Autism

What is autism?

Autism, autism spectrum disorder (ASD) or autism spectrum conditions (ASC) are terms for a neurodevelopmental condition that affects specific aspects of a person’s development with lifelong impacts.

It is mainly diagnosed in childhood, though sometimes it is not recognised until adulthood. Some people prefer to consider autism as a difference (neurodivergent condition) rather than as a disorder.

Autism is sometimes referred to as autism spectrum disorder (ASD). That is the term used in current diagnostic classifications that are used by many researchers and clinicians.

Current diagnostic systems classify ASD as a neurodevelopmental disorder (together with ADHD, communication problems, intellectual disability, specific learning disorder (e.g. dyslexia), and Tourette syndrome.

Under previous classification systems, ASD was split into autism, Asperger’s syndrome and pervasive developmental disorder not otherwise specified, but more people are now using the broader term ‘autism’ instead.

It often forms a core part of a person’s identity, and so many prefer the term autistic person (identity-centred) over person with autism (person-centred).

Autism usually becomes apparent in early childhood, but people with less obvious autistic traits may not be recognised and diagnosed as autistic until their teenage years or later.

Around 1% of the population is autistic.

Autism is more likely to be recognised and diagnosed in boys and men than girls and women. This gender gap is reducing as more women are receiving an autism diagnosis in adulthood.

There is no single cause of autism. Research has shown that for most autistic people, multiple genetic factors play a strong role, though some environmental (non-genetic) factors may also be involved. For a few people, rare genetic syndromes can lead to autism.

Broadly, research suggests that the early development of brain systems seems to be affected, but exactly how this occurs is unclear.

Despite media reports in the past, there is no scientific evidence linking childhood vaccinations to autism, and the research which first triggered these concerns has now been thoroughly discredited and withdrawn.

Autistic people can experience a range of difficulties – you may have heard the phrase ‘autistic spectrum’. This is another way of saying that autistic people can be affected in a wide variety of different ways, and that no two individuals will have identical difficulties or needs.

This includes intellectual ability; while some autistic individuals have intellectual disability, others have the full range of intellectual abilities.

Autistic people tend to have some trouble with social communication and relationships. They also often need routines to feel comfortable and have repetitive behaviours or interests. They can find it difficult to cope when these are disrupted.

Many autistic people also have sensory difficulties, such as being hyper-sensitive to loud or unpleasant sounds.

Sometimes autistic people may also have co-occurring physical (e.g. epilepsy) or mental health problems (e.g. anxiety, eating disorders), or other neurodevelopmental and learning difficulties (such as attention deficit hyperactivity disorder or ADHD).

Getting support

If you think you or a family member may be autistic, the first step is to speak to your GP.

If they agree that there are signs of autism, they will then refer the individual for a formal assessment. This can sometimes take time. Because autism can affect people in such a wide variety of ways, there may be an assessment by several different specialists before a formal diagnosis is made – this is known as a “multi-disciplinary” assessment.

Similarly, once the autistic person has a diagnosis, they may receive support from a multi-disciplinary team. Some areas of the UK have created neurodevelopmental clinics because autism overlaps with so many other neurodevelopmental conditions.
In Wales there are specific integrated autism services to support autistic adults.

These specialists might include a doctor or mental health nurse, a clinical psychologist, a speech and language therapist or an occupational therapist. Again, this can vary between individuals. Information from the persons family, or someone who has known them for a long period of time is usually required.

There are no specific treatments for the main features of autism, and many autistic people do not want to be ‘treated’, although there are strategies to help reduce the difficulties linked with the features of autism. These aim to improve quality of life for autistic individuals and their families.

Helpful strategies vary greatly between individuals, so it is important that a care plan is tailored to a person’s specific needs.

Medication is not routinely prescribed for autism, but there are circumstances in which it may be appropriate to do so.

As autistic children and young people reach adulthood, their needs may change as their circumstances change – for example when they leave full time education, start a job or if they move on from their family home.

Some autistic people live independently as adults; however, some people may need significant ongoing support.

Autistic people are also more likely to experience mental health problems (e.g. depression and anxiety) than non-autistic people, and to need help with these difficulties.

Tips for autistic people and their families

Whether an individual or a family member has been expecting it or not, receiving a diagnosis of autism may come with all sorts of different emotions which may change over time.

The assessment process may have been lengthy and the individual and their families are likely to have been living with the difficulties for a long time.

It is important to ask for help when someone is diagnosed with autism, both for the person themselves but also for other family members.

As well as the services mentioned in the sections above, there are a range of local and national agencies in Wales, including social care and voluntary organisations, which are available to help autistic people and their families.

A young person with an ASD might also need help at school or college to get the most out of their learning. Some people with ASD stay in mainstream schools though they may need extra help, and some people may have their needs better met in a special school.

Also, in some situations, a ‘statement of special educational needs may be put in place.

Within a school setting, a young person may need to see an educational psychologist or have help from learning support assistants or a special educational needs coordinator.

Resources

NCMH leaflet: Autism in adults

NCMH leaflet: Autism in children and young people

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