Autism Spectrum Disorder (ASD)

September 21, 2021

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Team Mindsum

About the author: This article is written by our team of researchers and writers. Our content is published after careful review and approval by the editorial board.

What is Autism Spectrum Disorder?
Signs of ASD in children and young adults
Causes of ASD in children and young adults
Diagnosis in females
Managing ASD
What types of professionals are involved?
The journey of managing ASD
Supporting someone with ASD
Useful resources

What is Autism Spectrum Disorder

Autism spectrum disorder (ASD) is a neurodevelopmental condition that affects social interaction, communication and behaviour. It is referred to as a spectrum condition because it affects each person differently.

ASD is not an illness. It is a life-long condition that affects the way people see and interacts with the world.

Not all children and young people with ASD suffer from mental health issues, although it is very common. Children and young people with ASD can have mental and behavioural issues such as anxiety, depression, oppositional defiant disorder, attention deficit hyperactivity disorder and learning difficulties. It is important to support children and young people with ASD in managing the condition and preventing these mental health problems.

Signs of ASD

The signs of ASD are usually there before the age of 3 years old. This includes difficulties in social interaction, communication and repetitive and restrictive behaviours. These difficulties cause challenges in the everyday life of the child or young person. For example, people with ASD generally have a hard time understanding and knowing how to react in the social world. Difficulties with social interaction or communication can include:

Avoiding eye contact
Not point at objects to show interest (for example, not point at an aeroplane flying over)
Do not look at objects when another person points at them
Not able to pretend play
Taking things literally
Rarely using spoken language
Talking at people, rather than engaging in a back-and-forth conversation
Taking a long time to process information
A hard time understanding sarcasm or processing verbal information literally
Difficulty understanding other people’s feelings and intentions
Discomfort with physical touch
Appearing others to behave strangely or not appropriate for the situation (e.g. smiling at someone crying)
Lose skills they once had (for example, stop saying words they were using)

The world is full of unwritten rules which can make it unpredictable and confusing for people with ASD. For this reason, they often prefer to do things the same way. Repetitive and restrictive behaviours can include:

Preferring the same clothes, food or travel to school
Repeating movements (e.g. hand flapping, rocking)
Repeat or echo words or phrases said to them
Repeating actions (e.g. opening and closing the door, turning the TV on and off)
Feeling stressed out or anxious when there is a change in routine
Having an intense interest in a particular topic from a young age
Having a sensitivity to loud noises, lights, tastes or touch

It is common for people with ASD to feel extremely anxious and overwhelmed, especially in social situations and when things change. They can easily shut down or go into a meltdown when things become too much. In this case, the child or young person might lose control, scream, shout, cry or get extremely quiet and switch off. It is important to support children and young people with ASD so that they are able to develop ways of coping and preventing serious problems in mental health.

Please note some symptoms may not appear due to masking behaviours. This is where the child/young person suppresses their behaviours as a way of ‘blending in’.

Causes of ASD

The specific cause of ASD is not known. It is likely due to a combination of genetic and environmental factors. Here are some factors that are associated with ASD:

Boys are 3-4 times more likely to be affected by ASD than girls
Genetics (e.g. sibling with ASD)
Parents with psychosis, schizophrenia or affective disorder
Birth defects
Premature birth
Use of sodium valproate during pregnancy
Existing learning difficulties
Attention deficit hyperactivity disorder
Other genetic conditions (e.g. muscle dystrophy, down’s syndrome, fragile X syndrome)

Diagnosing females

Diagnosis in females tends to be more difficult as they are either misdiagnosed or diagnosed later than boys. This is because girl symptoms don’t tend to fit the stereotypical ASD behaviours as they are seen to be quieter and do not exhibit as much repetitive or restricted behaviours. They also appear to cope better in social situations which is why it can be harder to detect and diagnose. Again, this may also be due to girls masking their symptoms more than boys.

Managing ASD

There is no cure for ASD. It is a life-long condition that needs to be managed. There are many interventions for ASD, depending on how severely ASD affects the child or young person. This includes psychological, behavioural and educational programmes. These interventions are usually tailored to the specific needs of the child or young person. All interventions focus on:

Reducing impairments caused by ASD (e.g. in attention, concentration, engagement)
Improving functioning (e.g. ability to take the school bus alone, making friends)
Reducing behaviours that cause problems in everyday life (e.g. meltdowns, aggression when stressed out)

These therapies focus on the child’s development and their ability to communicate and relate to others. This can include psychotherapy, applied behavioural analysis, speech therapy, play therapy, and occupational therapy. Support can be given from schools as they should have Special educational needs staff (SENCO) who help any autistic children in the classroom by giving them extra support in the classroom so that they can achieve their goals.

Social learning programmes are a type of therapy which helps the child/young person develop their skills in interacting with others. It can include strategies for dealing with social situations, discussion and peer feedback as well as modelling where a child learns by watching others' behaviours.

Play therapy is a type of social learning programme that focuses on helping the child to develop their social skills, language and communication through playtime sessions and it is often used in combination with other therapy. According to research, play therapy is effective in helping children with ASD to develop more social and emotional behaviours.

The idea behind this is to play with the child as they take the lead, giving the therapist opportunities to initiate and encourage social interactions and develop coordination, the use of language and communication. This is also an opportunity for the child to expand their interests. The therapist will use toys and games to prompt the child to do different things such as making eye contact, communicating their needs, understanding how to move toys and engaging in two-way conversations. Play therapy is provided by trained therapists, who usually involve parents in play sessions and might coach parents to do it at home.

Speech therapy is an effective type of therapy that focuses on helping the child or young person to develop language and communication skills. The idea behind speech therapy is to improve the child’s ability to engage in spoken language, non-verbal language, signs and gestures. The speech and language therapist might help the child by strengthening the muscles of the mouth, improving sounds, forming words, matching emotions with facial expressions and understanding body language.

The child or young person will learn to develop their language and communication skills, which will allow them to be more successful in everyday life.‍

Occupational therapy ‍focuses on the development of practical skills that encourage independence in the everyday life of the child or young person with ASD. The therapist will help the child or young person with the skills that they may have difficulties with. This might include dressing, grooming, eating, using the bathroom, colouring, using stationery and taking the bus independently. Eventually, the child or young person will be able to do these activities without help and will live a more independent and successful life.

Parent/carer training programmes support parents in understanding ASD and learning new skills that will help the child succeed in their everyday life and are effective. This can include communication skills, positive reinforcement skills and play activities between the parent and child. Other helpful habits can make a difference in the child’s everyday life. This can include:

Using the child’s name, so that they know they are being spoken to
Reading available online forums on autism and communication skills
Keeping language clear and simple
Using gestures or images to make it easier to understand what you are saying
Making sure your child has a regular bedtime
Connecting with other parents of children with ASD in local support groups

‍It is common for people with ASD to have mental health difficulties. Therefore, talk therapies can be very helpful for them to learn to manage these issues. According to research, cognitive behavioural therapy (CBT) is a talk therapy that can be effective in helping children with ASD to cope with anxiety.

The idea behind CBT for ASD is to help the child to cope better with mental health difficulties in a way that is adapted to their needs and characteristics. The therapist will work with the child or young person to understand and learn the skills to manage their mental health challenges. The therapist might use games, their own special interests, pictures, technology and regular breaks to help them to engage.

What types of professionals are involved?

The management of ASD usually involves a multidisciplinary team of professionals. This means that the child or young person will be assessed and treated by different experts. These might include psychotherapists, counsellors, clinical/ educational psychologists, cognitive behavioural therapists, speech and language therapists, occupational therapists, social workers and neurologists. These terms might be confusing, but the main difference is in the training that each of these professionals has received.

Counsellor or Psychotherapist

In the UK, there is not much of a distinction made between counsellor and psychotherapist. Counsellors are trained to help people with what they need right now, whereas psychotherapists are trained to help on a more long-term basis. People with ASD might benefit from talking through their difficulties with these professionals. Here at Mindsum, we have counsellors and psychotherapists who are available to provide support.

Clinical or Educational Psychologists

Clinical psychologists are trained in the diagnosis, evaluation of clinical history and specialised interventions for different conditions, including ASD. Educational psychologists are trained in psychological assessments and providing help towards learning for children in educational settings.

Speech and Language Therapist (SLT)

SLTs are trained in assessing and treating problems with speech, language, communication, or eating, swallowing and drinking. The SLT provides specialised sessions for the child or young person with ASD to practice and develop the most effective ways to communicate.

Cognitive Behavioural Therapists

These are therapists who have been trained in Cognitive Behavioural Therapy using this model to form an idea of a patient’s mental health difficulties and to treat them. The cognitive behavioural therapist will support the child in managing their mental health difficulties, changing behaviours and challenging thinking styles throughout sessions.

Occupational Therapists

These professionals are trained in how to help people to be successful in practical skills in daily life. They assess and identify helpful adaptations that may be needed, and they help the child or young person to achieve this.

Social workers

Workers trained in working with vulnerable individuals and the community might also be involved with the child or young person. These professionals might help to provide support for the family and make arrangements for interventions.

Neurologists

This is a doctor who specialises in diagnosing and treating conditions related to the brain and nervous system. Since ASD is a neurodevelopmental condition, they might also see a neurologist.

The journey of managing ASD

‍When it comes to ASD, it is about management as opposed to recovery. This is because ASD is a life-long condition. The way ASD is managed can look different for each child and young person, depending on where they are on the spectrum. An overall journey through the management of ASD is discussed below.

Assessment

This is an important phase, where professionals will need to identify and assess the child, in order to confirm a diagnosis of autism. This might involve more than one professional who might administer specialised tests to the child and will interview parents to understand what is going on.

Depending on the child’s needs on the spectrum, these professionals will provide or refer the child for therapy and specialist services.

Therapy sessions

These might include any combination of counselling, psychotherapy, ABA, occupational therapy, speech therapy or play therapy. Each therapy will aim to target certain goals that are specific to the child. Parents are usually highly involved in many of the sessions. The techniques used in some therapies are usually taught to parents for them to use at home. Sessions usually go on for many months or years throughout the child or young person’s life.

Progress and setbacks

When managing ASD, it is common for setbacks to occur. The difficulties associated with ASD can take a long time to change, so it is not realistic to expect the child or young person to improve quickly or without any setbacks. It is important to not get discouraged when setbacks happen. It is an opportunity for the child or young person, parents and the therapist to think about new ways to move forward.

Ending therapy

The professional will eventually prepare the child or young person and their parents for the end of therapy.

This is a very important phase because it is vital for the child or young person to develop more independence. This will take place once the child or young person has made a lot of progress and has reached their goals. The child or young person and their parents will leave therapy with many skills that they can use independently.

Follow up

There are usually follow-up meetings following any type of therapy for ASD. Professionals would need to assess whether the child or young person has maintained their progress. At this point, the child might have additional therapy sessions, depending on their needs.

Supporting someone with ASD

It can be challenging when you have a loved one who has been diagnosed with ASD. It is a condition that has no cure and that needs to be managed. There are some things that you can do to help support your loved one. These are discussed below.

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Understand ASD

It is a good idea to read as much information about autism as you can. Understanding autism and what it means can help you to recognise the ways that your loved one is affected and the ways that you can help.

Find the right support

It is important for you to find support for your child as soon as you suspect that they might have autism. Your child will have a better chance at a successful life if they get support starting from an early age. You might:

Book an appointment with a GP, paediatrician or therapist
Offer support when they attend appointments (e.g. attending some sessions if you need to or waiting in the waiting room)
Find parent groups to connect with and ask for advice. You can find local support groups on the NHS support page for autism.
Take available online courses on autism to help you learn better ways to support your loved one. You can find these on the family support page of the national autistic society website.

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Be mindful of their sensitivities

Many children with ASD are hypersensitive to things such as lights, sounds, smells and movement. You need to know what they might be sensitive to so that you can make adjustments to their environment and they can feel more comfortable.

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Understand how they communicate

You will be able to support your loved one better if you understand their way of communicating. Do not rely on only verbal forms of communication. They might also use some non-verbal forms of communication such as body language, movements or facial expressions. Learning the ways that they communicate will help you understand what they need. This can also help you to improve the connection between you and your loved one.

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Educate family and friends about autism

It will be helpful for your loved one if family and friends also understand autism and the way it affects your loved one. This will help them to be mindful and make changes to the way they interact with the child.

For example, if your child is sensitive to loud noises, they can try to avoid making sudden loud noises when they are around. This will help your child to feel more at ease when they are around other people.

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Encourage them to have a structure

Children with ASD see other people and the world differently from others. Sometimes this can be overwhelming and can cause them to feel anxious, especially when there are uncertainties.

Having a routine can help them to complete tasks and feel less anxious because they will know what to expect. You might help them to:

Make a regular timetable
Make a checklist
Use fun colour codes for their schedule
Use creative stimulators (e.g. fridge magnets, sticky notes, phone reminders)
Have a regular bedtime routine
Be prepared for any changes to the schedule

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Be patient and accepting

A child with autism has an entire life to develop more and more skills that will help them to be successful in their daily life. It is important to be patient with your loved one.

It is also good to be accepting towards your loved one. Sometimes, parents might get carried away with trying to help their children because they are different. Instead of focusing on the things that they are not good at, you could focus more on their strengths and other ways that they are special.

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Make time for fun

Your child also needs to do fun activities that do not feel like work. Don’t allow your child’s schedule to be full of therapy and skills programmes without any time for fun. Schedule time for them to do activities that they enjoy, because play is important for development and learning for all children.

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Look after yourself too

You need to look after yourself. Whether you are a parent, family member or a friend, you will be in a better position to give help, as long as you are taking care of your well-being too. To do this you might:

Get other family members also involved in supporting your loved one
Schedule some time off for yourself
See a professional that can support your mental health