Autism is a disorder that affects the way a person communicates with, and relates to, other people. Most (but not all) people with autism also have a learning disability. People with autism need specialist care and education.

Autism and autistic spectrum

Autism is most likely to be a group of similar disorders with various degrees of severity. So the term 'autistic spectrum disorders' is sometimes used rather than autism.

What are the symptoms of autism?

Symptoms start in the first 3 years of life. It usually develops from birth (about 4 in 5 cases). In about 1 in 5 cases there is a period of normal development first before symptoms begin. There are four different groups of symptoms, all of which usually occur in children with autism.

Social difficulties
There are different types of problems and not all will occur in each case. These can generally be described as an "not being able to get on with people". So the child may:

• seem to be aloof and rather 'stuck up'.
• have little or no interest in other people.
• have no real friends.
• not understand other people's emotions. For example, not understanding why anyone has got cross with them.
• prefer being alone.

Problems with language and communication
Speech usually develops later than usual. When it does, the language (the use and choice of words) may develop wrongly. The sort of problems that children with autism have include one or more of the following.

• Not be able to express themselves well.
• Not be able to understand gestures, facial expressions, or tone of voice.
• Say odd things. For example, repeating your words back to you, time and time again.
• Use odd phrases and odd choices of words.
• Sometimes use 10 words when 1 would do.
• Make up their own words.
• Not use their hands to make gestures as they speak.
• Not be able to understand difficult commands.

Poor imagination
Imaginative play is limited in children with autism. They tend to do the games and activities that they learn over and over again. Games may remain exactly the same every day. Games are usually those that a younger child would normally play.

Unusual behaviours
These are typical and include one or more of the following.

• Odd mannerisms such as hand-flapping or other odd pointless movements.
• Anger or aggression if routines are changed. Children with autism often hurt themselves when they are angry by banging their head or hitting their face. Sometimes they do this to get attention.
• Actions are repeated over and over again (like rocking back and forward).
• Obsessions may develop in older children and adolescents. For example, they may have interests in unusual things like train timetables and lists.

Parents often find these problems very confusing. Not surprisingly, parents often get frustrated.

What is the IQ (intelligence) of children with autism?

Most children with autism have a low IQ. Around 7 in 10 have an IQ level below 70 which is low enough to be classed as 'learning difficulty'. (The average IQ of the normal population is 100.) Some children with autism have normal, or even high, intelligence.

How common is autism?

Autism is uncommon, but it seems to have become more common in recent years. Boys are 3 times more likely than girls to have autism. A recent study has shown that between 1988 and 1999 the number of cases of autism increased 7 times. In this study 8 in 10 cases were boys. The most common age for diagnosis was between 3-4 years. A small number of children were not diagnosed until 12 years or older. The results of this study suggest that autism will now occur in about 2-3 per 1000 children.

What is the cause of autism?

The cause is not known. There are various theories, and various factors may be involved.

Recently there has been speculation that the MMR vaccine may somehow cause autism. There is no evidence that this is true. Recently 2 studies have shown that, whereas the incidence of autism has increased 7 times in the last 10 years, the amount of the children receiving the MMR vaccine has remained the same. Based on these facts, and other studies, there is a strong case to say that there is no link between the MMR vaccine and autism.

What is the treatment for autism?

Most children with autism are under the care of a specialist in child psychiatry. The sort of treatments that are provided include the following.

• Special education to help with language and communication skills.
• Behaviour therapy which aims to reduce 'bad' behaviours and promote 'good' behaviours.
• Medication is rarely used, but sometimes may be needed to help control outbursts of excitement or aggression.

There is no 'cure' for autism. The specialist education and support aim to maximise the potential of each child as they grow into adults. It is thought that the earlier the specialist input is started, the better the outcome.

There are various other treatments that some people say will help autism. These range from special diets to intensive psychological therapies. It is difficult to get hard evidence to prove whether or not these treatments help. You can get details of these treatments from the organisations listed below.

What is the outlook (prognosis)?

Autism continues for life. As the severity can vary, it is difficult to predict the outcome for each child. Even without treatment, sometimes there is improvement in the teenage years and some people with autism become more sociable. Some adults with autism manage to work and get by with just a little support. Many need more support and live at home with parents or family. A placement in a residential home may be needed when older.

Further help and information

National Autistic Society
393 City Road, London, EC1V 1NG
Tel (Helpline): 0845 070 4004   Web: www.nas.org.uk

Autism Independent UK
199-203 Blandford Avenue, Kettering, NN16 9AT
Tel: 01536 523274   Web: www.autismuk.com

© EMIS and PIP 2004   Updated: May 2003   CHIQ Accredited   

The authors and editors of this article are employed to create accurate and up to date content reflecting reliable research evidence, guidance and best clinical practice. They are free from any commercial conflicts of interest. Find out more about updating.

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