Autism Spectrum Disorder

Autism spectrum disorder (ASD) is a lifelong neurodevelopmental difference that affects social communication and is accompanied by restricted interests, repetitive behaviour and sensory differences. It is a spectrum: some autistic people need substantial daily support and do not use speech, others live independently and are diagnosed as adults.

Autism is not a disease to be cured. Support aims to build communication and daily living skills, adapt the environment and treat conditions that commonly occur alongside it, such as epilepsy, sleep problems, ADHD and anxiety.

Symptoms

• Limited eye contact, not responding to name, or little pointing and showing by 12 to 18 months
• Delayed speech, loss of words already gained, or unusual speech such as echoing phrases
• Difficulty with back-and-forth conversation and reading social cues
• Strong need for routine, with distress at change
• Repetitive movements such as hand flapping, rocking or lining up objects
• Intense, narrow interests
• Over- or under-sensitivity to sound, light, touch, taste or pain
• In adults and in girls: exhausting effort to mask differences, with anxiety or burnout

Causes and risk factors

Autism is strongly genetic, with heritability estimated at around 80 percent, involving many common variants and, in a minority, a single identifiable condition such as fragile X syndrome, tuberous sclerosis or Rett syndrome. Older parental age, extreme prematurity and valproate exposure in pregnancy raise the likelihood. Vaccines do not cause autism; this has been examined in very large studies. Parenting style does not cause it either.

How it is diagnosed

• Developmental screening: Questionnaires such as M-CHAT at 18 to 24 months identify children who need full assessment.
• Multidisciplinary diagnostic assessment: Detailed developmental history plus structured observation, often with ADOS-2 and ADI-R, by a child psychiatrist, paediatrician or psychologist with a speech therapist.
• Hearing and vision tests: To exclude sensory causes of delayed language.
• Cognitive and language assessment: Defines strengths and support needs for education planning.
• Genetic testing: Chromosomal microarray, fragile X or exome sequencing, particularly with learning disability, seizures or unusual physical features.
• EEG or MRI: Not routine. Used only if there are seizures, regression or abnormal neurological signs.

Treatment options

• Early developmental and behavioural intervention: Play-based, parent-mediated programmes started in the preschool years have the best evidence for improving communication.
• Speech and language therapy: Including picture systems, signing and speech-generating devices for children with little speech.
• Occupational therapy: For motor skills, daily living and sensory regulation.
• Educational support: An individual plan with classroom adjustments or specialist placement.
• Parent training and family support: Reduces stress and improves behaviour at home.
• Treating co-occurring conditions: Melatonin for sleep onset problems, standard treatment for epilepsy and ADHD, adapted cognitive behavioural therapy for anxiety.
• Medication for severe irritability: Risperidone or aripiprazole for a limited period with monitoring, when behaviour is dangerous and other approaches have failed.
• Avoiding unproven treatments: Chelation, hyperbaric oxygen, stem cells, bleach products and restrictive diets have no good evidence and some are dangerous.

When it is urgent

Seek urgent local care for a first seizure, sudden loss of skills, serious self-injury, stopping eating or drinking, or talk of suicide in an autistic teenager or adult. Sudden behaviour change in a person who cannot describe symptoms may signal pain or physical illness and deserves a medical examination.

Travelling to Türkiye for treatment

Effective autism support is weekly, long-term and woven into home and school life in the child's own language, so it cannot be delivered on a trip. A diagnostic assessment abroad is also of limited value unless done in the child's language and accepted by your education system. What a visit can offer is a medical work-up for associated problems such as epilepsy, genetics or sleep. Please decline stem cell, chelation or similar offers marketed to families: they are unproven and carry risk.

Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.

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