Autism

Autism is a disorder that affects the way a person communicates with other people. Most (but not all) people with autism also have a learning disability. There are a number of related disorders known as autistic spectrum disorders. These include Asperger’s syndrome, which involves fewer or less disabling autism symptoms. About autism and Asperger’s Around 9 in a 1000 children aged four to five are affected by an autism spectrum disorder (ASD). Autism is rarer, affecting about 1 in 5,000 children. It is four times more common in boys than girls. An ASD is any disorder where autistic symptoms are present. Autism is thought to be caused by an abnormality in the development of the brain that occurs before, during or soon after birth. The exact cause is unknown, but doctors think that there may be a genetic factor, but no pattern of inheritance. Symptoms Symptoms of autism first appear in children in their first three years. In severe cases, autistic behaviour may be noticed soon after birth. There are three main types of symptoms. Children with autism, rather than ASD, usually have some symptoms from all of the groups. Social difficulties Generally, this group of symptoms can be described as difficulty getting on with other people. Children with ASD may:

• rarely make full eye contact
• not seek affection in the usual way, and resist being cuddled or kissed
• be unable to play with their peers, and have difficulty making friends
• not understand other people’s emotions
• find it difficult to accept simple social rules, which can cause problems at school

Imagination

Behaviour

Intelligence and autism Around 70% of people with autism have an IQ below 70 (the average IQ of the population is 100). This is classed as a learning disability. Some people with autism have normal or high intelligence. Many people with Asperger’s have normal or above average intelligence and can lead independent lives. Diagnosis and assessment Autism is usually diagnosed in childhood, when a parent may raise concerns about their child with a GP or health visitor. The most common age for diagnosis is between three and four years, though some children may not be diagnosed until the age of 12. Mild autism spectrum disorders, such as Asperger’s syndrome, are often not noticed until the child starts school because many aspects of their development are normal. At school their poor social skills are more noticeable and challenging behaviour may arise. There is no specific test for autism. Tests may be carried out to exclude other conditions (eg blood and hearing tests). Diagnosis is then based on observation of communication, behaviour and development. A number of health professionals, as well as the parents or carers are involved. If autism is suspected, the child will be assessed to identify specific needs. He or she may see a child psychiatrist (doctor specialising in children’s mental health), paediatrician, speech therapist, psychologist, and an educational expert such as a specialist teacher or educational psychologist. Each child should have an appointed key worker, such as a health visitor or school nurse, who knows about the assessment process and acts as a contact for the parent or carer. Treatment Treatments include special education, behavioural training, social skills training and, in some cases, medicines. Special education All children with autism need special education. This may be in a special school, or if symptoms are less severe, in a mainstream school with additional individual help. In general, autistic children do better if classroom activities are very structured. Behavioural therapies These may be provided by a clinical psychologist and can help a family cope with any behavioural problems associated with autism. Similar methods may be used at school where the child can be taught better ways to express themselves. Medicines Sometimes medication is used to reduce specific symptoms. For example, some drugs can be used in the short term to help relieve agitation, obsessional or hyperactive behaviour. However, these can have side-effects if used for a long time. For example, drugs to reduce hyperactivity can increase repetitive and obsessional behaviour. Other treatments There are various approaches available to help with communication, such as music therapy and picture symbols. However, there is only limited evidence that these treatments are effective. Some people claim that a hormone called secretin can help with the symptoms of autism. However, again there is no scientific evidence for this and the sideeffects have not been investigated fully. Help for carers Parents and carers need information, help and support too. This should be provided by the health professionals involved in the child’s care, but further advice is available from charities such as the National Autistic Society (see Further information, below). Respite breaks give the parent or carer a chance to rest while somebody else looks after the child. They may be provided by social services. Some families are also entitled to welfare such as disability living allowance.