- 1 in 160 children has an autism spectrum disorder (ASD).
- ASD begin in childhood but tend to persist into adolescence and adulthood.
- While some people with ASD are able to live independent and productive lives, others have severe disabilities and require life-long care and support.
- Evidence-based psychosocial interventions, such as behavioural treatment, can reduce difficulties in communication and social behaviour, with a positive impact on wellbeing and quality of life.
- Interventions targeting people with ASD need to be accompanied by broader actions for making physical, social and attitudinal environments more accessible, inclusive and supportive.
- Worldwide, people with ASD are often subject to stigma, discrimination and human rights violations. Globally, access to services and support for people with ASD is inadequate.
OverviewASD consist of a range of conditions characterised by some degree of impaired social behaviour, communication and language, and a narrow range of interests and activities that are both unique to the individual and carried out repetitively.
ASD begin in childhood but tend to persist into adolescence and adulthood. In most cases the conditions manifest during the first 5 years of life.
These conditions currently belong to the category of pervasive developmental disorders, within the broader category of mental and behavioural disorders in the International Statistical Classification of Diseases and Related Health Problems (Tenth revision). ASD is an umbrella term covering conditions such as childhood autism, atypical autism and Asperger syndrome.
The level of intellectual functioning is extremely variable, extending from profound impairment to superior cognitive skills.
Individuals with ASD often present other co-occurring conditions, including epilepsy, depression, anxiety and attention deficit hyperactivity disorder (ADHD).
EpidemiologyIt is estimated that worldwide 1 in 160 children has an ASD. This estimate represents an average figure, and reported prevalence varies substantially across studies. Some well-controlled studies have, however, reported figures that are substantially higher. The prevalence of ASD in many low- and middle-income countries is so far unknown.
Based on epidemiological studies conducted over the past 50 years, the prevalence of ASD appears to be increasing globally. There are many possible explanations for this apparent increase in prevalence, including improved awareness, expansion of diagnostic criteria, better diagnostic tools and improved reporting.
CausesAvailable scientific evidence suggests that there are likely many factors that make a child more likely to have an ASD, including environmental and genetic factors.
Available epidemiological data are conclusive that there is no evidence of a causal association between measles, mumps and rubella vaccine, and ASD. Previous studies suggesting a causal link were found to be fraught with methodological flaws.1,2
There is also no evidence to suggest that any childhood vaccine may increase the risk of ASD. Evidence reviews to look into the potential association between thiomersal preservative and aluminium adjuvants contained in inactivated vaccines and the risk of ASD on the contrary strongly concluded the absence of any risk.
Assessment and managementIntervention during early childhood is important to promote the optimal development and well-being of people with ASD. Monitoring of child development as part of routine maternal and child health care is recommended.
It is important that, once identified, children with ASD and their families are offered relevant information, services, referrals, and practical support according to their individual needs. A cure for ASD is not available. Evidence-based psychosocial interventions, however, such as behavioural treatment, can reduce difficulties in communication and social behaviour, with a positive impact on the person’s wellbeing and quality of life.
The health-care needs of people with ASD are complex and require a range of integrated services, including health promotion, care, rehabilitation services, and collaboration with other sectors such as the education, employment and social sectors.
Interventions targeting individuals with ASD and other developmental disorders need to be accompanied by broader actions for making physical, social, and attitudinal environments more accessible, inclusive and supportive.
Social and economic impactsASD may significantly limit the capacity of an individual to conduct daily activities and participate in society. ASD often negatively influence the person’s educational and social attainments as well as employment opportunities.
While some individuals with ASD are able to live independent and productive lives, others have severe disabilities and require life-long care and support.
ASD often impose significant emotional and economic burden on people with ASD and their families. Caring for children with the severe spectrum of the condition may be demanding, especially where access to services and support are inadequate.
Human rightsPeople with ASD are often subject to stigma and discrimination, including unjust deprivation of health, education and opportunities to engage and participate in their communities.
People with ASD have the same health problems that affect the general population. Furthermore, they may have specific health care needs related to ASD or other co-occurring conditions. They may be more vulnerable to developing chronic noncommunicable conditions because of behavioural risk factors such as physical inactivity and poor dietary preferences, and are at greater risk of violence, injury and abuse.
People with ASD require accessible health services for general health-care needs like the rest of the population, including promotive and preventive services and treatment of acute and chronic illness. Nevertheless, people with ASD have higher rates of unmet health-care needs compared with the general population. They are also more vulnerable during humanitarian emergencies.
A common barrier is created by health-care providers’ inadequate knowledge of ASD and misconceptions.
WHO Resolution on autism spectrum disorders (WHA67.8)In May 2014, the Sixty-seventh World Health Assembly adopted a resolution entitled “Comprehensive and coordinated efforts for the management of autism spectrum disorders (ASD),” which was supported by more than 60 countries.
The resolution urges WHO to collaborate with Member States and partner agencies to strengthen national capacities to address ASD and other developmental disorders.
World Health Assembly resolution WHA67.8: Comprehensive and coordinated efforts for the management of autism spectrum disorders
WHO responseWHO and its partners recognize the need to strengthen countries’ abilities to promote optimal health and well-being of all persons with ASD.
Efforts are focusing on:
- contributing to enhancing commitment of governments and international advocacy on autism;
- providing guidance on creating policies and action plans that address ASD within the broader framework of mental health and disabilities;
- contributing to the development of evidence on effective and scalable strategies for the assessment and treatment of ASD and other developmental disorders.