Autistic spectrum disorder (ASD) includes a range of impairments in social interaction, communication and behaviour.
Autistic spectrum disorder is defined in the DSM-5. It takes previously recognised diagnoses (Asperger’s syndrome, autistic disorder and pervasive developmental disorder) and groups them into one spectrum.
On one end of the autistic spectrum, patients have normal intelligence and the ability to function in everyday life but display difficulties with reading emotions and responding to others. This was previously known as Asperger’s disorder. On the other end, patients can be severely affected and unable to function in typical environments.
Features
The features of ASD vary significantly between individuals along the spectrum. They can be categorised as deficits in social interaction, communication and behaviour. Features are usually observable before the age of 3 years.
Deficits in social interaction include:
- Lack of eye contact
- Delay in smiling
- Avoiding physical contact
- Unable to read non-verbal cues
- Difficulty establishing friendships
- Not displaying a desire to share attention (e.g., not playing with others)
Deficits in communication include:
- Delay, absence or regression in language development
- Lack of appropriate non-verbal communication (e.g., smiling, eye contact, responding to others and sharing interest)
- Difficulty with imaginative or imitative behaviour
- Repetitive use of words or phrases
Deficits in behaviour include:
- Greater interest in objects, numbers or patterns than people
- Stereotypical repetitive movements (e.g., self-stimulating movements, such as hand-flapping or rocking)
- Intense and deep interests that are persistent and rigid
- Repetitive behaviour and fixed routines
- Anxiety and distress with experiences outside their regular routine
- Extremely restricted food preferences
Diagnosis
An autism specialist should make the diagnosis. Diagnosis usually involves assessment by psychiatrists and clinical psychologists. It involves a detailed evaluation of the patient’s current and historical behaviour and communication.
Management
Autistic spectrum disorder is a life-long condition and cannot be cured. Management depends on the severity of the condition. Patients with mild impairments may be highly functioning and not require any formal support.
A multidisciplinary team can help support patients and carers (e.g., parents) with greater impairments. For example:
- Child and adolescent mental health services (CAMHS)
- Psychologists
- Speech and language specialists
- Dieticians
- Paediatricians
- Social workers
- Specially trained educators and special school environments
- Charity organisations (e.g., National Autistic Society)
Last updated June 2024
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