Those at risk
The precise cause of autism is not known, however, a number of different genetic, neurobiological, and environmental factors are thought to play a role in its development.
Factors associated with an increased prevalence of autism in children and young people include:
- Some chromosomal and genetic anomalies — such as Down's syndrome, muscular dystrophy, neurofibromatosis type 1, and tuberous sclerosis.
- Parental schizophrenia-like psychosis or affective disorder. Prenatal exposure — maternal use of sodium valproate during pregnancy. Birth complications resulting in central nervous system (CNS) malformation or dysfunction, such as cerebral palsy.
- Neonatal or epileptic encephalopathy, including infantile spasms
- A learning disability.
- Neurodevelopmental disorders such as attention deficit hyperactivity disorder.
- Family history — the rate of autism in siblings and in parents and grandparents is much higher than the rate in the general population.
Autism diagnosis
Receiving a timely autism diagnosis is vital in getting the right support and helping autistic people and those supporting them to better understand their needs. Many people are still waiting longer than the National Institute for Health and Care Excellence (NICE) recommended 13 weeks between referral and first assessment.
As a result, estimates suggest approximately 750,000 undiagnosed autistic people aged 20 and above in England. If this is the case, the total autistic population in England would exceed 1.2 million people.
Autism and gender
The proportion of males to females diagnosed with ASD varies across studies but always shows a greater proportion of males to females, mostly ranging from 3:1 to 5:1
Its is believed that females may “mask” which can delay identification and assessment
Autism and health outcomes
Nationally Autistic people die on average 16 years earlier than the general population. Locally LEDAR reviews are currently considering Autism but the numbers referred are very low.
Autistic people face substantial health inequalities, are more likely to have poorer general health than non-autistic people and are at increased risk of virtually every cause of death that has so far been studied. Around 70% of autistic people have at least one physical or mental health issue, including anxiety disorders, epilepsy and attention deficit hyperactivity disorder (ADHD), but these are often unrecognised.
They are more likely to develop a wide range of conditions including heart disease, diabetes, stroke, Parkinson’s disease, allergies, gastro-intestinal disorders and autoimmune conditions.
Almost 8 in 10 autistic adults experience a mental health problem. Autism is not a mental health condition itself, but mental health problems are one of the most common and serious challenges experienced by people across the spectrum. Up to 10% of adults in inpatient mental health settings are autistic, even though only 1% of the population is on the spectrum.
Autistic people are often unable to access community mental health support. Reports suggest difficulties for mental health services in integrating autism.
Autistic people are less likely to be satisfied with the healthcare they receive, and to understand and be understood by health professionals. Differences in experience, expression and interpretation can mean that issues like pain are dismissed (known as clinical overshadowing).
International evidence suggests that autistic people are more likely to end up in hospital care or using emergency services. Problems that could be identified and managed early are often left to escalate, unnoticed by health professionals or even by autistic people themselves, until a crisis is reached.
Autism and employment
Evidence shows that there is currently a significant employment gap for autistic people. Data published by the Office of National Statistics for the first time in February 2021 shows that as of December 2020, 22% of autistic people aged 16 to 64 are in employment, in contrast to 52% of disabled people, and 81% of non-disabled people.