Autism Spectrum Disorder

Advice & Guidance: Autism Spectrum Disorder

What is Autism Spectrum Disorder (ASD)?

ASD is a Neurodevelopmental condition that effects how someone understands the world and relates to others. People on the Autism Spectrum have differences in their social communication and interaction. This means that they can find social interaction more difficult and social situations can be anxiety provoking.

They may find it more difficult to understand another person’s thoughts and feelings. It can also be more difficult for them to engage in conversation and understand more subtle aspects of language, such as humour and sarcasm.

People on the Autism Spectrum can also have differences in their sensory processing and can find it difficult to manage change.

The Autism Spectrum is very broad and people with this diagnosis will present with varying degrees of difficulty in their daily life. Some people experience significant impairment in their daily life and need a lot of support whereas others may not experience much impairment at all and do not require additional support to manage daily life.

ASD is recognised as a disability and it is expected that reasonable adjustments are made in education and employment settings to support someone with a diagnosis of ASD where this is required. Despite this many young people with ASD do not experience significant impairment in their daily life and are able to manage adult life without too much difficulty. In fact a number of adults with ASD view it as a positive thing.

Who is more likely to be on the Autism Spectrum?

Anyone can be born with an Autism Spectrum condition. We do not know for certain what causes Autism spectrum conditions and it is likely to be a combination of genetic and environmental factors.

Features of an Autism Spectrum condition usually present in early childhood and can present as young as 18 months. Some young people do not display obvious difficulties until they are older and social demands exceed their capabilities.

A higher number of boys are diagnosed with ASD than girls. The ratio is approximately 4:1. This has led people to believe that ASD is more common in boys; however it has been suggested that the difference in prevalence rates for boys and girls may be due to girls being under diagnosed as ASD presents differently in girls. Girls are often more able to mask the extent of their difficulties as they tend to have more developed language and social skills.

How is Autism Spectrum Disorder (ASD) diagnosed?

There is no biological marker for Autism and therefore it can not be diagnosed by a medical test, such as a brain scan or blood test.

The diagnosis of ASD is made by clinicians who have expertise in the assessment and diagnosis of ASD. This is usually a Community Paediatrician, Speech and Language Therapist, Clinical Psychologist or Psychiatrist.

Assessments are multi-disciplinary in that more than one of these professionals would be involved in an ASD assessment.

An ASD assessment follows the guidelines set out by NICE.

A diagnostic assessment for children and young people includes the following elements :

  1. A detailed interview with parents / carers that focuses on social communication, interaction and rigid / repetitive / sensory behaviour.
  2. Observations of the young person. This often, but not always, includes a standardised measure known as an Autism Diagnostic Observation Schedule (ADOS)
  3. Information from school.

All information that is gathered during an assessment is then reviewed alongside the diagnostic criteria outlined in DSM V or ICD 10 to see if a child or young person meets the diagnostic threshold.

Local organisations and support groups who can help after a diagnosis

Greenwich

Bexley

Bromley

Oxleas services

If there are concerns that a child or young person may be on the Autism Spectrum, they will need to be referred to the Community Paediatric or Speech and Language Therapy team in the first instance. If the referral is accepted then a child will have an initial appointment with a Community Paediatrician or Speech and Language Therapist who will decide if a referral to the ASD assessment team for further assessment is required.

If there are concerns that an adult may be on the Autism Spectrum, they can be referred to the adult ASD team.

Often young people with ASD have other difficulties that may require support, for example speech and language difficulties or mental health difficulties. Children and young people can access the full range of health services available without a diagnosis if they present with sufficient need. Music therapy is the only service that requires a diagnosis of ASD to access.