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19 - Services for autism-spectrum disorders

Published online by Cambridge University Press:  02 January 2018

Christine Williams
Affiliation:
Consultant Child Clinical Psychologist, Lime Trees CAMHS, North Yorkshire & York Primary Care Trust
Barry Wright
Affiliation:
Consultant Child and Adolescent Psychiatrist, Lime Trees CAMHS, North Yorkshire & York Primary Care Trust
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Summary

‘I can't stress enough the importance of early diagnosis because without a diagnosis, without explanation of the way the child is behaving there is nothing you can do, there's no way you can move on … Once a diagnosis has been given, an explanation of why this child is frustrated and behaving this way, then we can begin to put in appropriate strategies for the family and for the child. It makes one huge amount of difference to their lives.’

Dr Judith Gould

Introduction

Autism-spectrum disorders are thought to affect many more people than is generally recognised. It is very difficult to give precise figures about the prevalence of these disorders because of difficulties with diagnosis, use of diagnostic terms and prevalence study methodology. Reviews indicate approximately 60 per 10 000 children under the age of 8 years (Medical Research Council, 2001), but other estimates are around 1 in a 100 children in the UK (Green et al, 2005; Baird et al, 2006).

Children and adolescents with autism show abnormalities in:

  • • communication and language development

  • • reciprocal social interaction

  • • symbolic play

  • • patterns of interests (the range of interests is restricted, and they centre on repetitive or stereotyped activities).

  • A number of different disorders appear to overlap, each overlapping area having different characteristics (Fig. 19.1).

    Difficulties in each of these areas vary considerably with the age of the child, severity of symptoms and individual differences in the child. The autism spectrum includes the syndromes described by Kanner (1943) and by Asperger (1944), but is wider than these two subgroups (Wing & Gould, 1979). Child and adolescent mental health services are frequently asked to assess children who may have autism; such assessment is complex, as described in Box 19.1.

    Box 19.1 Difficulties in assessment

    Children and young people with autism-spectrum disorders may present in very different ways at different times.

    • The range of intellectual ability extends from severely intellectually disabled to those who are of average or above average intelligence. Similarly, language skills range from those with no language to those who display complex, grammatically correct speech.

    • Changes occur with age, especially in those with higher levels of ability; different aspects of the behaviour patterns are more obvious at some ages than at others.

    Type
    Chapter
    Information
    Child and Adolescent Mental Health Services
    An Operational Handbook
    , pp. 182 - 190
    Publisher: Royal College of Psychiatrists
    Print publication year: 2010

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