Autism, or Autistic Spectrum Disorder (ASD), or Autistic Spectrum Condition (ASC) - is a lifelong condition affecting how people communicate and interact with others and how they relate to the world about them.
Autism is diagnosed by two elements: social communication difficulties and restricted, repetitive behaviours or interests. It can be described as a continuum of normal development or a spectrum, from mild, or high-functioning Autism, sometimes known as Asperger Syndrome, to a severe, non-verbal condition.
It is estimated that about one in 100 people are autistic, a greater number of boys than girls. Autism can co-exist with other pervasive conditions, such as ADHD, PDA or dyslexia. The diagnostic criteria for Autism are continually being reviewed and developed.
All people with Autism have some degree of social and communication difficulties. Some people may have accompanying learning differences, others have average or above-average intelligence.
People with Autism experience difficulties with some or all of:
- Language - speaking and understanding
- Interaction with others (social skills)
- Independence skills
- Attention difficulties
- Danger Awareness
- Obsessional attention paid to a small number of limited, often repetitive, tasks
- Problem solving
- Motor skills
- School work / intellectual development
- Non-literal or conceptual understanding
- Sensory issues, either a heightened awareness of the senses, e.g. loud noises, or reduced awareness of senses eg walking over toys to reach a goal.
Characteristics of Autism
Language development
Children with Autism usually have difficulty with language acquisition, often developing language later than normal. Alternatively, they may develop language at the same time as other children, but their language use is unusual. In addition, there may be difficulties with speech sounds and voice, as well as pragmatics – or how we use language socially. Severely autistic children can be pre-verbal and reliant on visual cues.
Social interaction
The difficulties in social interaction pose very particular problems. Children with Autism find it difficult to read social cues and non-literal signals and to infer what other people are thinking and feeling. For instance, a person with Autism may not be able to spot when a companion is upset, angry or bored.
They may come across as lacking in empathy for other people’s feelings, which could be interpreted by others as wilful self-centredness. Children with Autism may show no interest in what other people are doing, even avoiding joining in games with their siblings, peers or parents. Parents often describe them as being engrossed in a world of their own.
Some children with Autism may often show a desire to be sociable, but their attempts to make friends may be thwarted by their lack of comprehension of the social nuances of negotiating friendships. Lining up, moving round between lessons or playing team games can all present problems.
Social Skills difficulties can affect children who have no firm diagnosis of Autism, it is often these social difficulties in the playground, and not the academic work, that creates the most unhappiness. Social settings can prompt an anxious response - read more about Anxiety in Autism.
Repetitive routines and behaviours
People with Autism often say they like ‘sameness’. They dislike things that upset their routines, because routine gives them a sense of security. Children with Autism often repetitively perform the same actions and some show no signs of developing imaginative play. Others may become fascinated by a particular topic, for example dinosaurs, and become extremely knowledgeable about it, but be uninterested in branching out to other related subjects. They are often thought to have particular interests in systems eg maths, IT or science.
Co-occuring qualities
Impairment of imagination does not mean that people with Autism are necessarily uncreative; some are very creative. It is more that lack of flexibility of thought, the inability to foresee the consequences of their actions, and inability to put themselves in another person’s place and understand their point of view are all likely to cause difficulties for them.
Children with Autism may be precocious readers or have an early fascination with letters, numbers, patterns and logos. This is known as hyperlexia and is seen as a splinter-skill of Autism. However, often the child experiences a gap between reading ability and understanding language.
Diagnosis of Autism
Autism occurs in all racial, ethnic and socio-economic groups. More boys are diagnosed than girls (more than 4:1 in UK) Generally, diagnosis occurs after the age of five, but can be as young as two, and is the result of screening profiles and behavioural assessments. There is no physiological test for Autism.
The process of diagnosing usually involves assessment by a multi-disciplinary team, made up of a paediatrician, psychologist and a speech and language therapist, who will want to monitor your child's behaviour over time, try therapies and ask the opinion of parents and teachers. As part of the diagnosis process, a child will screened for a genetic condition call Fragile X. If you think your child may have Autism, you should go to your GP and request a referral to a consultant or speech and language therapist with an understanding of the condition.