National Institute for Health and Clinical Excellence (NICE)
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Tailor management of autism in children and young people to individual needs

Health and social care professionals should tailor the management and assessment of children and young people with autism to individual needs to ensure they receive the best care, according to NICE.

Managing autism can be challenging due to the range of problems it is associated with, and because the way in which autism is expressed will differ across different ages.

Coexisting psychiatric disorders can also present challenges for management, with around 70 per cent of people with autism also having conditions such as attention deficit hyperactivity disorder (ADHD), or anxiety disorders.

While there is no 'cure' as such for autism, interventions do exist that can help with some of its core features, the symptoms and behaviours and problems it is associated with.

NICE´s guideline on the management and assessment of children and young people with autism recommends a range of treatments and interventions to help ensure management addresses individual needs.

Interventions covered include anticipating and preventing behaviour that challenges, the assessment and management of behaviour that challenges, and psychosocial interventions for behaviour that challenges,

NICE recommends health and social care professionals should receive training in autism awareness and managing autism. This training should include cover a range of areas, including the nature and course of autism, and of the behaviour that challenges in children and young people with the condition.

The training should cover how to provide individualised care and support and ensure a consistent approach is used across all settings.

It should also cover recognition of common coexisting conditions including mental problems such as anxiety and depression, and other neurodevelopmental conditions such as ADHD.

Some features of behavioural problems associated with autism may not show until a change of situation, such as starting nursery or school, or the change from primary to secondary school.

As a result, NICE recommends that training should cover the importance of key transition points. In addition, it should cover the child or young person's experience of autism and its impact on their family, including their siblings, or their carers.

The guideline stresses the importance of good communication between health and social care professionals, and children and young people with autism and their families.

NICE recommends that training should cover skills for communicating with a child or young person with autism.

Furthermore, behaviour that challenges should be anticipated and prevented, with factors that may increase the risk of behaviour that challenges assessed in care planning.

Such factors include impairments in communication, coexisting mental health disorders, physical environments such as lighting and noise levels, and changes to routines or personal circumstances.

Professor Gillian Baird, Consultant Paediatrician and Professor of Paediatric Neurodisability at Guy's and St Thomas' NHS Foundation Trust and Chair of the Guideline Development Group, said: "Many people who have autism will have other physical, neurodevelopmental or mental health conditions such as intellectual disability, attention deficit hyperactivity disorder, anxiety and sleep problems which are not always recognised.

"Assessment needs to be tailored to the individual and their families or carers, to enable them to get the right intervention and support from education, health services and voluntary organisations."

Professor Tim Kendall, Medical Director and Consultant Psychiatrist at Sheffield Health and Social Care NHS Foundation Trust and Director of the National Collaborating Centre for Mental Health, said: "Autism affects brain development, and although there are common symptoms, the impact it has on individuals can differ greatly.

"The way that autism is expressed depends on many factors, such as co-existing conditions or changes in circumstances. In children, it may also change over time as they mature.

"It's really important that health and social care professionals working with children and young people with autism understand the nature of the condition and the child's experience as well as the impact autism has on them and their family."


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