Autism

Brief Information

Introduction

Autistic spectrum disorder (ASD) is a lifelong condition that affects how a person communicates with, and relates to, other people. It also affects how they make sense of the world around them.

Autistic spectrum disorder is the term that is used to describe a group of disorders, including autism and Asperger syndrome. The word 'spectrum' is used because the characteristics of the condition vary from one person to another. Those with autism may also have a learning disability. Those who have Asperger syndrome tend to have average, or above average, intelligence, but still have difficulty making sense of the world.

The causes of ASD are still unknown, and research is ongoing. However, research suggests that genetic factors may be involved, and there is also some evidence to show that the condition may be linked to environmental factors, such as pollution, or viruses like rubella (German measles).

Recent research suggests that around 1 in 100 people have ASD in the UK. It is thought to affect four times as many males than females, although the reason for this is unknown.

There is no cure for ASD and it continues throughout life. However, many treatments and different types of support are available. An early diagnosis can help to put appropriate support into place for both the individual and their families.

Causes

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.

Genetic Link

Research that has been carried out with twins, and families, suggests that autism may have a strong genetic link, but the sites of relevant genes have yet to be identified. Scientists have been attempting to identify which genes might be responsible for autism for some years.

It is likely that multiple genes are responsible for causing autism, rather than a single gene. However, it is difficult to establish exactly which genes are involved because of the interaction between genes, and their interaction with environmental factors. For these reasons, at the moment, there is no way of genetically testing someone to find out whether they are likely to develop autistic spectrum disorder.

Environmental Factors

Environmental factors, such as pollution and certain viruses, may play a part in autism, although their exact role is unclear. In the past it was thought that the MMR vaccine may possibly be linked to ASD, but research has shown that there is no evidence to suggest that this is the case.

In a minority of cases, there is evidence to suggest that autism, along with other developmental disorders, may be caused by a variety of physical factors, all of which affect brain development and occur before, during, or after birth. For example, maternal rubella, tuberous sclerosis, lack of oxygen at birth, and encephalitis as a complication of an infectious illness. However, autism is not caused by emotional deprivation or the way a person has been brought up.

Treatment

There is no treatment that can cure autistic spectrum disorder (ASD). However, there are many ways that a person with ASD can get help and support in order to manage their condition. These are often called interventions. Some people with ASD will require specialist care and support throughout their lives, whereas others will require limited support at different times in their lives.

As there is such a large number of interventions available for people with autism, parents and healthcare professionals may find it difficult to decide which approach is best suited to their particular circumstances.

It is important to remember that although different approaches have been known to work for some people with an autistic spectrum disorder, some have not been evaluated on a long-term basis. Before using any particular approach it is best to find out as much information as you can about it. Any approach should be positive, build on people's strengths, and help to discover their potential, increase their motivation, and provide the opportunity for them to develop their skills.

Because ASD differs from person to person, the type of support needed will depend on the individual's own circumstances. It will also depend on what support is available in the area that you live, as not all services are available on the NHS in all areas.

Education

When a child is diagnosed with ASD, they may have an assessment of their educational needs. Some children may need to attend a specialist school for children with ASD, whereas others may be able to attend a mainstream school, but require some extra support during lessons. In some cases, it might be more appropriate for your child to be educated at home.

Visual supports are often helpful to children with ASD. Teachers may use a visual timetable showing times and simple drawings of the activities, so that the child knows exactly what they will be doing and when. Many schools use sophisticated computer software packages to write out stories, descriptions and instructions in both words and symbols simultaneously.

Most schools that educate children with autism have adopted the TEACCH approach (Treatment and Education of Autistic and related Communication handicapped Children). It is based on the principle that children with autism learn better in a structured educational environment, and each child should have a unique programme based on regular assessment of their abilities.

The TEACCH approach is grounded in theories of cognition (thought processes) and behaviour. Understanding the causes of unwanted behaviour is important in the process of trying to reduce it. The physical learning environment in which the child is learning is organised in a structured way to help them learn what activities take place in particular areas, and to avoid sensory distractions. They are given clear instructions for every stage of an activity, usually presented in a visual way. The TEACCH approach is one in which parents work with the professionals to continue the techniques at home.

Communication

Many children with ASD benefit from support with communicating in social situations. This may take the form of social groups, social stories, through behavioural therapies, counselling or speech and language therapy.

Some children with ASD may be taught social skills, such as greetings, turn taking in conversation, and watching for cues in social skills groups, which may be run by speech and language therapists or teachers.

Children with autism tend to be visual learners and find it easier to understand the world about them using visual aids. The Picture Communication Exchange System (PECS) involves the adult using pictures as symbols in order to teach the child the names of different objects. Gradually, the child is taught to exchange a picture for the object they want, to construct simple sentences using the pictures, and indicate choices between various objects

You can communicate more effectively with a person who has ASD by:

• Avoiding using metaphors and sarcasm,
• Saying exactly what you mean, and
• Using visual cues where necessary (for example, a fork for mealtimes, or a towel for bath time).

Medication

Medicines cannot be used to treat ASD. However, medicines can be used to control some of the additional symptoms, such as hyperactivity or obsessive behaviour. For example, a medicine called methylphenidate can make children with ASD less irritable and hyperactive. However, some medicines that are used to treat the additional symptoms of ASD can cause side effects, so your doctor will only use them if the benefits outweigh the risks of taking them.

More Information

• National Autistic Society
• MIND - Understanding autistic spectrum disorder
• Autism Patient UK
• Autism and Asperger syndrome
• What is autism - part 1
  (Autism Independent UK)
• What is autism - part 2
  (Autism Independent UK)
• Information on Autism

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