Autism Spectrum

Autism Spectrum Disorder (ASD) impacts on how an individual interacts with the world around them. Children with autism spectrum condition usually experience difficulty in three main areas: social interaction, social communication and imagination and cognitive flexibility. Each of these diagnostic features can be present in different forms and varying degrees. Individuals with ASD are motivated by what interests them and may have difficulty seeing things from the perspective of other people. Individuals diagnosed with ASD demonstrate differences in how they communicate and interact with other people, in addition to this, unusual patterns of behaviour or interests can be present.

The reason that this is called a spectrum disorder is that there is a wide variability in how individuals present. Not all children display every listed feature.

Difficulties with social interaction can include not understanding the subtleties of social situations, recognising and interpreting other people’s feelings, managing emotions or making and maintaining friendships.

Difficulties with social communication tend to encompass problems with using and understanding verbal and non verbal language, such as modulating tone of voice and gestures.

Children with autism also tend to present with difficulties with creative play, intense interests and lack of flexibility.

What causes autism?

The exact causes of autism are still not yet fully understood.

  • The causes of autism are still being investigated. Many experts believe that the pattern of behaviour from which autism is diagnosed may not result from a single cause. There is strong evidence to suggest that autism can be caused by a variety of factors, all of which affect brain development and function. This can include genetic factors, environmental factors and hormonal and biochemical factors. This is not always visible on an MRI brain scan as the differences can be at a microscopic or a chemical level.
  • Research seems to suggest that there is a genetic influence that increases the child’s risk of having autism. For example, if one child in a family has autism, a sibling has a three to five per cent chance of also having the condition or a related problem, such as a language disorder. This is a much higher rate than in the population as a whole.
  • Autism is more common in individuals with genetic differences for example chromosomal anomalies, microdeletions or .microduplications which can be identified through microarray. The difficulty of establishing gene involvement is compounded by the interaction of genes and by their interaction with environmental factors. For these reasons genetic testing to diagnose a pre-disposition to an autistic spectrum disorder is not, at present, possible.
  • Whole genome sequencing enables scientists to look for single gene changes. Some single gene changes result in alterations in the brain development and/or function. If a child with autism spectrum disorder has intellectual disability or other physical differences whole genome sequencing may be offered to look for a possible underlying cause.
  • The factors that influence brain development and function cause are not specific to ASD- the same factors that cause difference in brain development may also result in other problems e.g. epilepsy, eye malformations, cerebral palsy, mental health difficulties, atypical behaviour.

CGH Microarray (506.8 KB)

What are the signs and symptoms of autism?

The onset of autism is usually apparent prior to or around three years of age.

However, for children who might have more subtle difficulties or are very able, the symptoms may be recognised only when they are older.

This is because some children are very well supported in their home and nurseries and their difficulties are not so apparent until they are expected to be more independent.

There are a range of early signs that parents tend to report. These include a child’s avoidance of eye contact, a child’s different way of communication, for example the child may not be sharing their interest or curiosity with others, although they may be able to request what they want.

Young children with autism spectrum may also have reduced non-verbal communication, and may not point or gesture. Some parents notice that their child’s play may be different to that of their peers, for example lacking in creativity and imagination.

Many children with suspected autism may have difficulty in joining with other children and may prefer to play alone or with adults. Children with autism have delayed development of language, which tends to be one of the most frequent causes for concern.

The world can be confusing for children with autism. They often have trouble understanding the subtleties of how to ‘read’ and relate to other people. This might mean they may not pick up social cues, or may behave in ways that are considered to be socially inappropriate.

Many autistic children find change upsetting and often prefer familiar routines, which enable them to understand and know what is going to happen every day. In school, this may lead to a child being seen as uncooperative or difficult. They might, for instance, become very anxious when ask to sit on a different place in class.

Some children will develop intense interests, which they prefer to engage with most of the time and can become distressed if interrupted.

Sensory sensitivities are another common problem. This can mean a child’s sense of sight, sound, smell, touch or taste is intensified (hyper-sensitive) or under-sensitive (hypo-sensitive). For example, some children can find certain sounds (such as vacuum cleaner) or textures (eg certain fabrics) very uncomfortable, or even distressing.

How is autism normally diagnosed? How can I get an assessment for my child?

Getting a diagnosis for a child can be helpful, as it enables parents, as well as others, to understand and support the child better.

Diagnostic assessment can also help to clarify if a child requires any extra support or resources for their special needs. Support from voluntary organization and opportunities to meet parents of children with similar difficulties can also be a source of great support.

If you have concerns relating to your child's development you may contact your GP and request for a referral to be made to your local Community Paediatrician or Child and Adolescent Mental Health team. It can be helpful if you ask school or nursery staff to provide a letter to support this referral outlining any concerns they may have noticed in the educational setting. In some areas this referral may be made directly from education to local Child Development services.

The assessment of autism tends to be conducted at child developmental centres or by child and adolescent mental health services by professionals such as paediatricians, psychologists, speech and language therapists or psychiatrists.

It usually involves detailed interviews with the child’s parents/carers concentrating on the child’s early development and current behaviour, direct play assessment with the child as well as collecting information from the child’s nursery or school.

National Institute of Clinical Excellence: Autism diagnosis in children and young people: Recognition, referral and diagnosis of children and young people on the autism spectrum

How is autism normally supported?

Everybody is different and different children need different things to help them, but after your child is diagnosed with an autism spectrum condition, some of the following might be helpful.

  • Talking to school - you might want to make an appointment to go and speak with the SENCo, about whether there are any areas that you think you child might benefit from a different approach or extra support in. Some areas have autism outreach teachers who can visit the school and offer advise depending on the level of expertise already in your child's school.
  • Attending a post diagnosis group for parents - most areas run post diagnosis groups for parents of children who have been diagnosed with an autism spectrum condition. Different groups cover different topics. Your local offer page, the NAS website (see below), your GP or paediatrician should know of how you can access your local group.
  • Build knowledge & Access different resources - it might be that you would like to find out more about other people's experiences of ASD and approaches to supporting children as they grow older. Link to resource page

There is no known specific medical intervention for conditions on the autism spectrum. However, there have been many useful approaches and programs developed to help the child with specific difficulties which may be impacting on their quality of life or which may be in the way of their optimal development.

Children with autism can be very effectively supported through people around them having an increased awareness of their condition, their support needs and their unique profile of their strengths and difficulties.

Families of children with more severe difficulties may also require some practical support or access to specialist resources to help them to support the child.

There is no ‘best’ intervention for children with autism. An intervention that helps one child may not be suitable for another, so parents should always seek professional guidance.

Parents are advised to be cautious about any treatment that claims to ‘cure’ autism.

National Institute of Clinical Excellence: The management and support of children and young people on the autism spectrum

National Autistic Society

What happens next?

Autism affects every child in a different way.

Many children with autism may develop a range of coping strategies and grow up to lead relatively independent lives. Others may need long term support to help them lead fulfilling life.

When children are younger it can be difficult to predict how their particular difficulties will develop as they get older.

There can also be specific times in life when their difficulties may be more apparent, for example during puberty or transition to secondary school or adulthood.

It is helpful to be aware that young people with autism are at increased risk of developing other difficulties, such as anxiety, depression, sleep difficulties or behavioural problems. These conditions are not part of autism and are often treatable, so it is important to seek professional advice if concerns arise.

While it is beneficial to help children with areas of difficulty, it is equally as important to support children in the areas of their strengths. It is often the child’s strengths that increase their quality of life, help them to achieve their potential and contribute to society.

Individuals with autism spectrum can have much better attention to detail, may be very precise, trustworthy and reliable. Some people report that a child with autism would never lie or break a promise they have given.

It is also possible to help children to channel intense interests into developing useful skills or academic pursuits. Many individuals with autism spectrum have made unique achievements and creative contributions to a variety of areas including science, art, music, sport and extended our understanding of the world through a different way of thinking and seeing things.

Last review date:
February 2017