ASD is the term used to describe a range of lifelong conditions across what is known as the autism spectrum, which impact on an individual’s learning, social interaction and communication, and is sometimes accompanied by additional learning disabilities.

ASD includes those diagnosed with high functioning autism (Asperger syndrome), where learning disabilities may not be present, although social difficulties associated with autism may still impact a person’s ability to form relationships or express themselves through non-verbal communication, for example.

Autism is not a mental health condition; it is widely conceptualised as being a pervasive developmental disorder (PDD) which is present from birth. It affects a person’s ability to relate to others and the world around them, and also to process information. Those with autism can be hyper-sensitive to sensory stimulation such as sounds, smells or colours, whilst predictability and a fixed daily routine are sought out by children or adolescents with autism.

ASDs can be very subtle in high functioning young people, and often they are diagnosed on transition to senior school when high levels of anxiety become evident due to all of the changes that are happening for the young person at that time. Although certain autistic traits can be seen in high functioning autism (Asperger syndrome), those with the disorder tend to be better able to express themselves verbally and are of average or above average intelligence.

The main difficulties experienced in a child or person with ASD include:

• Social communication - processing language, verbal intonation and tone, figures of speech and literal thinking
• Social interaction - understanding non-verbal cues, unspoken social rules, forming friendships and appreciating social contexts. They may also appear odd or inappropriate to others
• Social imagination - lack of empathy, seeing situations from another’s perspective, predicting and understanding feelings and reactions, and foreseeing consequences of events and actions

Research indicates that around 1 in 100 people are on the autistic spectrum, although the complex condition can impact people’s lives differently.

If your child is diagnosed with autism, there is a range of care and support services offered at Priory which can help them to manage the condition, while some people with autism continue their learning development enough to be able to live independently.

While the severity of ASD varies from person to person, common signs of the condition include learning disabilities and problems interacting and communicating with others in a way that would be expected, in line with a child or adolescent’s age.

Many signs and symptoms of ASD are usually observed during pre-school, where behaviours such as reacting to a voice or gazing at a person’s face, which are typical of this age group, may not be observed.

It is the lack of these types of reciprocal gestures and the ability to read the emotional cues of others, which can cause a toddler great difficulty when attempting to interact during social games or even to seek affection from parents.  

As your child moves through the age groups and into school age, these difficulties appear more pronounced as a greater level of social interaction is generally required. For example, a child aged between five and seven would usually have some understanding of another person having different thoughts, feelings and emotions than they have. However, a child with autism may lack this understanding, which can make it hard for them to forge early relationships and understand another child’s actions.                  

A child or adolescent with high functioning autism (Asperger syndrome) may appear to struggle less than an individual with other forms of autism, as they have the skills to copy and learn behaviours and present themselves as coping, when internally they may be really struggling. However, the social and communicative difficulties tied to problems regulating emotions in all forms of ASD, can make it increasingly hard for a child with ASD to grow, develop and function in their everyday lives as someone without the condition would.

Some of the behaviours that you might observe if your child is showing signs of an ASD before they reach school age can include:

Speech

• Speech development is delayed, with few words spoken before the age of 2, or even no speech at all
• Repetition of words and phrases
• Prefers to use single words rather than attempting full sentences

Responding

• Providing that they don’t have hearing difficulties, not responding to their name or other vocal prompts for them to behave in a certain way
• Difficulties with intimacy such as hugging a parent or carer, particularly when initiated by others
• Responding excessively negatively when asked to do something, or if a routine/plan changes

Interactions and behaviours

• Not understanding another child or adult’s need for personal space and becoming unusually defensive when others enter their own personal space
• Little to no interest in interacting with other children their age, instead preferring to play and engage in activities alone
• Experiencing little enjoyment from activities that other people their age usually would
• Rarely uses non-verbal gestures such as facial expressions to communicate with others
• Regularly avoids making eye contact
• Prefers routine
• Playing with toys or objects repetitively

Some of the behaviours you might observe if your child is showing signs of ASD during school age can include:

Speech

• Still avoids using spoken language to communicate
• Avoids trying to form new sentences, and will often use repeated or pre-learned phrases
• Struggles to engage in a typical dialogue of conversation and will appear to talk at, rather than with, other people

Responding

• Finds it difficult to read into the subtleties of language, such as when a peer or adult uses sarcasm, such as: “I can’t wait to do my homework tonight”
• Difficulty responding to everyday social cues such as greeting people or waving goodbye

Interactions and behaviour                       

• Finds it difficult to interact with others and form friendships, even if they desire to have friends
• Finds it hard to read the context of a social situation, such as speaking formally to teachers and more informally when talking to peers in the playground
• Develops an intense interest in a particular subject or activity
• Prefers to play or interact with objects rather than other people
• Repetitive movements such as rocking back and forth or flapping their hands

ASD and its cause is the focus for a significant amount of active research. Experts believe that ASD is caused by the way in which the brain develops before, during, or soon after birth, as well as genetic influences.

Although the exact cause of ASD is unknown, it is understood that there are a range of inherited, environmental and other factors which could lead someone to develop this complex condition.

Genetics

Research exploring the causes of ASD suggests that particular genes that you inherit as a child could play a role in the likelihood of developing the condition later in life. Having immediate family members such as siblings or parents with the condition can also increase the chances of developing ASD, with younger siblings of children with ASD, and identical twins, particularly vulnerable to the condition.

Environment

Certain genes may make a person prone to developing ASD, although environmental triggers are also thought to play a role. Even if your child has a genetic predisposition for developing ASD, it is entirely possible that specific interactions with their environment may dictate whether they ultimately develop related symptoms.

These environmental triggers are believed to include:

• Being born prematurely
• Being exposed to substances such as alcohol or drugs while in the womb
• Bacterial or viral infections passed onto the baby

Brain development

Scientists continue to look for a specific difference in the brain structure of people with ASD and those without the condition.

The complexity of the condition means that there are few studies which have shown common characteristics in the brain of people with ASD, meaning that there could well be a variety of causes of the condition, and ASD may affect people’s brain functioning in different ways.

Because the symptoms of ASD involve many aspects under the brain’s control, such as language, sensory, and cognitive difficulties, it is highly unlikely that there is one area of the brain that is responsible for the development of autism.