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Autism in Children and Teenagers

If you suspect your child may be autistic, you are no doubt wondering what to do. Autism in children and teenagers is much more widely recognised than in generations past but it is not always easy to obtain an assessment and autism diagnosis. If you have noticed developmental differences in your child, you are probably asking: how can I obtain an autism evaluation near me? What is the biggest indicator of autism?

Autism in children is better helped when better understood. For example, research with autistic children and young people showed 7 out of 10 respondents believed ‘school would be better if more teachers understood autism.’ But what about parents, and what can you do if you think your child might be autistic? Let’s break it down.

What is autism?

Autism (including ‘Asperger’s syndrome’) or Autism Spectrum Disorder (ASD) is a neurological and neurodevelopmental condition. It is lifelong. It is not an illness or disease and it cannot be cured. Autism means that a person’s brain functions in a different way to most other (‘neurotypical’) people’s. Hence people with autism are sometimes described as being ‘neurodiverse’.

Dr Spondita Goswami, Senior Child and Adolescent Clinical Psychologist: “Here at The London Psychiatry Centre, in our CAMHS team we have decades of experience in working with autism and we are often asked: What is the biggest indicator of autism? Children with autism experience the world in a different way to neurotypical children. But autism does not come with one single marker – it is a spectrum and within it, different autistic people have varying needs. Having said that, of course there are some common struggles and tendencies.”

So, what do autistic people struggle with? Autism in children and teenagers (and in adults) tends to create difficulties with:

• Social interaction – including struggling to understand, relate to, and be aware of other people’s emotions. Autistic children may find it difficult to share and take turns.
• Language and communication – Autistic children may have late language development (or in severe cases, be completely non-verbal). They may struggle with initiating and taking part in conversation.
• Sensory issues – People with autism often have sensory issues. They may be hypersensitive or hyposensitive (under-sensitive) to sounds, smells, tastes, sights and touch. They may have problems with balance and even awareness of their body positioning and movement, or awareness of sensations within their own body. They often struggle with a range of stimuli present in everyday life that can affect their ability to function as neurotypical people do. For example, bright overhead lights, ticking clocks and other background noises may create sensory overload.
• Unusual patterns of behaviour and thought – Autistic people may display repetitive movements (for example hand tapping or twisting), or specific routines of behaviour which if interfered with, can cause great upset. Some autistic people have trouble processing information.

Autism is referred to as a ‘spectrum’ because people with autism vary widely in the severity and type of symptoms they experience. Some autistic people need a lot more support than others. Some autistic people have average or higher than average intelligence. Others have difficulties with learning. Many autistic people have other challenges such as ADHD, dyslexia or anxiety, while others do not. Autism is present since birth and lifelong. While for many autistic people it is clear to those around them very early on that something about them is ‘different’, there are others who aren’t diagnosed until later in life.

Autism myths and facts

There are a lot of caricatures and myths about autism around and perhaps sometimes these are part of why autism in children goes undiagnosed. What are some common autism myths? Let’s break it down:

• Autism only affects boys: Not true. Autism absolutely affects females but women and girls with autism often present differently. They frequently learn to ‘mask’ their autism to blend in with their peers and others around them. For example, they may learn to suppress fidgeting and practise social interactions before they take place.
• We are all a bit autistic: This is simply not true. Yes many people are a bit shy or introverted, and a lot of people like routine, but this in itself doesn’t necessarily equate to autism. Autism is a neurological condition and a disability that qualifies for reasonable adjustments in law in areas like the workplace. It is a serious thing and it doesn’t help autistic people to minimise it with statements like ‘everyone’s a bit autistic’. Yes, autism is a spectrum and it has historically been underestimated, but even accounting for underdiagnosis, researchers estimate in England only around 2% of the population is autistic.
• Autistic people are all brilliant at maths: False. This myth has been around for decades, reinforced by films like Rain Man. Autism in children (and adults) doesn’t in itself imply skills like that. Autistic people vary in levels of intelligence and interests and abilities. Some are good at maths. Others are artistic or athletic. Some have high IQs. Others have a learning disability. There is enormous variation among people with autism.
• Autism in children will pass when they reach adulthood – false. In times gone by, autism was thought to be a childhood condition (as was ADHD). However it is increasingly acknowledged that autism in children means autism in adulthood – it is a lifelong condition.

Signs of autism in children

Most often, signs of autism in children are perceived in the years before school age.
Having said that, some children on the milder end of the autism spectrum – particularly if they are intellectually adept – are not diagnosed until much later.

• Delayed language and speech development or noticeable communication differences.
• Poor eye contact.
• Lack of non-verbal communication in younger children; for example, the child might not gesture or point.
• Struggling to mix, join in, and share with other children.
• Differences in play style. Play might be less imaginative and more repetitious. They might avoid playing with other kids, opting to play on their own or with grown-ups instead.
• Unusual behaviour for a child of their age, because of difficulty ‘reading’ others and social cues.
• Extreme preference for familiar routine. The child might experience change as very upsetting or overwhelming, and disruption to routine may create a lot of anxiety. As a result, if a child is undiagnosed and at school, they may be seen as unamenable, challenging or stubborn – for example if they are requested to switch seats in the classroom, or if there is suddenly a shift in teachers.
• Fervent absorption in their interests or hobbies with a desire to take part in them all the time, and they may become very upset if disturbed from them.
• Sensory differences. Your child’s sense of sound, smell, sight, taste or touch is heightened (hyper-sensitivities) or reduced (hypo-sensitive). For instance they might find some everyday noises (such as a vacuum cleaner) or bright lights intolerable. Or they may be hyposensitive to common sensations such as hunger and pain. Many autistic people have both sensory hypersensitivities and hypo-sensitivities.

What should I do if I think my child might be autistic?

If you think your child might be autistic, seeking an assessment is generally an important step. A diagnosis is a signal carried to professionals, carers, and perhaps in future, employers, that help them to understand the child much more, enabling them to make any necessary adjustments and to interact with the child in a much more helpful way.

Parents of undiagnosed autistic children sometimes meet unfair judgement and criticism from people who don’t understand. A diagnosis can be very useful for parents also – helping mum and dad to understand their child better and also to have more empathy for themselves regarding the unique experiences and challenges they might face raising a child with different needs. You can access support, not to mention the empathy and camaraderie of other parents facing similar challenges if you wish.

While it is not a disease or illness and there isn’t a cure for autism spectrum disorder, the challenges that come with ASD can be managed with educational adjustments, social skills training, and behaviour management strategies – to help your child to flourish. Every autistic child, just like every neurotypical child, is an individual. So a thorough, expert assessment to pinpoint the range and extent of the challenges is indispensable for a child and their carers. Knowledge is key. Knowledge is the first step.

How is autism in children diagnosed?

Getting a diagnosis for autism in children is useful because it helps professionals, parents, and other adults to understand them more fully and give them the support they need.
Autism is a neurodevelopmental disorder and lifelong condition. For a diagnosis of autism, signs must have emerged by the time the child reached three – though this is sometimes only realised in retrospect.

Assessments for autism in children are quite in-depth. They often take place at Child and Adolescent Mental Health Services (CAMHS), conducted by experts such as psychologists, psychiatrists, paediatricians, and speech and language therapists. Normally, there will be in-depth interviews with parents/carers focusing on the child’s early years, development, and day to day behaviour and communication. Information will usually be gathered from staff at school or nursery. Part of the assessment will usually involve observing the child playing too. Often, there are considerable waiting lists through the NHS, and you may wish to seek help privately.

When it comes to autism in children, diagnosis and early intervention can make all the difference in helping your child to flourish. Here at The London Psychiatry Centre, we can provide support from our dedicated private CAMHS team with decades of experience in working with autism in children. Our team includes dedicated child and adolescent psychiatrists, clinical psychologists and child and adolescent mental health nurses. We know that every child is an individual and a label is not about limits. In short, we work with families to help young people live their best lives.

To book an appointment, call us on 020 7580 4224 or email info@psychiatrycentre.co.uk