What is autism spectrum disorder (ASD)?

Autism spectrum disorder (ASD) is a lifelong developmental disorder. It affects how people behave and interact with the world around them.

In people with ASD, the brain does not grow in the same way it does in most people. ASD presents differently in boys and girls.

ASD is not a mental health problem or an intellectual disability. But some people with ASD will also have those problems.

Children and adults with ASD may be highly intelligent, of normal intelligence, or have an intellectual disability. Along with some challenges, an autistic person will also have a range of strengths.

Doctors used to think that Asperger's syndrome and autism were separate conditions. They now think that they are all part of one condition, called autism spectrum disorder or ASD. People with ASD will all have different experiences.

About 1 in 150 Australians has ASD.

The characteristics of ASD usually start in infancy. But they may not be noticeable until the age of 2 or 3 years. Sometimes ASD is diagnosed much later in life.

Most people with ASD can learn the skills they need to function independently or in a supportive environment. Research shows that early diagnosis and treatment is important.

A late diagnosis of ASD can have consequences. Growing up with ASD without support can have an impact on a person’s mental health, education, development, and social life. They may find themselves at a higher risk of bullying, abuse, and violence.

The earlier your child receives an ASD diagnosis, the earlier they can get support. And the more likely it is they’ll develop:

• communication skills
• social skills
• life skills

These skills are important for a good quality of life.

What are the indicators of ASD?

The main characteristics related to ASD fall into 2 broad areas:

• difficulty with social interactions and communication
• restricted and repetitive behaviours and interests

The common signs and traits of ASD in children include the following:

• lack of social or emotional exchanges like pointing, smiling, showing you things
• lack of non-verbal communication such as nodding and shaking head, using hand gestures
• difficulty developing and maintaining relationships appropriate to their age, such as peer play, lack of close friends
• delayed expressed speech and understanding of speech
• lack of eye contact when speaking
• loss of language skills at any age
• excessively following routines, patterns or behaviour, and becoming distressed at changes
• stereotyped or repetitive speech
• using objects in unusual ways, such as rolling wheels before eyes
• movements, such as flapping hands, toe walking
• strongly reacting to sensory input such as sound, pain or textures
• restricted or fixated interests. This might be only playing with certain toys or talking about certain topics
• having difficulty managing emotions, such as frequent and long tantrums

In adults, ASD traits may include the following:

• struggling with time management
• feeling sensitive to the environment
• feeling a sense of isolation
• difficulty paying attention
• struggling to pay attention to detail, or having too strong an attention to detail
• feeling anxious in social situations
• having difficulty maintaining relationships
• becoming overwhelmed easily

What causes ASD?

ASD is caused by differences in how the brain develops. This is caused by genes, which means that if someone in your family has autism, other family members are more likely to also have ASD.

Other factors may increase your chances of having ASD. This may include the age of your parents. Research is also looking at the role of the environment in triggering ASD.

Autism is not caused by:

• vaccinations
• foods
• other lifestyle factors
• your cultural or social surroundings

When should I see my doctor?

If you think your child has ASD, see your doctor. Early intervention offers the best outcomes for children with ASD, whether their traits are obvious or subtle.

There may be different signs of autism at different ages.

• In the first year, your baby with ASD might not be interested in other people. They may not make eye contact with you. They may not smile or gesture like other babies.
• As toddlers, children with ASD might not respond to their name. They might focus on one or 2 activities repetitively, like lining up toys. They may not be interested in playing with other children. They might develop unusual ways of speaking.
• Older children with ASD might have difficulties in social situations, following instructions or making friends.

You might receive an autism diagnosis as an adult. You may spend your life feeling like you don’t quite fit in. You may have difficulties with relationships, work and social situations. You may also have mental health conditions like anxiety or depression.

Autism Awareness Australia provides information about signs of autism in people at different ages.

How is ASD diagnosed?

If your doctor thinks you have ASD, they will refer you to a specialist to confirm the diagnosis. This may be a paediatrician, a psychiatrist or a psychologist.

The specialist uses a set of standard tests to make a diagnosis.

You must have lasting difficulties in social communication and social interaction in multiple situations to be diagnosed with ASD. You must also have restricted interests and activities and repetitive patterns of behaviour. These symptoms must have been evident from early life, and must significantly affect your life.

A diagnosis of ASD will also include a classification based on the level of support the person requires. The 3 levels are:

• level 1: people requiring support
• level 2: people requiring substantial support
• level 3: people more severely affected and requiring very substantial support

ASD in girls

Boys were previously thought to be 4 times more likely to have autism than girls. This is a misconception. ASD is underdiagnosed in girls and women. This is due to a few different reasons.

Most studies on ASD focus on men and boys. Only a small amount is known about ASD in girls. But studies show that autistic females have different characteristics compared to autistic males. Women with ASD appear to be better at masking, or hiding their autistic characteristic to fit in.

Other factors in females include:

• stronger language and communication skills
• mimicry of others in social situations
• less aggression
• shy and passive behaviour
• the ability to contain emotions in public, but prone to outbursts at home

Many females find out they have autism in adulthood.

How is ASD managed?

Various treatment options will be explained to you if your child is diagnosed with ASD. A number of organisations offer education programs and support services, such as Autism Spectrum Australia. These services can support children with ASD, and their parents or caregivers.

It’s best to start treatments early after diagnosis. The right support and programs will improve specific symptoms and social skills.

ASD is a dynamic disorder. Each person with ASD has a unique experience. which is influenced by many different factors. That is why autism is thought of as a spectrum. Treatment programs specifically tailored to individual needs often have the best results.

• Intensive educational programs and therapies can teach language and social skills.
• Speech pathology focuses on developing communication and social skills.
• Occupational therapy can support participation and independence as well as sensory motor development. For example, play skills, fine motor skills and learning how to cope in different environments.

Ensure that the therapies, treatments and supports you choose are informed by evidence. Avoid treatments that offer a ‘cure’ or ‘recovery’. There is no evidence to support these claims.

People with ASD may also have a mental illness. Your doctor can help you to get treatment under the mental health care treatment plan. This provides you with 20 appointments with a mental health professional each year.

Children with ASD can go to either public or private schools. Find out more about schooling options on the Autism Awareness website.

Autism Awareness Australia also offers self-care tips and helpful links and resources.

If you are an adult with ASD, there are different ways to get the help you need. You can get professional support from:

• counsellors
• occupational therapists
• psychiatrists
• psychologists
• speech therapists

You can also attend an ASD support group.

Misunderstandings about ASD

There are many misunderstandings about ASD that can be harmful. These make it harder for people with ASD to get the support they need.

People with ASD are ‘neurodivergent’. The term neurodivergent also includes those with conditions such as dyslexia, dysgraphia and attention deficit hyperactivity disorder (ADHD).

The word ‘neurotypical’ refers to people who do not have these disorders. The neurotypical perception of autism often involves terms such as mild, moderate, severe, low-functioning and high-functioning.

But autism is a dynamic disorder that affects each person differently. Characterising ASD this way can prevent autistic people from receiving the best treatment.

Here is the truth about autism:

• Vaccination does NOT cause autism.
• ASD is NOT caused by eating certain foods.
• People with ASD DO like to socialise and make friends — they just find this difficult.
• People with ASD DO have emotions — they just might show them differently.
• Most people with autism ARE able to learn, even if they may progress more slowly than some others.
• It IS possible for people with ASD to change their behaviour.
• ASD is NOT caused by bad parenting.
• Not all people with autism have savant skills, like in the movie Rain Man.
• Not all people with ASD have an intellectual disability.
• ASD is NOT a mental illness. But people with autism have higher rates of mental illness such as depression and anxiety.

Personal stories — video

Support for carers

Caring for a person with ASD is a lifelong commitment. If you are caring for an autistic person, you can find support through different organisations.

Carer Gateway can give practical information and useful resources. You can also learn more about carers' support and services in your state or territory through Carers Australia.

Resources and support

Having an autistic child or sibling can be a challenging experience at times. There are support services available such as counselling and respite.

For more information about ASD visit:

• Amaze
• Autism Spectrum Australia

Child Family Community Australia has resources and webinars for parents. These are found through the Australian Institute of Family Studies.

For adults with autism, the Aurora Neurodiversity Program can assist with beginning a career in public service. Services Australia runs this program.