Autism spectrum disorder (ASD) covers several disorders that greatly vary in presentation. It is more common in boys and is usually diagnosed in children >3 years old (children below this age are usually difficult to assess). Autism and Asperger’s syndrome are the two most known in the spectrum.
It is a spectrum of problems involving:
- Qualitative impairments in reciprocal social interaction
- May find relationships difficult to establish
- May not be motivated by the need for social approval
- May find group work difficult
- Seem to relate better to objects than people (except very familiar people e.g. family)
- May show no interest/awareness in the needs/feelings of others
- Qualitative impairments in communication
- May have no speech (see childhood development)
- May echo speech- immediate or delayed
- Conversely, may be verbally fluent but have little understanding of language
- Eye contact is commonly reduced/absent
- May have difficulty using pronouns
- Stress, pitch, rhythm and intonation of speech may be odd
- May have difficulty interpreting non-verbal communication
- May have difficulty with similies/metaphors
- Speech may be monotonous and mechanical
- May be unresponsive to non-verbal feedback
- Restricted, repetitive and stereotyped patterns of behaviour, interests and activities- including rituals and resistance to change
- Generally think in concrete and literal terms
- May have preoccupation with sameness- may become distressed at change/may impose routine on others
- Will often engage in stereotypical movements and resist new experiences e.g. new food.
- Sally- anne test
ASD individuals are at a higher risk of depression, anxiety, OCD, ADHD and other mental problems.
Management
Mainstream education should be tried if suitable. Speech and language therapy and special education is often required to help. Therapies based on reflection are NOT to be used.
Notes on Medicine/Surgery 