In this section
Autism is a neurodevelopmental
disability that affects the way people communicate, process information and
interact with the world.
Autism Spectrum Disorder (ASD) is a term that describes a
condition that presents in a wide range of ways, according to age and a child’s
The term has replaced terms such as
Autistic Disorder, Asperger Syndrome and Pervasive Developmental Disorder that
were once considered to be separate conditions. There are a number of adults
with this condition who prefer to be referred to as “autistic people” whereas
some families prefer the use of “child with autism” instead of the term “ASD”.
Around 1-2 in 100 Australians are
autistic and many people will have a connection with an autistic person. Often
autism runs in families and family members may have similar traits or have
already been diagnosed with ASD.
Children with ASD have
difficulties in two main areas: social communication and repetitive behaviour.
These present differently at different ages.
In infants and pre-schoolers, the
first indicators of ASD may be an unusual or delayed pattern of communication
and limited ability to interact or engage in play with others. Children may be
slow to learn to speak or use words in an unusual way. They may rely less on nonverbal
ways of communicating, such as eye contact, pointing and gestures. Carers may
notice particular habits in play such as repeating the same action or body
movement or exploring unusual aspects of toys. Some children need a strict routine in order
to feel comfortable. Others develop a special interest that dominates their
play. A child can also start to show unusual sensitivity or lack of sensitivity
to sounds, textures, pain or light. They may start to become fussy about food.
Some children present with
difficulties in primary school. They may be good at communicating their needs
and ideas, but struggle to share information or join in conversations.
Similarly, they may prefer to follow their own ideas in play rather than take
up the ideas of others. Many children have an intense special interest or
series of special interests. Changing from one activity to another and dealing
with unexpected changes can be harder for children with ASD. Heightened sensory
sensitivity can lead to discomfort in classrooms or noisy environments. Children
may fall behind academically and find it difficult to be part of social groups
such as sports or clubs.
ASD may not be considered until
adolescence or adulthood in some people. These people may have a history of
difficulty making lasting friendships, experience high anxiety and have a very
strong focus on particular ideas or interests. In others, a different diagnosis
has been considered first but the person appears to have extra support needs. Common
diagnoses that can overlap with ASD are Attention Deficit Disorder, language
delay, Intellectual Disability, eating and anxiety disorders. Girls with ASD
are more likely to present later.
Each child with ASD is different,
with a different pattern of strengths and difficulties. The most important next
step is to try to develop a comprehensive understanding of a child’s needs and
There are a range of conditions that may occur alongside
ASD. They include:
These conditions require separate consideration and
management strategies. They have an impact on the overall progress for the
child with ASD
Following assessment, the next step is to develop a plan for supporting a child’s development, so as to enhance their existing skills and help them develop strategies to overcome difficulties. Regular reviews by a paediatrician can help carers determine what is working and what else can be offered to their child.
The choice of support services is guided by the child and their carers but should be informed by existing evidence of what works. Therapies work best when the family can help the child to practise their skills in everyday life. The following supports are commonly suggested or considered:• Psychology: to help manage emotions and challenging behaviours and develop social understanding• Speech Pathology: to develop good communication skills and explore how language can be used for social engagement• Occupational Therapy: to help determine the pattern of sensory responses for a child and how the environment should be changed to help a child. They also work with children to develop joint play skills.
Medication is not recommended for the core features of ASD, but may be useful if a child had one of the co-occurring conditions listed above. In children under 7 years of age, an application to the National Disability Insurance Scheme (NDIS) can be made as soon as a child is found to have difficulties in two or more areas of development. A child can receive services with this funding before having a formal diagnosis. In children over 7 years, there is a need to meet access requirements to obtain NDIS funding. A diagnostic report can help with eligibility. There are also private services and community-based services that may be appropriate.
If there are concerns about a child’s behaviour or abilities, consult your family doctor and ask for a referral to a paediatrician, speech pathologist or specialist psychologist. Paediatricians and psychologists can investigate further and confirm a diagnosis of ASD or ask for further assessments to be performed. This often involves talking to people who know the child in the community such as teachers or preschool educators. Some children need a multi-disciplinary team to finally decide on a diagnosis or to complete an assessment.
An important part of the assessment process involves developing a comprehensive understanding of the child’s strengths and difficulties. This will often involve formal testing of language and thinking skills. The paediatrician or psychologist involved in the assessment can guide this process. Having a clear plan and a good support network helps parents through this difficult and often confusing time.
What will be my
child’s future?It is impossible to predict how any particular child with
ASD will develop. All children will learn and improve their skills as they get
older. Much progress has been made in understanding the condition and tailoring
services to meet the needs of children with ASD.
When do I talk to my
child about their condition?Evidence suggests that children who learn about their
autism early have better long term outcomes. The diagnosis can give a child a better
understanding of why they face difficulties and give them a reason to be
involved in supportive therapies. The decision is ultimately one for parents,
as they need to feel comfortable before talking with their child. It can be
useful to get the help of a therapist or doctor who knows you and your child.
Developed by The Royal Children's Hospital Specialist Autism Team. We acknowledge the input of RCH consumers and carers.
Reviewed December 2021.
Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit
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