Autistic Spectrum Disorders

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Autistic spectrum disorders affect the way a person communicates with, and relates to, other people. Many (but not all) people with an autistic spectrum disorder also have a learning disability. People with autistic spectrum disorders usually need specialist care and education.

Autism and autistic spectrum disorders

Autism is a group of similar disorders with varying degrees of severity. So the term autistic spectrum disorders (ASDs) is often used rather than autism.

Autism is actually one form of ASD. Other forms include Asperger's syndrome and Rett's syndrome. People with Asperger's syndrome tend to have fewer problems with language compared to people with classical autism. They are often of average, or above average, intelligence.

What are the symptoms of autistic spectrum disorders?

Symptoms usually become apparent in the first three years of life. Half of parents become concerned in the first 12 months. Some children with Asperger's syndrome are only diagnosed after they have started school. The symptoms of ASD vary between people. Some have minimal symptoms whereas others may have severe difficulties. People with ASD have varying levels of intelligence. A few have very high IQs, but a low IQ is found in about 5 out of 10 people with ASD. There are four different groups of symptoms, all of which usually occur in children with ASD.

Social difficulties

There are different types of problems and not all will occur in each case. These can generally be described as 'not being able to get on with people'. So the child may:

- Seem to be aloof.
- Have little or no interest in other people which can result in having no real friends.
- Not understand other people's emotions. For example, not understanding why anyone has been cross with them.
- Prefer being alone.

Sometimes a child may seem to lose social skills that they once had. This may be skills such as waving goodbye. This is found in about 1 out of 4 cases.

Problems with language and communication

Speech usually develops later than usual. When it does, the language (the use and choice of words) may not develop well. The sort of problems that children with ASD may have include one or more of the following:

- Not being able to express themselves well.
- Not being able to understand gestures, facial expressions, or tone of voice.
- Saying odd things. For example, repeating your words back to you, time and time again.
- Using odd phrases and odd choices of words.
- Sometimes using many words when one would do.
- Making up their own words.
- Not using their hands to make gestures as they speak.
- Not being able to understand difficult orders.

Poor imagination

Pretend play is usually limited in children with ASD. They tend to do the games and activities that they learn over and over again. Games may remain exactly the same every day. Games are usually those that a younger child would play.

Unusual behaviours

These are typical and include one or more of the following:

- Odd mannerisms such as hand-flapping or other odd pointless movements.
- Anger or aggression if routines are changed. Children with ASD may hurt themselves when they are angry by banging their head or hitting their face. Sometimes they do this to get attention.
- Actions may be repeated over and over again (like rocking backwards and forwards).
- Obsessions may develop in older children and adolescents. For example, they may have interests in unusual things like train timetables and lists.
- Medication may be considered to help with specific ASD-related symptoms. It is usually only considered if other ways of coping aren't working.

These symptoms may be anxiety, depression or obsessive-compulsive disorder. There is also medication that may help to control outbursts of excitement or aggression.

There is no cure for ASD. The specialist education and support aim to maximise the potential of each child as they grow into adults. It is thought that the earlier the specialist input is started, the better the outcome.

What is the outlook?

An ASD is a life-long condition. As the severity can vary, it is difficult to predict the outcome for each child. Even without treatment, sometimes there is improvement in the teenage years and some people with ASD become more sociable.

Some adults with ASD manage to work and get by with just a little support. In particular, many people with Asperger's syndrome are able to manage well, and live independently or need little support when adult. However, many people with classical autism need more substantial support.


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