Autistic Spectrum Disorder is a neurodevelopmental condition that affects how people communicate, interact with others, learn, and process sensory information. There are a wide range of symptoms and severity levels.

Some common traits include:

1. Social Communication and Interaction Differences: Autistic people might use verbal and nonverbal communication differently, including using facial expressions, gestures, and tone of voice. They might prefer to avoid eye contact or not understand what you mean when you ask open questions.

2. Engaging In Repetitive Behaviours: Autistic people may engage in repetitive movements, such as hand flapping or rocking from time-to-time. They may have strong, specialist interest in specific topics, and may adhere to strict routines. All of these things are things they find comforting.

3. Sensory Sensitivities: Autistic people may over- or under-react to sensory input, such as sounds, lights, or textures. They may find some textures very comforting, and some quite difficult. They may struggle to explain these at times, so be patient and kind.

Autistic Spectrum Disorder replaces the previous diagnoses of Autism, Autism Spectrum and Asperger's Syndrome. Some people in the community prefer to simply call it Autism or Autistic Spectrum Condition, rather than disorder.

There are also a number of myths around ASD. Let's bust them.

A medical doctor or multidisciplinary team usually diagnoses Autism Spectrum Disorder. Research suggests a prevalence rate of approximately 1 in 100 people in the UK, according to the National Autistic Society. Available data suggests that ASD is significantly under-diagnosed in women and girls.

To reach a diagnosis in children, they are assessed against criteria for social communication difficulties and restricted, repetitive behaviors using standardised assessments like the Autism Diagnostic Observation Schedule (ADOS) and the Autism Diagnostic Interview-Revised (ADI-R), along with clinical observations and developmental history.

To reach a diagnosis, the individual must meet criteria in both domains and demonstrate that symptoms have been present since early childhood. For adults, a retrospective assessment of childhood behaviors and current difficulties is typically required. 

An ASD assessment might be carried out by one or a number of the below as part of a Multi-Disciplinary Team (MDT):

1. One of the following Doctors:

   1. Consultant Community Paediatrician

   2. Consultant (Child and Adolescent) Psychiatrist.

   3. An Associate Specialist / Specialty Doctor (a grade below a Consultant).

   4. Clinical Psychologist or Practitioner Psychologist (non-medical doctors).

2. A Nurse Specialist in ADHD, Psychiatry, Mental Health or an Assistant Psychologist.

3. A Specialist Health Visitor or a Nursery Nurse for clinical observations.

4. A Clinical Support Assistant (QbTest or similar).

5. A Highly Specialist Speech And Language Therapist who carry out ADOS when children are less verbal, and also to provide assessment or treatment for their speech difficulties.

6. A Highly Specialist Occupational therapy who carry out ADOS bearing in mind their specialist knowledge around autism and sensory issues, and also to provide advice and treatment around sensory issues, or associated problems like Pica.

It is best practice for a child to be assessed by multiple professionals, but where this is more straightforward this doesn't always happen. Even when your children isn't assessed by multiple professionals, they will discuss your child in an MDT meeting to consider multiple expert perspectives.

Every area in England has a commissioned ASD assessment service of some kind for under-18s provided by an NHS Trust or a community provider. Their waits are often long and so sometimes adults might choose to use NHS Right To Choose.

The exact cause of ASD is not fully understood, but research suggests that it's a complex interplay of various factors:

1. Genetic/Gene Mutation Variations: In very care cases, single cell gene mutations have been linked to ASD alongside other rare developmental conditions. There are also common cell gene mutations that also explain ASD, and research suggests there are hundreds. We also know some mutations are inherited by parents, or can occur spontaneously during egg fertilisation.

2. Brain Structure Differences: Some studies found young autistic children have slightly larger brains than their non-autistic peers although this difference disappears in adolescence. Alongside this, differences in specific brain regions have been observed, such as:

   • Cerebellum: Involved in motor coordination, balance, and some aspects of cognition and social interaction.

   • Amygdala: Plays a role in processing emotions and social information.

   • Frontal cortex: Involved in higher-order cognitive functions, such as planning, decision-making, and social behaviour.

   • Temporal lobe: Involved in language processing and social understanding.

   • Connectivity: Alterations in the connections between different brain regions have also been found in individuals with ASD. This may affect how different brain regions communicate and work together.

1. Behavioral Therapies: Applied Behavior Analysis (ABA) is a commonly used therapy that focuses on teaching specific skills and behaviors through positive reinforcement. Other behavioral approaches like Pivotal Response Training (PRT) and Early Start Denver Model (ESDM) are also effective. ABA is quite controversial within the autistic community and has been compared to abuse and dog-training. A lot of practitioners and the community have moved towards Positive Behaviour Support (PBS) as a more affirming model.

2. Social Skills Training: Social skills groups and individual therapy can help individuals with autism develop social communication skills, understand social cues, and build relationships.

3. Occupational Therapy: Occupational therapy focuses on improving daily living skills, sensory processing, motor skills, and adaptive behaviours. This might mean helping them to manage their exposure to overwhelming sounds, integrate certain textures and learn coping skills, and even learn some motor skills such as writing, pen grip, etc.

4. Speech And Language Therapy: Speech and language therapy helps individuals with autism improve communication skills, both verbal and nonverbal. This might include building attention games, helping them with specific speech sounds, and coaching parents in using those interventions at home.

5. Medication: While there are no medications specifically for autism, certain medications may be prescribed to manage co-occurring conditions like anxiety, depression, or attention deficit hyperactivity disorder (ADHD).

6. Parent Training and Education: Parent training programs equip parents with strategies and techniques to support their child's development and manage behaviours that parents find challenging.

7. Reasonable Adjustments: In schools, children with autism may receive individualized education plans (IEPs) that provide accommodations and modifications to support their learning such as some one-to-one, access to a sensory room, etc. For adults in work or education, their employers or educators should take into account what they can do to make things easier for them including more remote learning/working, specialised equipment, etc.

8. Support Groups: Support groups for individuals with autism and their families provide a safe space for sharing experiences, gaining knowledge, and receiving emotional support.

9. Lifestyle Modifications: Maintaining a healthy lifestyle with regular exercise, a balanced diet, and good sleep hygiene can contribute to overall well-being and potentially reduce some challenges associated with autism.