows exactly what causes autism spectrum disorder (ASD). It’s likely to be a mix of factors rather than one single thing.

ASD runs in families – if a child has ASD, there’s about a one in 10 chance their brother or sister will have it too. Other factors that may play a part include:

  • their parents being over 35 when they were conceived
  • being born early and underweight
  • getting certain infections as a developing baby or soon after birth
  • the health of their mother while pregnant, for example, diabetes, high blood pressure or a vitamin D deficiency may increase the risk of ASD

Lots of research has proven that there is no link between ASD and the MMR (measles, mumps and rubella) vaccine.

Features of autism spectrum disorder

While the features or symptoms of autism spectrum disorder (ASD) can vary enormously, there are some common ones that everyone shares, which are listed below. The way ASD affects your child can change as they get older or as they have to adapt to the world around them. The common features of ASD can make home, school and work difficult, and make taking part in family life, relationships and friendships challenging.

Social communication

Children with ASD can have problems communicating with others in both how they speak and how they use eye contact and body language. For example, your child may:

  • not interact with you and play games like peek-a-boo (particularly in their first year)
  • not make eye contact with you
  • not have the same facial expressions for different emotions as other children
  • be slow to talk, not talk at all or have unusually ‘adult’ language at an early age
  • be very quiet or talk ‘at’ other people about the things that they find interesting rather than have a two-way conversation

Social skills and understanding others

Children with ASD often find it hard to recognise or understand what other people are feeling and may have trouble expressing their own feelings. This can make friendships hard, and make it difficult to fit in socially. For example, your child may:

  • not share well with other children, take turns or get involved in imaginative play
  • feel overwhelmed in social situation
  • have little awareness of personal space – they might not like it when someone comes into their personal space or may make others feel uncomfortable by getting too close
  • prefer to spend time on their own

Behaviour, interests and activities

Children with ASD are likely to have some rigid and repetitive behaviour such as flapping their hands or rocking their body while standing. Your child may have difficulty managing change, and have strict routines for certain things that must be done a certain way. This can help them feel less anxious.

Your child may develop a special and overwhelming interest in something – this can be anything from trains to rocks, to dinosaurs. Your child may collect lots of the same thing, number them or list them, and this interest can last a lifetime.

Children with ASD can also develop inflexible thinking, which means they may find it hard to be creative and imaginative. Unstructured times and situations can be particularly difficult. Your child may take what other people do and say literally, which makes sarcasm and jokes hard to understand.

Diagnosis of autism spectrum disorder

Autism spectrum disorder (ASD) can be diagnosed at any age. But parents often notice unusual behaviour before their children are 18 months old. Or their nursery or a teacher at school may notice some behaviours. One potential sign is if a child develops language or social skills, and then seems to lose them or goes backwards in their development. ASD is diagnosed after an assessment by a specialist team, which could include doctors, psychologists and other health professionals. If you think your child might be showing signs of ASD, see your GP or health visitor. Keep a diary for a few days to gather information about any behaviour you’re concerned about.

After a GP or health visitor referral, you may have to wait up to three months for the assessment. In the meantime, you can ask your health visitor or school to arrange other support that may be helpful. As part of the assessment or test, the ASD team may:

  • talk to you about any family history of ASD and your (or your child’s) behaviour and development
  • do a physical examination
  • test for other health conditions
  • look at reports from your child’s school or nursery or visit to watch your child at the nursery or at home

You might be told the result of the assessment straightaway and you’ll also get a written report. If the assessment finds a condition that overlaps with ASD, such as attention deficit hyperactivity disorder (ADHD), that may also be in the report.

Many parents find an ASD diagnosis a relief as it helps explain some of the difficulties their child has been having. And it helps them to get support at home and school.

Treatment of autistic spectrum disorder

While there isn’t a cure for autism spectrum disorder (ASD), there are ways to manage the symptoms and behaviours it leads to. What works best for you or your child will depend on how they’re affected by ASD and the impact it has on day-to-day life.

You’ll usually be supported by a team of specialists in your local area. This support will usually involve the whole family, including any brothers and sisters. If you’re a partner of someone with ASD or if you’re caring for an adult with it, you should be offered support too.

If your child has ASD, you may be offered the following:

  • A course or programme for parents that helps you to understand ASD, manage your child’s behaviour and give them the right support. There’s also a range of therapies to help children develop positive behaviour or adapt their behaviour.
  • Play activities, which may help your child with their communication and social skills.
  • Support to make physical changes to your home and school to make it more manageable for your child, such as changes to lighting or reducing the amount of noise.
  • Help to develop ways to prevent or manage challenging behaviour, including having structure and routines and managing times of change.
  • Treatments to manage other health problems and to help with any difficulties with sleeping and eating.
  • Extra help and support at school. For more information, see our FAQ: How will my child manage at school or college? below.
  • Therapies for specific problems such as speech and language therapy, physiotherapy to improve movement and coordination, and occupational therapy to develop daily living skills.
  • A cognitive behaviour therapy (CBT) programme if your child also has anxiety.

As your child matures and becomes an adult, they may be offered:

  • a course to help with social skills – either alone or in a group with other people with ASD
  • training programmes to help with life skills – these might be based around leisure activities
  • help to manage anger if this is an issue – this might include relaxation activities and developing problem-solving or coping skills
  • help to get a job

Talk to your ASD team for more information about the different approaches to managing ASD. You can also find out more from The National Autistic Society . For contact details, see our section: Other helpful websites below.

Medicines

Medicines can sometimes help to ease the more severe symptoms of ASD. For example, if your child has specific challenging behaviour or severe sleep problems, their specialist may prescribe medicines. Medicines are usually only considered if other approaches haven’t worked. Ask your doctor for more information.

Frequently asked questions

  • Living with autism spectrum disorder (ASD) or looking after a child with it can sometimes be challenging. ASD can affect every part of life, including relationships with other people. You’re likely to need support from teachers and education professionals, health professionals, social services and national and community organisations. You may find support groups particularly valuable as you can speak to other parents and share tips and advice. The National Autistic Society, for example, has a helpline and offers various types of support.

    It may be possible to get financial help to help cover some of the extra costs involved in living with ASD. Check the Gov.uk website to find out more. Families and carers may also be able to get respite care and short breaks for themselves and for a child with ASD.

  • Children with autism spectrum disorder (ASD) like life to be predictable and feel safer with routines, so any change can be very stressful. And stress can affect their behaviour and ability to do day-to-day things like shopping, travelling on public transport and going to the doctor or dentist. Some children with ASD also have sensory difficulties, which can make some places very challenging to be in.

    Here are some things that you can do to help your child manage new things.

    • Take time to prepare your child beforehand so they know what to expect. Describe what’s going to be happening clearly and carefully – you could use a timetable to explain what will happen and when. If you’re planning a trip, you can put it on the calendar and help them to count down to it.
    • Use things like photos, websites and films to show what a new place or activity looks like. If your child is changing school, take them to visit the new one, gradually building up their time there.
    • If your child’s school or the people supporting them are going to change, involve new people as well as your child in planning the changes.
    • Have a box or bag of familiar and comforting things to touch or smell in the new place.

    The National Autistic Society website has useful tips for planning new activities, including going to the doctor, going shopping and visiting the hairdresser.

  • If your child has autism spectrum disorder (ASD) and special educational needs, their school or college should provide extra help and support. The kind of support will depend on how severely ASD affects their learning and day-to-day life

    While specifics can vary between each part of the UK, general areas of support for every child with ASD include the following.

    • A written plan at school or college. This may include information about their needs, support and how teachers, parents and children will know if the support is making a difference.
    • A specialist assessment to see how well your child is learning and managing in school, and what further support they may need.
    • Support to cover the whole school or college day, including transport to and from school. This support might be given by a teaching assistant who may offer aids and adaptations such as ear defenders or sensory equipment.

    Many children with ASD go to a mainstream school but some children need more specialised help. If your child is severely affected and needs a lot of support, they may go to a special school. If you think your child needs more help, talk to the person who supports children with special educational needs. This may be the special educational needs coordinator (SENCO) at their school or college.

  • There’s no good evidence that a specific diet such as a gluten-free or casein-free diet can help autism spectrum disorder (ASD). But if your child has eating problems, such as eating a small number of foods or behaviour that stops them eating healthily, get specialist advice. Ask your GP to refer you to a dietitian.

    As your child is growing and developing, it’s important they have a healthy and balanced diet with a range of foods. Excluding foods can be harmful so get advice if you’re worried about what they’re eating or want to change their diet.



Did our information help you?

We’d love to hear what you think. Our short survey takes just a few minutes to complete and helps us to keep improving our health information.


About our health information

At Bupa we produce a wealth of free health information for you and your family. This is because we believe that trustworthy information is essential in helping you make better decisions about your health and wellbeing.

Our information has been awarded the PIF TICK for trustworthy health information. It also complies with the HONcode standard and follows the principles of the The Information Standard.

The Patient Information Forum tick  This website is certified by Health On the Net Foundation. Click to verify.

Learn more about our editorial team and principles >

Related information

    • Autism spectrum disorder. BMJ Best Practice. bestpractice.bmj.com, last reviewed May 2020
    • ICD-11 (mortality and morbidity statistics). World Health Organization. who.int, published 18 June 2018
    • Werlinga DM, Geschwind DH. Sex differences in autism spectrum disorders. Curr Opin Neurol 2013; 26(2):146–53. doi:10.1097/WCO.0b013e32835ee548
    • Autism in adults. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised June 2019
    • Autism. National Autistic Society. www.autism.org.uk, last reviewed 8 June 2016
    • Autism spectrum disorder in under 19s: recognition, referral and diagnosis. National Institute for Health and Care Excellence (NICE). www.nice.org.uk, last updated 20 December 2017
    • Autism spectrum disorder. Medscape. emedicine.medscape.com, updated 18 March 2020
    • Penzol MJ, Salazar de Pablo G, Llorente C, et al. Functional gastrointestinal disease in autism spectrum disorder: a retrospective descriptive study in a clinical sample. Front Psychiatry 2019; 10(179). doi:10.3389/fpsyt.2019.00179
    • Autism in children. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised October 2018
    • Lee BK, Eyles DW, Magnusson C, et al. Developmental vitamin D and autism spectrum disorders: findings from the Stockholm youth cohort. Mol Psychiatry 2019. doi:10.1038/s41380-019-0578-y
    • Vitamin D: supplement use in specific population groups. National Institute for Health and Care Excellence (NICE). www.nice.org.uk, last updated 30 August 2017
    • Schmidt RJ, Iosif A-M, Angel EG, et al. Association of maternal prenatal vitamin use with risk for autism spectrum disorder recurrence in young siblings. JAMA Psychiatry 2019; 76(4):391–8. doi:10.1001/jamapsychiatry.2018.3901
    • Mazahery H, Camargo CA, Conlon C, et al. Vitamin D and autism spectrum disorder: a literature review. Nutrients 2016; 8(4):236. doi:10.3390/nu8040236
    • Autism spectrum disorder in adults: diagnosis and management. National Institute for Health and Care Excellence (NICE). www.nice.org.uk, last updated 18 August 2016
    • Assessment, diagnosis and interventions for autism spectrum disorders. Scottish Intercollegiate Guidelines Network (SIGN). www.sign.ac.uk, published June 2016
    • Autism. National Institute for Health and Care Excellence (NICE). www.nice.org.uk, published 21 January 2014
    • Diagnosis for children. National Autistic Society. www.autism.org.uk, last reviewed 8 September 2016
    • Environment and surroundings. National Autistic Society. www.autism.org.uk, last reviewed 19 March 2018
    • Extra help at school in England. National Autistic Society. www.autism.org.uk, last reviewed 14 December 2016
    • Standard healthcare and autism. Research Autism. www.researchautism.net, updated 24 June 2019
    • Benefits. National Autistic Society. www.autism.org.uk, last reviewed 7 July 2017
    • Shopping. National Autistic Society. www.autism.org.uk, last reviewed July 2019
    • Preparing for change. National Autistic Society. www.autism.org.uk, last reviewed August 2017
    • Autistic pupils and transition. National Autistic Society. www.autism.org.uk, last reviewed 5 June 2017
    • SEND code of practice: 0 to 25 years. GOV.UK. www.gov.uk, last updated 30 April 2020
    • Ikuta N, Iwanaga R, Tokunaga A, et al. Effectiveness of earmuffs and noise-cancelling headphones for coping with hyper-reactivity to auditory stimuli in children with autism spectrum disorder: a preliminary study. Hong Kong J Occup Ther 2016; 28(1):24–32. doi:10.1016/j.hkjot.2016.09.001
    • School exclusions service (England). National Autistic Society. www.autism.org.uk, accessed 6 July 2020
    • Transition support service. National Autistic Society. www.autism.org.uk, accessed 6 July 2020
    • Healthy eating for children: food fact sheet. British Dietetic Association. www.bda.uk.com, published November 2017
  • Reviewed by Rachael Mayfield-Blake, Freelance Health Editor, September 2020
    Expert reviewer, Dr Sammad Hashmi, Consultant Psychiatrist
    Next review due September 2023

ajax-loader