All about autism

What is autism? Understanding the spectrum

Autism spectrum disorder (ASD) is a lifelong neurodevelopmental condition. It affects how a person communicates, interacts and experiences the world around them.

No two people are affected by autism in the same way – so it’s described as a spectrum. Some people who are autistic need regular support at home or school. Others live independently and draw on their interests and strengths in daily life.

Autism influences how a person processes sensory information, expresses their needs and interprets social cues. These differences can shape thinking, emotional well-being and how someone moves through busy or unfamiliar spaces. Sensory differences are common. Light, sound or touch may feel intense, making busy environments tiring without the right adjustments.

In the UK, diagnosis usually follows guidance in the DSM-5 and ICD-11, which focus on two areas:

1. Social communication and interaction – this might include finding back-and-forth conversation tricky or missing cues like facial expressions.
2. Patterns of behaviour or interests that are repetitive or strongly focused – a child might flap their hands when excited or find it hard to join in with group play. A teenager might excel in maths yet feel anxious speaking in front of others.

People with autism have varied strengths, such as creativity, focused interests, problem-solving and strong attention to detail. Seeing autism through a neurodiversity lens shifts the focus from deficit to difference. It also highlights the way many people who are autistic thrive when their interests and skills are recognised. Many build meaningful careers in fields like art, engineering, IT or scientific research.

Viewing autism as a broad spectrum reminds us that there’s no single “right” way to communicate, learn or take part in life. Understanding that every person is unique, with strengths, needs and preferences, helps shape support that feels relevant and respectful.

The prevalence of autism in the UK

Estimates suggest that around 1 in every 100 people in the UK has autism, equating to roughly 700,000 individuals. The reported prevalence has increased over the past two decades. Greater public awareness, broader diagnostic criteria and better systems for recognising people who were previously overlooked all play a part.

Boys and assigned-male individuals continue to receive diagnoses more often than girls, at a ratio of about 3:1. Evidence suggests this gap narrows in adulthood, since more women receive a diagnosis later in life.

Many children now receive an autism diagnosis during the primary school years. Yet a significant number of adults remain unidentified, especially those who have learned to mask their differences. Recent research suggests that around 90% of adults with autism in the UK don’t have a formal diagnosis. This can limit their access to support, workplace adjustments or benefits.

Prevalence also differs by region and social context. Diagnostic rates are often higher in urban areas with established specialist services. Families dealing with language barriers and limited access to healthcare may experience delays in assessment. In some areas, waiting times are longer, meaning more people are undiagnosed.

Diversity within the autistic community is key to understanding support needs. Around 20–30% of people with autism also have a learning disability, while many have average or above-average intellectual ability.

Sensory profiles vary widely. Some people prefer strong sensory input; others are easily overwhelmed by everyday noise, touch or light. Communication also differs. Some people speak fluently; others communicate non-verbally or with assistive technology.

The underlying causes of autism

Although the precise causes of autism are still being studied, current evidence points to a complex interaction between genetic and neurological factors. Twin and family studies estimate heritability at around 90%, indicating that multiple genes contribute to autistic traits.

To date, researchers have identified more than a hundred gene variants linked to neurodevelopmental pathways involved in brain connectivity, synaptic function and early neuronal growth. There is no single “autism gene”, but many genetic patterns appear to interact with environmental influences during key prenatal and early postnatal periods.

Neurologically, brain-imaging studies show differences in how certain regions communicate:

• Areas involved in social understanding, including the prefrontal cortex and amygdala, may display altered activation or synchronisation.
• Networks supporting sensory and motor processing can also show heightened or reduced connectivity, which aligns with the sensory sensitivities and repetitive behaviours that are sometimes observed in people with autism.
• Researchers have also identified differences in the density and organisation of cortical minicolumns – microscopic columns of neurons – which may influence sensory filtering and information processing.

Environmental factors, such as parental age, prenatal exposure to certain medications and birth complications, are being explored as possible contributors. But it’s important to note that none have been shown to cause autism on their own. Crucially, vaccines and parenting styles are not associated with autism – a conclusion confirmed by extensive UK and international research.

Spotting autism in toddlers and pre-schoolers

Autism can begin to show in the early years – though each child is different.

Parents and carers might notice small things at first. Here are some of the possible signs:

• Seeming less responsive when their name is spoken
• Relying more on gestures than spoken words
• Talking later than expected or communicating in ways that feel different from peers
• Using fewer facial expressions
• Finding it harder to share attention during play
• Repetitive behaviour – flapping the hands when excited, lining up toys with care or spending long periods exploring a favourite object
• Preferring familiar routines and becoming upset when life deviates from that known structure
• Repeating the same pattern in imaginative play again and again

These signs don’t confirm autism alone, but they suggest that a developmental assessment could help build understanding.

Health visitors check children’s development at routine reviews around 18 and 24 months. These appointments look at communication, social interaction and motor skills. In nursery and pre-school, staff may spot early differences by observing the child in group play (for instance, looking at how they communicate and share) and during transitions.

If concerns arise, families are usually referred through a GP, health visitor or early years team to a paediatrician or child development service. Diagnosis isn’t a prerequisite for support. Practical strategies from speech and language teams or early support workers can help children communicate and take part in daily activities. They can also give parents tools to manage the child’s behaviour and help them feel comfortable.

Recognising early signs helps families and professionals work together from the start. This shared understanding can ease anxiety, strengthen communication and support each child’s well-being in ways that feel right for them.

Diagnosis pathway – from GP referral to multidisciplinary assessment

In the UK, the diagnostic journey usually begins with a discussion between parents and their GP. The GP reviews developmental history and, if concerns persist, makes a referral to a specialist service. This may be a community paediatrician, child and adolescent mental health service (CAMHS) or a dedicated neurodevelopmental team, depending on local arrangements.

Assessment is typically multidisciplinary, involving different professionals:

• A paediatrician or psychiatrist takes a detailed medical and developmental history, looking at the child’s early milestones, birth and family mental health.
• A clinical psychologist or speech and language therapist evaluates social communication using structured tools such as the Autism Diagnostic Observation Schedule (ADOS-2) and the Autism Diagnostic Interview–Revised (ADI-R).
• Occupational therapists may assess sensory needs or motor co-ordination.

Schools contribute too. A special educational needs co-ordinator (SENCO) is often asked to provide information about the child’s behaviour, attention and learning in the classroom.

After assessment, families receive a written diagnostic report outlining the child’s challenges – and strengths – alongside recommendations for support at home, in school and in the community. A diagnosis can cause uncertainty and mixed feelings for parents, carers and families – but many describe relief at having a document that makes sense of their earlier concerns. It can also open the door to statutory support, including applications for an education, health and care plan (EHCP) and access to local services and peer networks.

Autism in girls and women

Autism in females has historically been under-recognised because girls often present differently from boys. However, awareness is improving.

Many girls learn to blend in by copying facial expressions, rehearsing phrases or watching others closely to match their behaviour. This camouflaging can make autistic traits harder to notice and often delays diagnosis. Girls’ interests may look socially typical, which makes autistic patterns harder to spot. Boys’ interests are more likely to stand out, which prompts earlier recognition.

Research suggests that girls may show fewer visible repetitive behaviours but feel high levels of internal distress, including anxiety, low self-esteem or burnout after social situations. Some build friendships but find it difficult to keep them going, as the social effort can be draining. Because of this, many girls may first be treated for anxiety, depression or eating disorders before autism is even considered.

Families and practitioners can look for subtler signs of autism in girls, including:

• Intense perfectionism
• Cycles of self-criticism
• Sensory avoidance (such as avoiding noisy environments)
• Strong, deeply focused interests

Screening tools don’t always capture these patterns. The Social Communication Questionnaire (SCQ) can help, but conversations about social pressure and how long it takes to recover after socialising often give a clearer picture.

Conditions that often co-occur with autism

Autism often appears alongside other conditions that also shape daily life and well-being. Understanding these offers a fuller picture of each person’s needs.

• ADHD – difficulties with focus, impulsivity or restlessness are common. ADHD and autism share some genetic features, and the two conditions often overlap.
• Anxiety – social anxiety or general worry affects many children and adults who are autistic. Sensory sensitivities, uncertainty in social settings and pressure to mask can heighten anxiety.
• Depression – this mental health condition is often linked with loneliness or the emotional effort of coping day to day. It may become more noticeable in teens and adults.
• Epilepsy – research suggests that the prevalence of epilepsy in people with autism ranges from 6% to 27%. Seizures can begin at any age, though many start in childhood or adolescence.
• Gastrointestinal difficulties – constipation, reflux or abdominal discomfort are common. These can affect sleep, appetite and daily comfort.
• Sleep differences – children may find it harder to settle or stay asleep, affecting concentration, mood and family routines.
• Specific learning differences – dyslexia, dyspraxia (developmental co-ordination disorder) or related challenges may appear alongside autism, influencing reading, writing and co-ordination.

Holistic assessment helps connect these needs. In some NHS regions, clinics bring paediatricians, neurologists and mental health teams together to identify co-occurring conditions and recommend the best support. For instance, cognitive-behavioural approaches adapted for autism can help with anxiety. Medication may support ADHD and epilepsy. Occupational therapists can advise on sensory strategies and sleep, and speech therapists support communication.

Communication and social interaction

Differences in communication, both verbal and non-verbal, are common in autism.

Some people with autism speak fluently but find pragmatic language difficult. For example, they may interpret idioms literally, miss sarcasm or feel drained by back-and-forth chat. Others are minimally verbal and use augmentative and alternative communication (AAC), such as picture cards or speech-generating devices. Eye contact may feel physically uncomfortable, and body language cues like gestures or facial expressions often need to be learnt explicitly.

Support becomes more effective when it reflects the person’s strengths and preferences. Helpful approaches for children include:

• Speech and language therapy – shared goal-setting with families and schools, use of clear language and visual prompts to make routines easier to follow
• Social stories – preparation for specific situations, such as joining a playground game or moving between classrooms
• Small-group role play – space to practise greetings, turn-taking and everyday interactions in a calm, supported setting
• Peer support – pairing autistic pupils with understanding classmates during structured tasks to build confidence and reduce isolation
• Communication workshops – practical support to build confidence in real-world situations, such as preparing for job interviews or handling phone calls at a comfortable pace
• AAC access – steady access to communication tools, whether picture cards or speech-generating devices, with classmates, teachers, colleagues or friends who know how to use and understand them

Across all approaches, the aim is to honour each person’s preferred way of communicating – spoken, signed or technology-based – so they can take part, feel understood and build relationships that feel safe and rewarding.

Sensory processing differences: Strategies for sensory needs

Many people with autism experience the world through stronger or more subtle sensory signals. For some, everyday sounds, lights or fabrics feel intense – a buzzing light, crowded corridor or scratchy jumper might be genuinely painful. Others may feel under-stimulated and look for stronger input, such as deep pressure, movement or loud music, to feel settled.

Making simple changes to the environment can make things easier. In school, dimmed lighting and noise-reducing headphones can make the setting easier to handle. The child may also benefit from a quiet space, which they can step into and find immediate calm. Weighted blankets, soft seating, chewable jewellery or fidget items offer safe ways to meet sensory needs.

Occupational therapists may put together a “sensory diet” – a mix of activities that help keep someone regulated through the day. Calming options might include slow swinging or yoga; energising ones could be jumping, brisk movement or music.

Home routines – based on what feels reassuring for the individual – are helpful. Some people like time to settle after school – reading, doing crafts or simply resting somewhere quiet. Others may enjoy a short burst of movement outside to reset before sitting down for a meal. Using familiar, unscented toiletries or offering a choice of clothing textures can also ease day-to-day discomfort.

When visiting new places, bringing a comforting item – such as a favourite jumper, headphones or a small toy – and showing pictures of what to expect can make the transition feel safer.

Education and SEND support

Schools in the UK follow the SEND Code of Practice, which sets out how children should be identified, supported and included. In most cases, support begins in the classroom. Teachers and SENCOs work together using the graduated approach – assess, plan, do, review – to understand a child’s needs and adjust teaching.

Under the Equality Act 2010, schools must make reasonable adjustments so autistic pupils are not placed at a disadvantage compared with their peers. Helpful changes might include extra time in exams, quieter seating, access to sensory breaks or visual timetables to support predictability. Some schools train staff in autism awareness or appoint “autism champions” to build whole-school understanding.

Where a pupil needs more support than a school can provide from its own resources, families can request an EHCP – a legal document that outlines long-term goals, the child’s strengths and needs, and the provision required – for example, speech and language therapy or specialist teaching. Plans are reviewed each year to make sure the child is getting the best support for them.

Some children learn best in specialist settings. Autism units or specialist schools offer quieter, more sensory-friendly spaces with higher staff-to-pupil ratios.

Collaboration is central. SENCOs, teachers, therapists and families should work together to share strategies. When everyone is moving in the same direction, children are better able to navigate the school day with confidence and thrive – socially and academically.

Therapies and interventions

A wide range of therapies can support people with autism at different stages of life.

• Applied behaviour analysis (ABA) aims to build useful skills and reduce distress by breaking tasks into small steps. Some families find it helpful; others have concerns about rigidity, which has led to growing interest in more child-led, neurodiversity-affirming approaches.
• Structured teaching models such as TEACCH use visual organisation and predictable routines to help learners understand what’s happening and what comes next.
• Speech and language therapy supports communication, whether it’s spoken, signed or supported by technology. Therapists use play-based methods to help children build vocabulary, develop sentence structure and strengthen social communication.
• Occupational therapists focus on sensory regulation, motor skills and everyday tasks such as getting dressed and preparing meals.
• Clinical psychologists may offer autism-adapted cognitive behavioural therapy to help children and adults manage anxiety or rigid thinking.
• The EarlyBird programme offers UK-based parent training for pre-schoolers, sharing strategies to support social interaction at home.
• The Picture Exchange Communication System (PECS) helps non-verbal children communicate through picture cards, often increasing their confidence and reducing frustration.

There is no single “best” therapy. The most effective support is usually flexible and based on the person’s strengths and challenges. It should be reviewed regularly, with families, practitioners and schools working together to adapt as needs change.

Assistive technology and tools

Technology can make daily life easier for many people with autism. Helpful options include:

• Visual schedules – tools like Choiceworks or “First–Then” visual schedules break the day into clear steps, easing transitions at home or school. They help prevent difficult surprises or uncertainty.
• AAC tools – software such as Proloquo2Go or Grid Player lets non-verbal users build sentences with symbols.
• Sensory regulation – calming-sound apps or gentle white noise help with settling or resetting during busy moments. Some wearables track stress signals and prompt the user to take a break.
• Learning supports – text-to-speech tools, keyboard adaptations and writing aids help pupils who find handwriting or reading difficult.
• Video modelling – platforms show social situations (e.g., greeting classmates or joining a game) so users can watch before trying the skill themselves.
• Smart environments – voice-controlled lights or devices allow children to adjust their surroundings quickly and easily, whenever they want.

Transition to adulthood

Moving from adolescence into adulthood brings new freedoms but fresh demands.

Many autistic young people continue learning after 16. Some stay on at a sixth form they already know; others move to specialist colleges or take part in supported internships that combine study with time in the workplace. Financial help, such as the 16–19 Bursary Fund and disabled students’ allowances, can support costs and provide equipment.

Work is another important step. Through the Access to Work scheme, young adults can receive funding for things like job-coach support, workplace adjustments and assistive technology. These changes often make it easier for people to use their strengths – perhaps in tech, design, customer support or hands-on roles. Some enter paid work gradually through traineeships or apprenticeships, which offer structure and mentoring while skills develop.

Building independence looks different for everyone. Some young people enjoy learning to cook, manage money or use public transport, gaining confidence one small step at a time.

Housing options vary – from shared supported living to fully independent homes with remote help. Under the Care Act 2014, local authorities can assess needs and help arrange the right level of tailored support.

Community connections matter too. Volunteering, local clubs or creative groups can offer routine, purpose and a chance to meet people with shared interests. For some, besides social connection and community, these spaces become a stepping stone to further training or paid work.

Getting support in the UK

People who are autistic and their families can draw on a wide range of support across the UK.

The organisations and networks below offer information, practical help and community connection, helping people navigate different areas and stages of life with comfort and confidence.

• National Autistic Society (NAS) – information, training and helplines. Local branches run groups for parents and adults.
• Ambitious about Autism – campaigns for education and employment inclusion. Runs specialist schools and youth programmes.
• Autism Alliance UK – links local charities that provide services such as short breaks and family support.
• Autistica – a research charity that funds studies on health, diagnosis and quality of life.
• Scottish Autism – support, outreach and advice for people in Scotland.
• Dimensions – services for learning disability and autism, including supported living.
• Local parent carer forums – these groups often organise casual gatherings, like coffee mornings and workshops, where families can share experiences and advice.
• University support teams – provide guidance with study skills, social support and reasonable adjustments.
• Online communities – social media spaces where people share their experiences, the challenges they have faced, tips and strategies, and useful resources. These offer peer connection across different backgrounds.