Autism spectrum disorder: Updated guidelines for GPs
ASD is currently defined by the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) of the American Psychiatric Association. Although it is a lifelong condition, ASD emerges in early infancy and can be reliably diagnosed as early as age 2. Possible red flags include signs of communication, social, and behavioural disturbances at 12–24 months of age. In particular, children who do not babble, coo, or gesture by pointing, waving, or grasping by age of 12 months, who do not say single words by 16 months, and who do not say any two-word phrases without prompting by age of 24 months should be referred for specialist assessment. Any child with a loss of language or social skills at any age should also be referred, since deterioration in behaviour might indicate an acute illness in a person with ASD such as an ear infection. Comorbid anxiety, attention deficit hyperactivity disorder, and depression are also common. However, it is important to remember that children with ASD can present in a number of different ways depending on their current symptoms, cognitive ability, and educational and life experiences.