Find out about this spectrum condition, how it affects people differently and the approaches and interventions available to help support people with autism.
Autism is a lifelong developmental condition that affects the way a person’s brain works and the way they communicate and make sense of the world. As a result, they may need support in some areas.
Autism is a spectrum condition, which means that people are affected in different ways. While many people with autism share common characteristics, everybody’s experience of autism is unique to them.
Autism was first given its name by psychiatrist Leo Kanner in 1943. Back then, the condition was thought to be rare, but improved understanding and awareness has led to a rapid increase in diagnoses around the world.
Numbers vary by country, but studies suggest that globally, one in every 132 people is on the autism spectrum.1 Research by Autism Spectrum Disorders in the European Union (ASDEU) found that on average across Europe, one in 89 children aged seven to nine years old has some form of ASD.2 In the US, the Centre for Disease Control and Prevention (CDC) reported that the ASD prevalence for eight-year-olds in 2016 was even higher, at one in 54.3
Research published in the Journal of the American Academy of Child & Adolescent Psychiatry also shows that males are affected more than females, with twice as many boys diagnosed with autism as girls4. Scientists are still investigating how autism may impact boys and girls differently, and the ways in which gender might influence its diagnosis.
It’s important to remember that everyone experiences autism differently. Just like anyone else, autistic people have their own strengths and weaknesses, likes and dislikes.
There are some characteristics that are often shared by people with autism5, however, these may be noticeable to different degrees depending on each individual.
Autism is something people are born with or that first appears at a young age, so the first signs are often noticed early in childhood.
In young children, early signs often include not responding to their name, avoiding eye contact, not returning smiles, being slow to start speaking or not speaking at all, making repetitive movements such as flapping hands or rocking, experiencing strong responses to taste, sound and smell and having meltdowns that can seem like temper tantrums.
Older children may also find it hard to express how they feel and to identify with others and they may start developing obsessive interests and find it hard to make friends.
Research into the causes of autism is yet to provide any definitive conclusion, but it does suggest that both genetics and environment may play a role.
Nobody knows whether autism has a cause, but it is known that autism is not caused by vaccines, bad parenting, diet or lifestyle, and it is not a contagious condition that can be passed from one person to another.
Sometimes autism can affect people within the same family, and there is credible research showing that it may be genetic.
Many studies on twins and autism have been conducted, such as the Twins Early Development Study. This study found that if one twin has autism, the likelihood that the other twin also has autism is between 62% and 94% for identical twins, and between 5% and 61% for fraternal (non-identical) twins.
While studies like these help researchers build a better understanding of the role of DNA (genetic material) in autism, it remains a complex subject and nothing has been definitively proven yet.
Studies suggest that certain factors can play a part, although these aren’t related to everyone with autism so should not be treated as a definitive cause.
For example, children with too many or too few copies of certain genes are more likely to have autism, as well as babies whose mothers battled a severe infection during pregnancy. Research7 suggests that autism symptoms can be more acute when these two factors combine.
Autism is a lifelong condition, but while there is no cure, the effects of autism can often be well managed with the right support in place. The section below on treatment and medication explains more about the range of approaches that can help people with autism.
Autism in itself does not lower life expectancy. However, people with autism do tend to die younger than the general population. A study by Karolinska Institutet in Sweden published in The British Journal of Psychiatry8 showed that the leading causes of early death include epilepsy, which people with autism may be vulnerable to, and suicide, which is linked to higher rates of mental health problems among autistic people.
While autism is often diagnosed in children and young people, some people are not diagnosed until they reach adulthood. This may be because they have learnt ‘mimicking behaviour’ to cover the outward signs or because another related diagnosis was made in childhood, while autism went undetected.
Depending on your age, your route to diagnosis will be slightly different.
The first stage is to talk to a health professional. This may be:
If one of these professionals thinks you or your child may have autism, they can refer you for an autism assessment, which will be done by autism clinicians. The process of diagnosis can take time. It’s a good idea to find out what additional support is available from your doctor or local autism charities during the pre-diagnosis phase.
Autism is usually diagnosed after an assessment which involves a range of tests. These may take place in one long assessment or over a number of appointments. The tests vary between children and adults.
The tests for children include a range of observations to see how a child plays and interacts, and the assessment team may visit schools or nurseries to see how they behave there. They will also read through reports from the child’s doctor, school or nursery and talk to parents or carers in depth about their child’s development.
Assessments for adults involve looking at doctors’ reports and questionnaires that the adult being assessed will be asked to complete. Assessors may also want to get a better picture of how the adult behaved as a child, by talking to people they were close to in childhood.
Autism is a lifelong disability and there is no cure or set treatment. It’s better to think of treatment in terms of support – there are a range of approaches that can be used to help people with autism manage their difficulties and live life to the full.
Because autism is a complex condition that affects people differently, the approaches will depend on the individual’s needs and may well change over the course of their life.
Many autistic people also have co-existing conditions, such as a learning disability, mental health problems, epilepsy, sleep problems and digestive issues. Certain treatments or support methods may be helpful for these and should always be monitored carefully.
At the moment there are no medications that can cure autism but different interventions may be helpful and can improve behaviour, skills and language development. Moreover, pharmacological approaches can help in dealing with neurological, psychiatric and other co-occurring conditions. These include antiepileptics, antipsychotics, stimulants and hypnotics.
Therapy can play an important role in helping people with autism. It can help individuals successfully accept their condition, develop strategies to manage it, and learn techniques to relax.
Therapists use different approaches depending on their specialization and what the individual needs help with. Methods may include:
Cognitive Behavioral Therapy (CBT) - a useful therapy for managing negative thought patterns and helping individuals understand how thoughts are connected to feelings and actions.
Play Therapy - often used with children by encouraging them to voluntarily engage in play activities together with a play therapist to improve their social and emotional skills, help them think in different ways, and enhance language and communication abilities.
Other specialized therapies - such as speech and language therapy, physiotherapy, and occupational therapy.
You may be referred to this care through your doctor or other healthcare professionals, it may be offered by your employer or your child’s school, or you can seek it privately.
If you choose a private counselor, make sure they are a member of an appropriate professional organization.
Research shows that support that combines psychological and social factors plays an important role in helping people with autism. For children and adolescents, this includes play-based strategies involving parents, caregivers, and teachers. For adults, employment programs, structured leisure activities, and social skills training can be beneficial.
Many children with autism will receive additional support through the school system. Some may remain in mainstream schools and receive assistance through special educational support, while others may be offered a place in a special school that specializes in teaching children with autism and other disabilities.
These forms of support can be crucial in helping people with autism learn life skills and manage stress-related behaviors, such as self-harm or damaging objects around them.
Some people find that specific dietary approaches – can be beneficial. Some studies12 have looked at different dietary interventions and found that they could be potentially helpful, but wider research is needed to provide stronger evidence.
Exercise is essential for maintaining good health and well-being in autistic children and adults. It not only provides excellent opportunities for interaction and practicing social skills in a relaxed environment, but it also helps improve fitness and muscle strength. This is especially important because studies show that children with autism generally have lower muscle strength and endurance than other children of the same age group.
The key is to find the activities that are most suitable for the individual. Many autistic people prefer quieter places or smaller groups and usually like to be with the same people and activity leaders each time so they know what to expect.
Exercise with animals—such as horseback riding—can be a positive way to interact nonverbally. It is also a good idea to consider activities that help develop specific skills, such as balance, flexibility, and coordination, as well as activities that involve elements of running, catching, and throwing.
Our understanding and awareness of autism has developed rapidly in the past few decades, and research plays a key part in this. In 2019 the National Institute of Health in America awarded more than four million dollars to a number of research projects aimed at developing screening tools to detect signs of autism spectrum disorder in the first year of life.
However, when it comes to looking at broad figures – such as the number of people who are autistic – different study methods are often used in different countries. This can make it hard to make meaningful comparisons about how autism affects people.
For example, some studies include Asperger Syndrome when researching autism and others don’t. This can greatly affect statistics on gender, as a much higher proportion of males are diagnosed with Asperger’s. Similarly, statistics only tell part of the story, as it is believed that many adults and many females remain undiagnosed.
Studies into co-existing conditions can be helpful in building a better understanding of the needs of autistic people. For example, research14 shows that around 50% of people with autism also suffer from anxiety or depression. This compares to roughly 15% of the neurotypical (individuals of typical developmental, intellectual, and cognitive abilities) population and helps to develop a strong case for mental health support for people with autism.