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Autistic spectrum disorders (ASDs)

Published by Bupa's health information team, February 2010.

This factsheet is for parents of children with an autistic spectrum disorder, or people who would like information about autistic spectrum disorders.

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

About autistic spectrum disorders

According to the National Autistic Society, over 500,000 people in the UK have an ASD. A study published in 2006 shows that as many as one in 100 children may have an ASD. Recent research suggests there is a similar rate of the condition in adults.

Children with an autistic spectrum disorder (ASD) don't develop the social and language skills that other children do. As a result, they find relating to other people difficult. They may also have unusual behaviours and learning difficulties.

The word 'spectrum' is used because ASDs vary widely from person to person and affect people to different extents. Autistic spectrum disorders include autism and Asperger syndrome.

Autism

Children with autism have difficulty communicating and interacting with others. This is often first noticed by the time they are two. Some children with autism may have learning difficulties. Autism is four times more common in boys than girls and also more common in adult men than women.

Asperger syndrome

Asperger syndrome is similar to autism, but is usually less severe. Children with Asperger syndrome generally communicate better than those with autism and have average or above average intelligence. They don't usually have the learning difficulties seen in children with autism.

Symptoms of autistic spectrum disorders

Children with an ASD have three main types of problems. These are to do with their:

Communication

Children with ASDs don't develop the usual speech or non-verbal (eg pointing) skills of other children the same age. They may also have trouble with understanding meaning in spoken or written language.

Your child may have a very literal sense of language, and be unable to understand jokes or sarcasm. He or she may also find it difficult to read body language and facial expressions.

Your child may also:

Older children may have an unusual use of language, and difficulty starting or keeping up conversations.

Children with severe autism may never speak at all but can be helped to communicate in other ways, such as through signing or using picture symbols.

Social development

Children with an ASD have difficulty making friends and getting on well with their peers. They also find it difficult to understand how other people feel and may be unable to cope with new situations. Your child may:

Children with an ASD can be affectionate, but may not be able to respond to another person's need for affection.

Behaviour and interests

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

Your child may take up a special interest at a young age, such as collecting, or music and art.

Older children and adolescents may develop obsessions such as an excessive interest in timetables or lists, and in storing up trivial facts.

Other symptoms

Your child may also:

Around three out of four children with an ASD have a learning disability. Many children with an ASD also have other conditions such as attention deficit hyperactivity disorder (ADHD), dyspraxia or epilepsy.

Causes of autistic spectrum disorders

The exact causes of ASDs aren't fully understood at present. Some research indicates that the genes we inherit from our parents play an important role. Many different genes have been implicated in ASDs, suggesting that ASDs have a variety of causes.

Autism and the MMR vaccine

There is no scientific evidence to support media reports about a possible link between autism and the MMR (measles, mumps and rubella) vaccine. However, there is plenty of evidence to support the safety of the MMR vaccine. The similar incidence of ASDs in adults who didn't receive the vaccine and children who did, strongly suggests no link.

Diagnosis of autistic spectrum disorders

If you notice signs of an ASD in your child, contact your GP or health visitor.

Children can usually be diagnosed between the ages of two and three. However, some ASDs, such as Asperger syndrome, only become apparent at school, when a child's poor social skills and challenging behaviour become more noticeable.

You will need to describe your child's behaviour to your GP. He or she will also observe your child's behaviour and development. Your GP may carry out a screening interview called CHAT (Checklist for Autism in Toddlers) if your child is pre-school.

Your child may have some other tests such as a hearing test to exclude other conditions.

If your GP thinks your child may have an ASD, he or she may be assessed at a child development centre to identify any specific needs. You and your child may need to see a range of professionals including a paediatrician, a child psychiatrist, a speech therapist, an occupational therapist, a psychologist, and an educational expert such as a specialist teacher or educational psychologist.

A tool commonly used by specialists is the Autism Diagnostic Observation Schedule - a complex group of structured tests that can be tailored to different age groups.

Your child should have an appointed key worker, such as a developmental paediatrician (a doctor who specialises in child development), health visitor or school nurse, who knows about the assessment process and acts as a single point of contact for you.

Treatment of autistic spectrum disorders

There is no cure for ASDs, but children can be helped in many ways. Therapies can be used to help your child to function independently, socialise and provide the best possible quality of life for him or her.

Many parents find the following therapies helpful for their child, although there is limited evidence that they are effective. These therapies may not always be available where you live.

Behavioural therapies

Therapies such as applied behaviour analysis (ABA) may help to improve your child's social functioning and communication. This type of therapy involves your child seeing a clinical psychologist or trained therapist, who will reward good behaviour with praise. The psychologist or therapist will also set out a consistent and structured way of dealing with challenging or harmful behaviour.

Other therapies

Other therapies aim to help your child with communication and learning. These include the following.

Remember that one therapy may work for one child but not for another, as all children have different levels of needs and abilities.

Medicines

Sometimes your doctor may prescribe medication for your child to take in the short-term to reduce symptoms such as agitation or obsessional or hyperactive behaviour. However, these medicines can have side-effects. For example, drugs to reduce hyperactivity can increase repetitive and obsessional behaviour.

Help and support

Health professionals involved in your child's care can provide help and support for you and your child's carers. Further advice is available from charities such as the National Autistic Society.

Respite breaks give you a chance to rest while somebody else looks after your child. They may be provided by social services. Some families are also entitled to benefits such as disability living allowance to help cover the extra expenses involved in caring for a child with an ASD.

School

All children with an ASD need an educational assessment and some special educational support. Your child may go to a special school or attend a mainstream school with extra individual help.

In general, autistic children do better if classroom activities are very structured. Most schools use the TEACCH approach, (Treatment and Education of Autistic and Communication-Handicapped Children) which provides a very structured learning environment, with mostly visual instructions. Parents work closely with teachers, using the same techniques at home.

Related topics

Further information

Sources

This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: February 2010.