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Autism and Primary Care: Challenges

This section contains information about some of the key issues, challenges and problems facing people on the autism spectrum.


Introduction

People on the autism spectrum face many difficulties on a day to day basis. For example, they may find it difficult to understand what someone means if that person doesn't use clear and precise language or if they are not given plenty of time to process what is being said. Or they may become extremely anxious if they are asked to talk to someone they have not met before.

People on the autism spectrum are also more likely to be socially excluded, being denied access to employment or community facilities. They are also more likely to be mistreated by others, being bullied, being given inappropriate treatments or having their liberty restricted.

Many people on the autism spectrum are likely to find your surgery a confusing and intimidating place, especially if they have not been there before or if they had an unpleasant experience on a previous visit. (However there are many simple steps - reasonable adjusments - you can take to make your surgery more accessible. Please see the Key Information section for advice.)

Co morbidities

People on the autism spectrum are likely to experience the same medical problems as everybody else. However they are also significantly more likely to have one or more co morbidities including:

  • genetic conditions such as Fragile X and tuberous sclerosis
  • physical disorders such as epilepsy and gastro-intestinal problems
  • developmental disabilities such as ADHD and cerebral palsy
  • motor skill problems such as a clumsy walk and difficulty balancing
  • sensory sensitivities such as hypo-sensitivity to pain and hyper-sensitivity to bright lights
  • mental health problems such as anxiety and depression
  • cognitive problems including difficulties planning actions and understanding how other people think and feel
  • difficulties with a range of functional skills such as sleeping or travelling independently.

Challenging behaviours

Some people on the autism spectrum have challenging behaviours. These are sometimes defined as: 'Culturally abnormal behaviour(s) of such intensity, frequency or duration that the physical safety of the person or others is placed in serious jeopardy, or behaviour which is likely to seriously limit or deny access to the use of ordinary community facilities.'

In the past challenging behaviours were considered to be 'a part of autism'. However it is now clear that challenging behaviours

  • are often caused as much by the way someone is supported - or not supported - as by their autism. That support should be flexible and personalised to the needs and circumstances of the individual and their family
  • often occur when someone has problems understanding what is happening around them or communicating what they want or need
  • may occur as the result of underlying medical issues, such as abdominal pain; mental health problems, such as anxiety; or sensory sensitivities, such as a dislike of strong smells.

Challenging behaviours can usually be prevented or reduced if the right kind of support is provided. All challenging behaviour happens for a reason and we should not rush to judge what that might be. It is very important to explore the possible causes with the individual and their family before providing any kind of intervention.

Relatives and carers

Relatives and carers of autistic people also face many issues and challenges on a day to day basis. For example, many of them become worried and exhausted looking after someone on the autism spectrum. And they face the frustration of trying to find accurate information about interventions which work or of trying to cope with the lack of adequate services.

Interventions

There is no cure for autism but there are some interventions which can help with some of the problems and challenges faced by people on the autism spectrum.

Please see: Interventions section


More Information

Please see the following pages on the Research Autism website:  Adaptive behaviours | Cognition | Motor sensory issues | Medical issues | Mental health issues | Challenging and disruptive behaviours | Impact on the family | Other issues


Related Pages

 

                          Updated  21 January 2016

 

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