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AUTISTIC SPECTRUM DISORDERS including Asperger Syndrome


AUTISTIC SPECTRUM DISORDERS including Asperger Syndrome

The current consensus in the research literature is that autistic spectrum disorders (ASD) affect approximately one in 100 people (Howlin, 2011). It is a developmental disability (that is, one which is not caused by illness or injury – although people with brain damage can display autistic like behaviours or symptoms) signs of which are usually apparent before the age of three years. Wing and Gould (1976) first identified the classic ‘triad of impairments’:

Wing and Gould (1976) first identified the classic ‘triad of impairments’:

• social interaction and reciprocity

• communication (verbal and nonverbal)

• lack of imagination and behavioural or cognitive inflexibility, often leading to restricted and repetitive behaviours (RRBs) and interests.

It is ‘spectrum’ disorder because its presentation varies widely between individuals with autism and it can range from severe to mild. At one end will be children and young people – also adults – who have severe impairments of social behaviour, communication and intellectual/cognitive functioning. At the other end are individuals of average or higher intelligence, known as “high functioning autism” (HFA). Individuals who have Asperger Syndrome (where verbal ability is often normal or better) are also at the higher end of the spectrum.

Diagnosis of ASD is done solely on the basis of a child’s behaviour – there is no biological marker or test for the condition – and inevitably, therefore, much comes down to professional judgement.

Sometimes, given the breadth of the autistic spectrum, it is difficult to ‘draw the diagnostic line’ between normality and abnormality, or between personality and pathology.

It can also be difficult to distinguish, particularly in HFA, between children who have ASD and those who have ADHD or anxiety disorders, or developmental language disorders.

Several Associates in the practice are trained in using the "gold standard" assessment procedure, ADOS-II, and this can be arranged on request.