Autistic Spectrum Disorder or ASD is a Neurodevelopmental Disorder that starts in early developmental years. The core features of this Disorder are problems with social communication and interaction; language problems; and restrictive, repetitive behaviours and interests (RRBI).
It can often present with a number of comorbid Psychiatric conditions. Anxiety and related disorders are commonly found alongside ASD. Some executive functions abnormalities are common and can mimic ADHD. However, ADHD can itself be present alongside ASD and hence it's important to consider all possibilities during assessment.
The autistic disorder treatment in Wales starts with the diagnosis of the condition. It includes an extensive comprehensive history from the patient, carers or other responsible sources such as school reports are important for the diagnostic assessment.
The Gold Standard is a combination of information gathering from carers, doing a structured interview such as the ADI- R (a detailed enquiry of Neurodevelopmental years) and then an objective observed interview such as the ADOS- 2 (Autism diagnostic observed schedule).
The diagnosis of ASD in Adults requires a fairly detailed assessment that involves a combination of several things as shown in the figure.
The autistic disorder treatment in Wales consists of both ADI- R and ADOS-2. It can take upto 3 to 4 hrs each and are done by separate professionals. This is followed by the professionals collating all the information available to come to a diagnostic outcome which is then feedback to the patient and the family/carers. Overall, it can take between 10- 12 hrs of clinical time to do a detailed, comprehensive assessment for ASD.
Can there be other conditions overlapping?
ASD symptoms in Adults can often overlap with symptoms of other Neurodevelopmental problems such as an Intellectual Difficulty, ADHD (Attention Deficit Hyperactive/Impulsive Disorder), Early onset of a psychotic illness and in adults other comorbid conditions such as Anxiety Disorders, Sleep Difficulties or Mood disorders may also be present.
From a pharmacological perspective or from a medication perspective, there is no specific medicine that is licensed for ASD. Often people with ASD have a high level of anxiety and relevant medications to improve that can be used. Similarly, medications are often helpful to manage comorbid conditions.
Sleep assessments and optimisation can be very helpful in some cases and general lifestyle improvements are helpful.
Patient and family education specific to the needs of the individual is very important and having structured sessions on understanding strengths and difficulties along with practical strategies to manage those for the individual can be very helpful.
Psychological interventions to manage thoughts, emotions and behaviours with CBT can be helpful as part of the package of management of ASD.
There are several support groups that can be helpful in understanding the condition better along with the National Autistic Society (NAS) that has several branches throughout the UK. NAS can provide a lot of support to the individual and the family and take self- referrals.
*Please look for a professional that can individualise or personalise treatments for the person
One very good book to Understand ASD and human behaviours is "Uniquely Human"
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