Autism in Young People

There are so many people in the world who have an autistic spectrum disorder and have never had it diagnosed. It can be incredibly beneficial to a young person to have it diagnosed. It opens so many doors of assistance and it allows school, family and the young person to understand their strengths and areas of difficulty and how to adapt to make life a happier and easier place.

At times, young people present in my clinic with an anxiety disorder or a depressive episode and it turns out that a major precipitant of this is the fact they have an undiagnosed autistic spectrum disorder which has made them find life confusing and difficult and frightening.

These young people are often struggling to make friends and if they have transitioned to senior school it is likely this has been particularly difficult. They certainly cannot cope with groups of people and they are at their happiest when they are alone in their own room engaging in their special interest which is often something quite unusual and they do it to the exclusion of other interests.

I find families often think the young person is “quirky” and they have adapted the family’s routine and way of working around the young person. Everything falls into place when they realise the young person has an autistic spectrum disorder.

Interestingly many of the most successful people have an autistic spectrum disorder. This is because they see the world slightly differently and solve issues others cannot find a way to solve. They also make great employees as they like the routine of work, they will turn up bang on time and they will be intensely knowledgeable about their work if it is an area of special interest. They might not have a large group of friends but they will be very loyal to the ones they do have. There is no reason why they cannot develop normal relationships and have good careers. Having a diagnosis does come as a large relief to most people as they finally understand why they have felt different for such a long time.

What is autism and how would you spot signs that would suggest an assessment is sensible?

Autism is a neurodevelopmental condition which means they have been born with impairment in the development of several aspects of brain function that will unfold as the young person grows.

Children with autism have problems in the following areas:

  • They struggle with emotional understanding of others and interaction which can affect their interpersonal relationships
  • They have problems with how they communicate their thoughts
  • They are inflexible in their behaviour and in their thinking
  • They often have different sensitivity to sensory stimulation such as noises, lights, textures, tastes and smells and this can lead to distress

So many young people have autism which is not diagnosed and if they are in this situation, school and life in general can become really tough for them. If you see several of the below in a young person, who you feel is slightly different from the peer group, it might be worth having a consultation with a specialist regarding whether suggesting a referral to the parents is warranted.

Autism is a spectrum so people on the spectrum may have any combination of the below and they do not have to have them all. Please be aware you cannot diagnose autism from the below, only a specialist can diagnose autism.

 Social interaction:

  • Does not join in with peers playing games as you would expect
  • Prefers being on their own or with older or younger people
  • Demonstrates the wrong emotional response to peers such as laughing when they are upset
  • Friendships are only because they share one or two interests they seem obsessed about
  • They are bullied or teased more than others in their class
  • Struggles to join in team games
  • Resists or struggles to take turns
  • Finds managing losing difficult


  • Not much variety in their facial expressions
  • They seem unhappy much of the time
  • They can laugh or cry for no obvious reason
  • They often look puzzled
  • They are often anxious or upset

Unusual movements or sounds or responses to sensations:

  • They jump and down or spin round more than you would expect than them to
  • They flap their arms or hands
  • They rock when sitting down or standing up
  • They make funny noises or facial grimace
  • They sometimes try and hurt themselves, poking or hitting themselves or banging their heads
  • They break things aimlessly and repeatedly
  • They do not like being touched
  • They might breathe heavily or too quickly at times
  • They do not react to pain as you would expect
  • Certain sounds upset them or they can hear sounds others do not really notice
  • They might like watching things spin or looking at shiny things

Attention span:

  • They have a poor attention span if the topic is not part of their special interest or if staff do not supervise and
  • They can be restless and struggle to sit for the lessons

Routines and dislike of change:

  • They collect objects or carry an unusual object round in their pocket
  • They arrange objects in straight lines
  • They do not like changes in the classroom environment even if they are small
  • They get really upset if something they do is imperfect in any way
  • They are fussy over foods
  • They ask the same questions repeatedly
  • They can become obsessed with one individual in school
  • They do not want routines in school to change
  • They struggle with different teachers or changes of seats in classrooms and moving up a year


  • Struggles with pretend play or imaginative games or activities
  • Consistently repetitive play
  • Little interest or curiosity in other people or their environment or the wider world other than limited to their own special area of interest?

To diagnose, or not to diagnose an autistic spectrum disorder?

Many parents ask what the benefit will be of giving their child a diagnosis of an autistic spectrum disorder and they worry how this diagnosis might impact on their child’s future. The below is intended to be helpful for parents and teacher’s when discussing the option of referring a child for a diagnostic assessment.

What does a diagnostic assessment involve?

There is no gold standard for diagnosing autism and depending on the complexity of the child or young person’s presentation; differing amounts of investigation might be used.

As a minimum

Most clinicians would take a full psychiatric history (to rule out any other diagnoses), then take a very detailed developmental history of the child from birth to the current day from the parents.

Following this it is likely the child or young person will be seen (with their parents present if they wish), to do some puzzles. They are not difficult and there is no right or wrong to them but the assessor will look at how the child interacts while doing the puzzles.

A diagnostic report is normally available following these appointments.

In addition

Often school views are requested in the form of a school report and sometimes a school observation by a clinician might be recommended, where a clinician subtly watches a child’s interactions in school.

Sometimes a cognitive assessment by a psychologist might also be helpful to understand the young person’s intellectual ability and areas of strengths and difficulties.

Sensory reintegration assessments can also be very informative to demonstrate if the young person is particularly sensitive to lights, sounds, touch, taste or smell as this can all become very confusing    for them if this is the case. At times this is helpful after diagnosis when considering how best to help the young person.

Your child may benefit from an assessment from a speech and language therapist if his ability to speak or understand speech is unusual.

Why is a diagnosis of an autistic spectrum disorder helpful?

  • It stops the parents from doubting their own abilities at parenting; they will begin to understand why things that work for most children do not work for their child and it stops guilt and blame and a sense of failure.
  • It helps people understand that your child is differently abled and your child will benefit from people knowing how to assist them to learn and cope with the world when their nervous system processes information slightly differently
  • You can develop constructive relationships with school, voluntary services and healthcare services to help the child or young person
  • It helps the child or young person understand why they feel different and helps them understand themselves and that there are other young people they can identify with
  • It allows a language to be used between professionals to understand the child’s needs and how to help them
  • A diagnosis opens many doors for advice and support
  • The child may be entitled to apply for an EHCP (Education, Health and Care Plans)
  • Adaptations can be made to your child’s environment to help make the world a less distressing and confusing place
  • It will help you learn which parts of your child’s behaviour is normal pushing of boundaries and which is due to their autistic traits so you can learn to manage all aspects appropriately

“I was so worried about labelling my child but getting a diagnosis has been so helpful. We as parents now understand him much better and can manage his behaviour, the school have also learned about his needs and help him more appropriately and he is definitely happier.”