Autism spectrum disorder (ASD) is a condition that affects social interaction, communication, interests and behaviour.  ASD is now commonly seen as part of the relatively new concept of neurodiversity. Neurodiversity refers to the naturally occuring diversity in cognitive styles and the way people's brains develop.  More recently, there has been a shift towards neurodiversity as a concept, rather than more formal medical terminology. Whilst being neurodivergent undoubtedly brings about a range of unique strengths, it can also lead to challenges and an increased risk of mental health difficulties. 

The features will be present before the age of three, but often a child or adult will not get a diagnosis until much later on.  Statistics show that around 1 in every 100 people in the UK has ASD, with more boys being diagnosed with the condition than girls.  However, Georgina is now seeing many more girls and femail adults being diagnosed with autism, where their challenges and differences have been misunderstood, often as part of an anxiety disorder.  

Signs and symptoms

People with ASC tend to have differences in how they communicate and understand social interactions. The impact of these differences will vary depending on each person.

Children and adults with ASC frequently experience a range of cognitive (thinking), learning, emotional and behavioural problems. For example, they may also have attention deficit hyperactivity disorder (ADHD), anxiety, or depression.

For more information, the National Autistic Society has a fantastic website www.autism.org.uk/about/what-is.aspx for parents, adults and professionals.  They also have a helpline number.

Diagnosis

Because each child and adult on the autistic spectrum presents with a different cluster of features, a thorough assessment needs to be carried out by professionals trained specifically in assessing and diagnosing autism.  This assessment will rule out learning difficulties and ADHD as primary underlying contributors, although, as stated above, these may be also present alongside ASC.  Part of the assessment will involve input from a paediatrician or psychiatrist to ensure the assessment is Gold Standard and in line with NICE guidelines. 

What will the assessment involve?

For children:  

A meeting with the parents or adult to gather a thorough developmental history.

A school observation or a conversation with teachers and the SENCO. This can be done prior to or after the assessment with your child.  If a an Educational Psychology Assessment has not already been completed, a cognitive assessment may be undertaken. 

The Autism Diagnostic Observation Schedule (ADOS) will then be carried out with a child.  This is a semi-structured assessment of communication, social interaction, and play (or imaginative use of materials) for individuals suspected of having autism. This will take approximately an hour.

A 3Di or ADI-R will be carried out with one, or preferably both parents. This is a developmental and diagnostic interview. This will take approximately two hours. This will be carried out by a Consultant Paediatrician or a Consultant Psychiatrist. 

A report will be written and a feedback session will be held with the parents and the child (depending on your child’s age).

For adults:

The Autism Diagnostic Observation Schedule (ADOS) will then be carried out.  This is a semi-structured assessment of communication, social interaction. This will take approximately an hour.  

An ADI-R with be carried out by a clinical psychologist. This will take about two hours. 

It may also be helpful to talk to a person's partner/friend/colleague with the adult's consent. 

A report will be written and a feedback session will be held with the parents and the child (depending on your child’s age).

What support will be offered afterwards?

There is no "cure" for ASD, but speech and language therapy, occupational therapy, educational support, plus a number of other interventions are available to help children and parents. Often a family may need the support of clinical psychologists to help reduce some of the behaviours that can present in a child with ASD. 

For children, depending on each child's needs, your child may be eligible for support from the local authority.  It may be that we think a cognitive assessment will be needed.  This is not usually the case but is helpful if there are identified learning needs.

We will signpost you to support in your local area.  This will vary depending on where you live. Types of support include parent support groups and behavioural support. Unfortunately, some areas lack provision and it may be that you need to contact the NAS to get support or more information.