Autism

Autism is a lifelong neurodevelopmental condition, the core features of which are persistent difficulties in social interaction and communication and the presence of restricted behaviours and/or restricted interests.

Autistic people may:

  • find it hard to communicate and interact with other people.
  • find it hard to understand how other people think or feel.
  • find things like bright lights, loud noises, certain foods or clothing overwhelming, stressful or uncomfortable.
  • get anxious or upset about unfamiliar situations and social events.
  • take longer to understand information.
  • do or think the same things over and over.

The prevalence of autism in the UK population is estimated at between 0.7% and 1.1%.

The term ‘autism’ refers to autistic spectrum disorder or ASD (also known as ‘autism spectrum condition’ or ASC) which encompasses autism, Asperger’s syndrome and atypical autism.

Being autistic does not mean you have an illness or disease. It means your brain works in a different way from other people. It’s something you’re born with and often first becomes apparent when you’re very young.

If you’re autistic, you’re autistic your whole life. Autism is not a medical condition with treatments or a “cure”. But some people need support to help them with certain things.

Nobody knows what causes autism, or if it has a cause. It can affect people in the same family, so there may be more than one person in a family with features of autism.

Autism is not caused by:

  • bad parenting.
  • vaccines, such as the MMR vaccine.
  • diet.
  • an infection you can spread to other people.

Autism does not automatically affect intelligence; some autistic people have average or above average intelligence but around 50% of autistic people will have an associated learning disability. This means they may find it hard to look after themselves and need help with daily life.

The way that autism is expressed in individual people differs:

  • at different stages of life.
  • in response to interventions.
  • with the presence of coexisting conditions such as learning disabilities.

The features of autism may vary in severity and may fluctuate over time or in response to changes in circumstances. Mental Health co-morbidities are common in people with autism, particularly anxiety and depression. The co-existence of other neuro-developmental conditions such as ADHD and tic disorders are also frequent.

A significant proportion of adults with autism experience social and economic exclusion. Their condition is often overlooked by healthcare, education and social care professionals, which creates barriers to accessing the support and services they need to live independently. In addition, people with autism are more likely to have coexisting mental, physical, and other developmental disorders. Some may have contact with the criminal justice system, as either victims of crime or offenders, and it is important that their needs are recognised.

Over recent years there has been increasing recognition of the needs of people with autism spectrum condition (ASC). The Autism Act (2009) has laid down in statute the requirements to address these needs. More recently NICE guidance has been published for adults with ASC (NICE, 2012), outlining best practice in recognition, assessment and management for adults with autism.

Autistic Spectrum Disorders in children and young people

Signs of autism in young children include:
  • not responding to their name.
  • avoiding eye contact.
  • not smiling when you smile at them.
  • getting very upset if they do not like a certain taste, smell or sound.
  • repetitive movements, such as flapping their hands, flicking their fingers or rocking their body.
  • not talking as much as other children.
  • repeating the same phrases.
Signs of autism in older children include:
  • not seeming to understand what others are thinking or feeling.
  • finding it hard to say how they feel.
  • liking a strict daily routine and getting very upset if it changes.
  • having a very keen interest in certain subjects or activities.
  • getting very upset if you ask them to do something.
  • finding it hard to make friends or preferring to be on their own.
  • taking things very literally – for example, they may not understand phrases like “break a leg”.

Autism can present differently in girls and boys. For example, autistic girls may be quieter, may hide their feelings and may appear to cope better with social situations. This means that autism can be harder to spot in girls.

Where to get advice if you think that your child may be autistic:

Speak to:

  • your GP
  • your health visitor (for children under 5)
  • any other health professional your child sees, such as another doctor or therapist
  • the school nurse or head teacher
  • special educational needs (SENCO) staff at your child’s school

Getting diagnosed can help your child get any extra support they might need.

Autistic Spectrum Disorders in adults

Common signs of autism in adults include:
  • finding it hard to understand what others are thinking or feeling.
  • getting very anxious about social situations.
  • finding it hard to make friends or preferring to be on your own.
  • seeming blunt, rude or not interested in others without meaning to.
  • finding it hard to say how you feel.
  • taking things very literally – for example, you may not understand sarcasm or phrases like “break a leg”.
  • having the same routine every day and getting very anxious if it changes.
Other signs include:
  • not understanding social “rules”, such as not talking over people.
  • avoiding eye contact.
  • getting too close to other people or getting very upset if someone touches or gets too close to you.
  • noticing small details, patterns, smells or sounds that others do not.
  • having a very keen interest in certain subjects or activities.
  • liking to plan things carefully before doing them.

Autism can sometimes present differently in women and men. For example, autistic women may be quieter, may hide their feelings and may appear to cope better with social situations. This means it can be harder to tell you’re autistic if you’re a woman.

Where to get advice if you think that you may be autistic

If you think you may be autistic consult your GP or, if you already see a health professional, such as another doctor or therapist, you could speak to them instead.

Getting diagnosed can help you get any extra support you might need.

Useful information about autism

Specialist referral

Children and young people

Children & Family Health Devon co-ordinates the diagnostic pathway for Autistic Spectrum Disorders in Devon (excluding Plymouth) for children and young people aged 5 – 17.

Anyone can refer onto the pathway including Schools and Parents who are often better placed to make a referral rather than a GP.

Prior to referral most children should have had an extensive early help assessment; this would normally be carried out within the school context and could include Educational Psychology input or other school support, or input from other health professionals e.g. Paediatrician, Speech and Language Therapy or Child Adolescent Mental Health Services (CAMHS).

Once on the pathway the following steps will take place:

  • Collation of all information known about a child including any assessments
  • A medical assessment by a paediatrician
  • A developmental history from the parents and an evidence-based assessment of the child
  • Further assessments if required e.g. cognitive or language

Following diagnosis, a report will be shared with the family and a feedback meeting will take place, potentially at a team around the child meeting at their school.

Adults

Information about services available for accessing specialist adult autism services in Devon can be found here.

Your GP will need to complete your referral.  You may, also, wish to speak to your GP about your Right to Choose another provider.  For a list of Right to Choose providers contracted by One Devon, visit the ADHD and Autism FAQ page on the Devon Formulary website.

What support is available?

ADHD information