🧠🌈 Autism Spectrum Disorder (ASD) is a lifelong neurodevelopmental condition characterised by differences in social communication, social interaction, sensory processing, and patterns of behaviour. It exists on a spectrum, meaning presentation, abilities, and support needs vary widely between individuals. ASD reflects differences in brain connectivity and neurodevelopment rather than “deficit” alone.

🔑 Key Features of ASD

🗣️ Social Communication Differences — Difficulty with reciprocal interaction, eye contact, facial expression, and conversational flow.
🔁 Repetitive Behaviours — Repetitive movements, routines, echolalia, or patterned speech.
🎯 Restricted Interests — Intense, focused interests in specific topics or activities.
🎧 Sensory Processing Differences — Over- or under-sensitivity to sound, light, touch, taste, or texture.
📏 Need for Predictability— Distress with change, preference for routines.

👨‍⚕️ Important Clinical Notes for Doctors

🧩 ASD is highly heterogeneous — no two patients present identically.
👥 Diagnosis requires a multidisciplinary approach (paediatrics, psychology, SALT, education).
📋 Management must be individualised and family-centred.
💬 Communication style should be adapted to patient needs.
🤝 Strength-based approaches improve engagement and outcomes.

🔍 Diagnosis and Assessment

📈 Developmental Surveillance Routine screening in early childhood improves long-term outcomes.
🧪 Comprehensive AssessmentClinical history, school reports, parental input, direct observation.
📊 Standardised Tools ADOS, ADI-R, and structured developmental assessments.
🏥 UK Pathway Referral via community paediatrics or CAMHS → MDT diagnostic clinic.

📘 DSM-5 Diagnostic Criteria (Simplified)

📉 Persistent social communication and interaction differences.
🔁 Restricted and repetitive behaviours/interests.
🧒 Symptoms present from early development.
⚠️ Clinically significant functional impact.

💊📚 Management and Support

🧠 Behavioural InterventionsSocial skills training, positive behaviour support.
🏫 Educational SupportEHCP/IEP, learning adaptations, classroom support.
🗣️ Speech & Language TherapyVerbal and non-verbal communication support.
🧩 Occupational TherapySensory integration, daily living skills.
💊 Medication (Adjunct Only)For comorbid anxiety, ADHD, irritability (not core ASD).
👪 Family SupportParental training, respite care, advocacy.

🔗 Common Comorbidities

⚡ ADHD
😟 Anxiety and Depression
🧠 Intellectual Disability
💥 Epilepsy
😴 Sleep Disorders
🍽️ Gastrointestinal Difficulties
🎯 Dyspraxia / DCD

📈 Prognosis

🌱 Prognosis varies widely and depends on early identification, cognitive ability, communication skills, and social support. With appropriate intervention, many individuals achieve high levels of independence and fulfilment. Others may require lifelong structured support. Quality of life is strongly influenced by societal inclusion and access to services.

🧠 Teaching Pearl
Autism is not a “behaviour disorder” — it is a difference in neurodevelopment. Many crises in ASD arise from unmet sensory or communication needs rather than “non-compliance”. Adjusting environment and communication style is often more effective than medication.

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Autism spectrum disorder