Autistic and imagination, usually known as the ‘triad
Autistic spectrum disorder is defined by the National Autistic Society (2000) and Royal College of speech and language therapists (RCSLT, 2017) as a lifelong hidden disability affecting social interaction, communication and imagination. People with ASD have difficulties in 3 major aspects of social development, including relationships, communication and flexibility of thought and action (NICE guidelines, 2005). ASD affects approximately 700,000 people in the United Kingdom or 1 in 100 people, however, no register or exact count of diagnosis is kept (National Autistic Society, 201).7 ASD does not discriminate between nationalities, cultures or religions. However, previous research has suggested that it may discriminate against more males than females. Historically, Hans Asperger (1944) believed ASD was male impairment, drawing conclusions from studies such as Kanner (1943) indicating that boys were four times more likely to have ASD than girls. ASD is lifelong, starting in childhood, autistic children become autistic adults. The whole spectrum is defined by the presence of impairments affecting social interaction, communication and imagination, usually known as the ‘triad of impairments’, often accompanied by a narrow, repetitive range of activities. It is essential to make a qualitative assessment of the individual’s social interaction skills. This should be carried out in a variety of social settings such as a school, nursery or day centre. Identification and management of difficulties should be addressed as early as possible. However, different characteristics of ASD are apparent at different ages. Some issues which are associated with ASD are poor communication, difficulties with learning, behaviour that challenges, poor social skills, mental health problems, reduced opportunities for work or leisure and increased stress within the family. SLTs have a key role in identifying the social and communication impairments, contributing to differential diagnosis and training of others involved in the care and education of those with Autism (RCSLT, 2017). Studies have recently shown that up to 70% of people with ASD also meet diagnostic criteria for at least one other, often unrecognised, psychiatric disorder than exasperates their psychosocial functioning. Deficits in social interaction are intrinsic in ASD. Depending upon the individual’s level of development and the severity of autism, interactive skills will range from extreme remoteness, through passivity, to active interest with but with restricted social awareness and inappropriate social interaction.