Autism in Young People

There are so many people in the world who have an autistic spectrum disorder and have never had it diagnosed. It can be incredibly beneficial to a young person to have it diagnosed. It opens so many doors of assistance and it allows school, family and the young person to understand their strengths and areas of difficulty and how to adapt to make life a happier and easier place.

At times, young people present in my clinic with an anxiety disorder or a depressive episode and it turns out that a major precipitant of this is the fact they have an undiagnosed autistic spectrum disorder which has made them find life confusing and difficult and frightening.

These young people are often struggling to make friends and if they have transitioned to senior school it is likely this has been particularly difficult. They certainly cannot cope with groups of people and they are at their happiest when they are alone in their own room engaging in their special interest which is often something quite unusual and they do it to the exclusion of other interests.

I find families often think the young person is “quirky” and they have adapted the family’s routine and way of working around the young person. Everything falls into place when they realise the young person has an autistic spectrum disorder.

Interestingly many of the most successful people have an autistic spectrum disorder. This is because they see the world slightly differently and solve issues others cannot find a way to solve. They also make great employees as they like the routine of work, they will turn up bang on time and they will be intensely knowledgeable about their work if it is an area of special interest. They might not have a large group of friends but they will be very loyal to the ones they do have. There is no reason why they cannot develop normal relationships and have good careers. Having a diagnosis does come as a large relief to most people as they finally understand why they have felt different for such a long time.

What is autism and how would you spot signs that would suggest an assessment is sensible?

Autism is a neurodevelopmental condition which means they have been born with impairment in the development of several aspects of brain function that will unfold as the young person grows.

Children with autism have problems in the following areas:

  • They struggle with emotional understanding of others and interaction which can affect their interpersonal relationships
  • They have problems with how they communicate their thoughts
  • They are inflexible in their behaviour and in their thinking
  • They often have different sensitivity to sensory stimulation such as noises, lights, textures, tastes and smells and this can lead to distress

So many young people have autism which is not diagnosed and if they are in this situation, school and life in general can become really tough for them. If you see several of the below in a young person, who you feel is slightly different from the peer group, it might be worth having a consultation with a specialist regarding whether suggesting a referral to the parents is warranted.

Autism is a spectrum so people on the spectrum may have any combination of the below and they do not have to have them all. Please be aware you cannot diagnose autism from the below, only a specialist can diagnose autism.

Social interaction:

  • Does not join in with peers playing games as you would expect
  • Prefers being on their own or with older or younger people
  • Demonstrates the wrong emotional response to peers such as laughing when they are upset
  • Friendships are only because they share one or two interests they seem obsessed about
  • They are bullied or teased more than others in their class
  • Struggles to join in team games
  • Resists or struggles to take turns
  • Finds managing losing difficult

Routines and dislike of change:

  • They collect objects or carry an unusual object round in their pocket
  • They arrange objects in straight lines
  • They do not like changes in the classroom environment even if they are small
  • They get really upset if something they do is imperfect in any way
  • They are fussy over foods
  • They ask the same questions repeatedly
  • They can become obsessed with one individual in school
  • They do not want routines in school to change
  • They struggle with different teachers or changes of seats in classrooms and moving up a year

Emotions:

  • Not much variety in their facial expressions
  • They seem unhappy much of the time
  • They can laugh or cry for no obvious reason
  • They often look puzzled
  • They are often anxious or upset

Imagination:

  • Struggles with pretend play or imaginative games or activities
  • Consistently repetitive play
  • Little interest or curiosity in other people or their environment or the wider world other than limited to their own special area of interest?

Attention span:

  • They have a poor attention span if the topic is not part of their special interest or if staff do not supervise and
  • They can be restless and struggle to sit for the lessons

Unusual movements or sounds or responses to sensations:

  • They jump and down or spin round more than you would expect than them to
  • They flap their arms or hands
  • They rock when sitting down or standing up
  • They make funny noises or facial grimace
  • They sometimes try and hurt themselves, poking or hitting themselves or banging their heads
  • They break things aimlessly and repeatedly
  • They do not like being touched
  • They might breathe heavily or too quickly at times
  • They do not react to pain as you would expect
  • Certain sounds upset them or they can hear sounds others do not really notice
  • They might like watching things spin or looking at shiny things

To diagnose, or not to diagnose an autistic spectrum disorder?

Many parents ask what the benefit will be of giving their child a diagnosis of an autistic spectrum disorder and they worry how this diagnosis might impact on their child’s future. The below is intended to be helpful for parents and teacher’s when discussing the option of referring a child for a diagnostic assessment.

What does a diagnostic assessment involve?

There is no gold standard for diagnosing autism and depending on the complexity of the child or young person’s presentation; differing amounts of investigation might be used.

As a minimum

Most clinicians would take a full psychiatric history (to rule out any other diagnoses), then take a very detailed developmental history of the child from birth to the current day from the parents.

Following this it is likely the child or young person will be seen (with their parents present if they wish), to do some puzzles. They are not difficult and there is no right or wrong to them but the assessor will look at how the child interacts while doing the puzzles.

A diagnostic report is normally available following these appointments.

In addition

Often school views are requested in the form of a school report and sometimes a school observation by a clinician might be recommended, where a clinician subtly watches a child’s interactions in school.

Sometimes a cognitive assessment by a psychologist might also be helpful to understand the young person’s intellectual ability and areas of strengths and difficulties.

Sensory reintegration assessments can also be very informative to demonstrate if the young person is particularly sensitive to lights, sounds, touch, taste or smell as this can all become very confusing for them if this is the case. At times this is helpful after diagnosis when considering how best to help the young person.

Your child may benefit from an assessment from a speech and language therapist if his ability to speak or understand speech is unusual.

Why is a diagnosis of an autistic spectrum disorder helpful?

  • It stops the parents from doubting their own abilities at parenting; they will begin to understand why things that work for most children do not work for their child and it stops guilt and blame and a sense of failure.
  • It helps people understand that your child is differently abled and your child will benefit from people knowing how to assist them to learn and cope with the world when their nervous system processes information slightly differently
  • You can develop constructive relationships with school, voluntary services and healthcare services to help the child or young person
  • It helps the child or young person understand why they feel different and helps them understand themselves and that there are other young people they can identify with
  • It allows a language to be used between professionals to understand the child’s needs and how to help them
  • A diagnosis opens many doors for advice and support
  • The child may be entitled to apply for an EHCP (Education, Health and Care Plans)
  • Adaptations can be made to your child’s environment to help make the world a less distressing and confusing place
  • It will help you learn which parts of your child’s behaviour is normal pushing of boundaries and which is due to their autistic traits so you can learn to manage all aspects appropriately

“I was so worried about labelling my child but getting a diagnosis has been so helpful. We as parents now understand him much better and can manage his behaviour, the school have also learned about his needs and help him more appropriately and he is definitely happier.”

Below are written comments from feedback from recent young people who have been seen by her in her clinic:

Dr Hayley is phenomenal – she has transformed our daughters life and we are grateful every day that we found Dr Hayley and got the help we so desperately needed.

Dr Hayley is the only doctor that we trust to help us with our daughter’s mental health; more importantly, our daughter also trusts her. She genuinely cares. She talks to her, understands her and engages with her and us. She quickly identifies the problem and suggests realistic, pro active plans to tackle the particular issues at hand. She is always available for us to contact by phone and email (no matter how small the problem) and has telephoned us during the day and sometimes in the evening when the situation requires it. As parents, we have at times really struggled but she always manages to reassure us and we feel very lucky to have her as our doctor.
We love Dr Hayley. She is the only person my daughter will engage with. She has been incredibly helpful in all kinds of ways, not only with medication but with diagnosis, advice and referrals. My daughter has come along way since seeing Dr Hayley
Dr hayley is always so positive and encouraging. She listens well, is very professional and is very calming. Always a positive and helpful experience. My daughter won’t speak to any therapists however she is happy to open up to Dr Hayley. Thank you.
Dr Hayley has made my child’s life happy again, and our families too. She has identified and helped him with his anxiety and adhd. Her practice is run with precision and care with excellent communication from Dr Hayley and her team. I can’t thank them enough.
Dr van Zwanenburg put my 10 year old at ease immediately which helped her open up
Dr Hayley van Zwanenberg is a very good doctor
I really thought I was going to lose my daughter. Lose her to her own despair and potentially her own life. I searched for what seems like too long to find her the support, acknowledgment and treatment she needed. Finding Dr H was not just a life line but a true life changer. The care, understanding and treatment my daughter has received is truly outstanding. With Dr H’s consultation and understanding, my daughter has been able to reconcile her feelings of despair and inadequacy. I now have a confident, happy, social daughter who is starting university in the autumn and is looking forward to life. I can not thank you enough Dr H. Honestly, thank you so very much.
Can’t recommend Dr van Zwanenberg enough for child ASD/ADHD assessment and follow up. She’s very empathetic & puts everyone in the family at ease.
Dr Hayley has been very good for my daughter – she has been kind, caring and has explained her condition to us very well. My daughter was really poorly but is now well on the way to a good recovery thanks to Dr Hayley’s treatment and care.
Very early in our treatment but Dr Hayley has already made a huge improvement to our daughter and her health.
Very friendly and helpful.
Thank you ever so much for a very thorough assessment.
Very approachable and friendly style, felt that she really listened and put our anxious daughter at ease. Explained very clearly what the problem was and how we were going to deal with it as a team. Highly recommend.

We have received a very positive experience using Dr van Zwanenberg. We have felt listened to and supported without any judgement getting our daughters autism diagnosis. We would highly recommend.

Very good doctor.
Dr Hayley took an impressive amount of care in advance of our initial assessment appointment, to evaluate our son’s situation from many angles. We felt listened to and reassaured by her suggestions of strategies to help manage his symptoms. My son commented after the appointment that “She was vey kind and understood me”. We have also appreciated her quick responses to our questions outside of the appointment itself

Dr Hayley is always really professional but totally relatable and understanding. Would definitely recommend her to others.

Dr Hayley is such a lovely and compassionate psychiatrist. She has transformed the life of my son. I am so grateful.
Hayley has always been very accessible and helpful if we’ve needed to contact her between appointments.
Hayley was amazing with my daughter and she felt very reassured that she would help her get back to her old self!
Without Doctor Hayley I am certain I would not be alive today and she has been a massive help to me and my family.
As always Dr Hayley listens, is empathetic, encouraging and non-judgemental and gives sound professional advice. Thank you.
Brilliant Doctor, I gave up and Dr Hayley picked me back up and got be back to myself. I feel like she actually cares and respects what I say.
We feel blessed that Dr van Zwanenberg was available when my daughter was referred. It was a relief for my daughter to be understood and feel that there was hope for getting better. Dr van Zwanenberg has been endlessly kind and provided the expertise needed so that we felt completely supported. Although we have not had to use it a lot she has been available for advice in between appointments, which again adds to our feeling of being well supported. We would wholeheartedly recommend her and know she would do the best for anyone who came to see her.
Lovely Dr who was there to listen and help anyway possible. Full in detail and good natured with myself and my son. Got a lot from it and finally felt we were listened too. Lots of advice and next steps to follow.

Very happy with Dr Hayley. She She’s very kind and makes us feel at ease within the session. listens carefully to problem and tries to recommend a right solution. She’s very prompt in replying emails or in event of asking for prescription, which itself has made me feeling better in the stressful situations we have been experiencing. I am very happy with her and would recommend to others. Thank you Dr Hayley.🙏🏼🌸

She is very helpful
Dr Hayley is very supportive and I would thoroughly recommend her through this organisation
The doctor was really personable and helped to make my son feel comfortable, she asked great questions to elicit information to help the diagnosis and was very good at listening to our feedback
Thank you, I am very grateful for your professional, committed and caring approach that underpins your clients’ healing of minds, developing self-confidence and sustainable growth as autonomous individuals in becoming. I hope you recognise you save lives and give hope with your calm faith that your clients will, and do get better.
Dr Hayley probably saved my son’s life. A great Doctor.
Dr van Zwanenberg’s tone, manner & approach was perfect for our child, she listened to us all and helped set wheels in motion. Thank you
I was highly recommended to yourselves by someone who had previously been to see you. I will also highly recommend you also. My husband and I Felt very at ease during the whole process.
Thank you so much. Straight forward. Caring. & already actioning a plan. I’ve recommended you to two people already
An excellent doctor who is thorough and non-judgemental and takes a collaborative approach.
Dr Hayley was very calming and listened carefully to my concerns
Very happy with the service Dr Hayley has provided.
When dealing with a person with mental illness it is essential that the patient feels that they are being believed by the Doctor who provides the treatment. Dr van Zwanenberg is able to build trust and rapport and is sympathetic, understanding and non judgmental in her approach.
Van Zwanenberg was able to see us much more quickly than we had expected for which we were very grateful, and we were touched by the level of care and personal attention we and our son were afforded when we met. The speed, depth and quality of the written follow up was impressive, too.
The level of care and communication from Hayley has been exceptional throughout and I have already strongly recommended her to several other parents.
As always Dr Hayley was fantastic. She is always one step ahead and any additional admin requests etc are never too much bother. We will be sorry to lose her, as my daughter moves on soon to an adult psychiatrist now that she’s 18. I will be surprised if we can get such attentive service from any other psychiatrist. Many thanks indeed for your amazing support over the past few years.
Dr van Zwanenberg was fantastic, everything we’d hoped for.
Dr H has made a lasting improvement on both my daughters’ states of mind and their approach and outlook to life. I can not rate her services highly enough.
Dr Hayley saved me from suicide and helped me turn my life around. She is the best!
Very kind and knowledgeable
Dr Hayley she is a amazing person, very caring, patient and helpful
Dr Hayley was wonderful with my son. She put him at ease very quickly and consequently he was very happy to open up to her and talk freely. Thank you so much.
Dr Hayley was incredibly thorough, supportive and engaged. My daughters confidence with the process soared and throughout the 2.5 hour process. I am profoundly grateful that expertise and care exists in professionals like Dr Hayley. She is life-changingly good.
Hayley was wonderful. She engaged with my son beautifully despite his almost constant hyperactivity and chattiness during the appointment! She has a lovely warm approach while remaining very professional and highly knowledgable. I wouldn’t hesitate to recommend her.
Thank you so much for a faultless service. I’ve recommended you already to friends!
So happy my son is finally getting the help he needs to free himself of a life of anxiety. Thank you.
Dr Hayley and her colleagues provide outstanding accessible compassionate and effective care for young people with emotional and mental health difficulties including ADHD. We can not thank her and her colleagues enough for the extraordinary difference they have made to my son’s well- being and helping him approach his full academic potential.
Empathetic, caring!
Dr van Zwanenberg was very friendly and put my son at ease so he felt comfortable to talk openly. She was very reassuring and seemed to understand him straight away.
She is so kind and supportive