Autism Spectrum Disorder (ASD)


Autism Spectrum Disorder (ASD) is a lifelong developmental condition which can be caused by a variety of genetic and physical factors that affect brain development.

Autism can affect how you communicate and interact with the world, but it’s a spectrum condition, which means it affects different people in different ways. 

The world can feel like an overwhelming, unpredictable, and confusing place for anyone with this condition. 

While some people find the variety of life invigorating and exciting, it’s not well designed for autistic people. If this is you (or you suspect it is) you may be more comfortable with routines and repetitive behaviours.

Changes, no matter how small, can be overwhelming for someone with ASD, causing you to suffer extreme reactions or shut yourself off from the world. Something as simple as a bus detour on the way to work can be really distressing for an autistic person.

Autistic people will often suffer with extreme anxiety, particularly in response to social situations or when facing a change.

It’s also very common for you to feel utterly overwhelmed, which can manifest in a variety of ways. When everything feels too much, you may go into meltdown, temporarily losing behavioural control, either verbally or physically, or you may retreat from the world completely.

Over one third of autistic people also have serious mental health issues. Once a diagnosis has been made, we aim to help those with ASD to recognise and regulate emotions to help improve the quality of life for the autistic person and their family.

Some of the common traits of ASD include:

  • Social communication and social interaction challenges
  • Repetitive and restrictive behaviour
  • Over – or under – sensitivity to light, sound, taste or touch
  • Highly focused interests or hobbies
  • Extreme anxiety
  • Meltdowns and shutdowns

It might be more difficult for you to understand your own, and others’, emotions and intentions. This can be confusing as it may be hard to work out how you feel, and you could find it more challenging to make sense of social interactions.

If you suspect you or someone you know could be autistic, we can help.

If you’re under 18, coming to us with a long history, or we need more information to fully understand your needs, we may recommend you come and see us for an assessment so that we can develop a cohesive and collaborative treatment plan.

 

The ASD assessment

 

An ASD assessment is done in stages.

First, our licensed therapists conduct an ADI (Autism Diagnostic Interview) with the person’s parents or someone who knew them well as a child, for example a nanny, grandparent, older sibling, or another caregiver.

The interview could involve speaking to several ‘informants’ to really understand the person’s childhood and their early development (particularly around the age of 4-5).

We ask questions about a person’s sensory functioning and imaginative play, but there are two key areas of ASD traits that we look for in the interview:

  • How the person has been developing with respect to their social interaction and communication skills.
  • The presence of any repetitive and restrictive interests or behaviours.

The ADI takes around two hours to complete and can be done via video call or by phone. The person undergoing the ASD assessment doesn’t have to attend.

The second part of the ASD assessment is the ADOS (Autism Diagnostic Observation Schedule), which we do with the person themselves.

The Autism Diagnostic Observation Schedule-Second Edition (ADOS-2) is an observational, activity-based assessment administered by trained clinicians to evaluate communication skills, social interaction, and imaginative use of materials in individuals who are suspected to have autism spectrum disorder (ASD). It usually lasts between 1.5 – 2 hours.

Although the ADOS-2 is considered the ‘gold standard’ for ASD assessment, it shouldn’t be used to make a diagnosis of ASD on its own. It’s part of a comprehensive evaluation that considers:

  • A person’s developmental history
  • Information provided by parents and other key informants
  • Behavioural observations both during and outside of the ADOS-2 assessment
  • The judgement of experienced clinicians

We discuss this information as a multidisciplinary team before giving a diagnosis or not. We will feed back what we have learnt from the assessment process and multidisciplinary team discussions to help you make sense of the diagnostic decision. We may ask the school/college for a report which we add to the evidence collected to make a decision about whether the person might be neurodivergent – whether they might be autistic.

The result of this assessment may be a diagnosis of autism, or not. Or, we may learn that you don’t have a diagnosis, but instead have some traits of autism. We’ll discuss with you what the outcomes mean and help you to start to make some sense of what we’ve learnt through the assessment.

 

What happens following a diagnosis?

 

Following a diagnosis, we provide recommendations for the person, their loved ones, and their school/university/work setting about how best to support them and make use of their strengths.

If you’re having treatment with one of our licensed therapists, we will help you and your therapist think about any adaptations you might find useful in your work together. For example, some people we’ve supported have explained it can be useful to sit side by side with their therapist to reduce overwhelm that they experience from eye contact; this is a helpful way of them being able to feel more relaxed in therapy.

The licensed and trained therapists at Altum Health can provide a professional ASD assessment. Please book a free initial consultation to find out how we can help.

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