What is Autism?

The Triad of Impairments Difficulty with Social Interaction Difficulty with Social Communication Difficulty with Social Imagination

The Triad is usually associated with repetitive patterns of activities. The reason for selecting social impairment as the only defining feature of autism spectrum disorders is purely practical and not related to any causal theory. What can a person with severe learning disability and typical autism have in common with someone brilliant in a chosen field and whose behaviour fits Asperger’s descriptions?

Everyone with an autism spectrum disorder has a number of specific problems in coping with everyday life All have difficulties following subtle, unwritten rules that govern social life All need other people to communicate with them in clear and easily understandable terms All are helped if complex, shifting ideas are explained in concrete terms e.g. with visual illustrations All have difficulty comprehending the passage of time All have, to varying degrees difficulty working out the consequences of their own and other peoples’ actions All need more time than most other people to process information All need to be informed clearly in advance with careful explanations if plans are changed Difficulties caused by over sensitivity to various kinds of sensory input are very common

Autistic Spectrum Disorder Tourette’s Syndrome Dyslexia Dyspraxia Attention Deficit Disorder (AD(H)D)

There is a high degree of overlap between a range of neurodevelopmental disorders that includes attention- deficit hyperactivity disorder (ADHD), dyslexia (specific reading difficulties), dyspraxia (developmental co- ordination disorder), and the autistic spectrum. Although these are all neurodevelopmental disorders of childhood, they all persist into adulthood, causing serious problems not only for those affected, but for society as a whole. Dr Alex Richardson Fatty acid metabolism in neurodevelopmental disorder: a new perspective on associations between ADHD, dyslexia, dyspraxia and the autistic spectrum.

Between them these conditions may affect as many as 10% of the population….However, a major problem is that formal diagnoses of ADHD, dyslexia, dyspraxia and autism not only involve different sets of operational criteria (many of which are acknowledged to be less than satisfactory), but also tend to involve specialists from different professional disciplines. Practitioners dealing with any one of these conditions are often unfamiliar with at least some of the others, and may therefore be unaware of co-morbidity issues and their implications.

The clinical overlap between ADHD and dyslexia is around 30-50% in both directions. A similar degree of overlap is found between dyslexia and dyspraxia. The comorbidity between ADHD and dyspraxia appears to be equally high. Autism - if narrowly defined - is the rarest of these disorders, and would always be the primary diagnosis. Nonetheless, it is evident that many features of the autistic spectrum are also characteristic of the other disorders under consideration here.

Throughout this guidance the term autistic spectrum disorders (ASDs) will be used to describe all children and young people within the triad of impairments. Autistic spectrum disorders will include individuals who have a diagnosis of: autism, autistic disorder, Kanner’s or classical autism, childhood disintigrative disorder, Asperger’s syndrome, pervasive developmental disorder (PDD), pervasive developmental disorder not otherwise specified, and semantic pragmatic disorder.

Asperger’s Syndrome Similar to autism except that children with the syndrome have higher intellectual abilities and better language development than the majority of children with a diagnosis of autism. There is theoretical debate over whether Asperger’s syndrome is the same as high-functioning autism. The main clinical features of Asperger syndrome are a lack of empathy and difficulties in understanding the reciprocal nature of conversations and relationships. Individuals can be pedantic with repetitive speech and develop an intense fascination for certain topics. Many also are clumsy and have co-ordination problems and difficulties in attending to more than one aspect of a task simultaneously. Diagnosis is usually later than for children with autism.