Important facts about autism and Asperger syndrome for GPs - | autism | Asperger syn...

Page 1 of 3

Autism Helpline Number: 0808 800 4104

Last updated: 20/01/2011 11:34:58

Important facts about autism and Asperger syndrome for GPs

What type of disabilities are autism and Asperger syndrome?
developmental - affecting social and communication skills life-long part of a range within what is termed 'the autistic spectrum' wide ranging - some people have accompanying learning disabilities while others have average or above average intelligence affecting boys more often than girls - classic autism sex ratio is four males to one female; for Asperger syndrome it is nine males to one female.

Important note 1
Autism and Asperger syndrome are all part of the same autistic spectrum and the differences between them relate more to degree than anything else. However, people at the more able end of the spectrum, such as those with Asperger syndrome, tend to have average or above average intelligence and generally have fewer problems with language, often speaking fluently though their words can sometimes sound formal or stilted.

The triad of impairments

The whole spectrum is defined by the presence of impairments affecting social interaction, communication and imagination. This is known as the triad of impairments. This is always accompanied by a narrow repetitive range of activities.

Social interaction
Problems engaging in reciprocal social interactions A severely affected individual will seem aloof and uninterested in people where someone less affected (but still affected) passively accepts social contact, even showing some pleasure in it, though he/she does not make spontaneous approaches.

http://www.autism.org.uk/working-with/health/information-for-general-practitioners/i... 02-01-2012

Important facts about autism and Asperger syndrome for GPs - | autism | Asperger syn... Page 2 of 3

Social communication
A lack of appreciation of the social uses and the pleasure of communication is always present in some form or other A significant proportion of people with classic autism fail to develop useful speech. If language is used, there is a failure to understand that it is a tool for conveying information to others. Some ask for their own needs but have difficulty in talking about feelings or thoughts and in understanding the emotions, ideas and beliefs of other people.

Social imagination
Inability to play imaginatively with objects or toys or other children/adults Pretend play can be absent or repetitive. A tendency to select for attention minor or trivial aspects of things in the environment instead of an imaginative understanding of the meaning of the whole scene is often found. Some imaginative activities may be displayed but these are usually copied, for example from TV programmes. This play may seem complex, but careful observation shows its rigidity and stereotyped nature.

Important note 2
These manifestations vary with the severity of the disability - changes occur with age, especially in those with higher levels of ability.

Important note 3
The presence of additional disorders, such as epilepsy, sensory impairments, Down's syndrome, or other physical disabilities can affect the clinical picture.

Important note 4
All people have their own personality, which affects their reactions to their disabilities.

Repetitive and stereotyped behaviours

Another important characteristic, in addition to the triad, is repetitive and stereotyped behaviours. People may be familiar with the image of children with autism obsessively lining up toys, repeatedly spinning objects or flapping their hands in the periphery of their vision. As development proceeds, however, the focus of attention may shift from physical activities to the collection of information.

Screening for autism

The Checklist for Autism in Toddlers (CHAT)
This Checklist screens for autism and Asperger syndrome in young children and is designed for use by GPs or health visitors at the 18 month check and can be completed in five minutes.

http://www.autism.org.uk/working-with/health/information-for-general-practitioners/i... 02-01-2012

Important facts about autism and Asperger syndrome for GPs - | autism | Asperger syn... Page 3 of 3

Further information on CHAT has been provided by The University of Cambridge.

Checklist for GPs

1. Consider screening all language-delayed children for autism using the CHAT. 2. The waiting room/consultation environment can be made more autism-friendly by giving consideration to: noise levels; presence of other people; proximity of other people; keeping to time. 3. Be aware of the complex impairment of communication in autism and Asperger syndrome. 4. Communicate with people who potentially have autism and Asperger syndrome by: using factual language and avoiding abstract terms; supporting verbal information with visual information; giving extra time for people to answer questions; being aware that eye contact is sometimes difficult for such people. 5. Refer to support professionals where appropriate, giving consideration to: diet; dental health; sleep; challenging behaviour. 6. Listening to the parents' story with attention and interest gives a real understanding of the child and establishes a good relationship with the family. 7. Consider putting parents in touch with a local support group or The National Autistic Society. The first point of contact for parents is the NAS Autism Helpline who provide a written and phone enquiry service. 8. Consider giving parents a copy of Who are the health professionals? .
The National Autistic Society 393 City Road London, EC1V 1NG United Kingdom Tel: +44 (0)20 7833 2299 Fax: +44 (0)20 7833 9666 Email: nas@nas.org.uk

[Administrative offices only] VAT registration number: 653370050; registered as a charity in England and Wales (269425) and in Scotland (SC039427) The National Autistic Society 2011

http://www.autism.org.uk/working-with/health/information-for-general-practitioners/i... 02-01-2012