Autism: recognition, referral, diagnosis and management of adults on the autism spectrum

NICE guidelines [CG142] Published date:

Glossary

Augmentative communication

An alternative way of helping people with communication difficulties by using assistive technology such as computers or other devices, such as a speech output device.

Behavioural principles

Ideas, such as reinforcement and function of behaviour, that underlie behavioural therapies and underpin many interventions teaching adaptive skills for community living for people with autism, including those with challenging behaviour.

Care pathway

A system designed to improve the overall quality of healthcare by standardising the care process and promoting organised efficient service user care based on best evidence to optimise service user outcomes.

Challenging behaviour

A term used to describe behaviour that is a result of the interaction between individual and environmental factors, and includes stereotypic behaviour (such as rocking or hand flapping), anger, aggression, self-injury, and disruptive or destructive behaviour. Such behaviour is seen as challenging when it affects the person's or other people's quality of life and or jeopardises their safety.

Chelation

A procedure that involves using one or more substances (chelating agents) to remove materials that are toxic, including heavy metals such as mercury, from the body.

Easy read

An accessible format for written communication designed for people with a learning disability. It uses simple jargon-free language, short sentences and illustrations.

Facilitated communication

A therapeutic intervention whereby a facilitator supports the hand or arm of a person with autism while using a keyboard or other devices with the aim of helping the person to develop pointing skills and to communicate.

Functional analysis

A method for understanding the causes and consequences of behaviour and its relationship to particular stimuli, and the function of the behaviour. The function of a particular behaviour can be analysed by typically identifying (1) the precursor or trigger of the behaviour, (2) the behaviour itself, and (3) the consequence of the behaviour.

Hyper- and hypo-sensory sensitivities

Being over-sensitive (hyper-sensitive) or under-sensitive (hypo-sensitive) to sound, light, colour, smell or taste, which can cause anxiety or even pain in a person with autism.

Informant

A family member, partner, carer or other third party known to the person with autism who is able to provide information about the person's symptoms and behaviour so that professionals can have a fuller picture of the person's developmental history. Some assessment tools for autism require information from informants.

Learning disability

Lower intellectual ability (usually defined as an IQ of less than 70) that leads to problems in learning, developing new skills, communication and carrying out daily activities. Learning disability severities are defined by the following IQ scores: mild=50–69, moderate=35–49 and severe=20–34. A person with a mild to moderate learning disability may only need support in certain areas. However, a person with a moderate to severe learning disability may have no speech or limited communication, a significantly reduced ability to learn new skills and require support with daily activities such as dressing and eating. Learning disabilities are different from 'learning difficulties', like dyslexia, which do not affect intellect. Learning disability is sometimes also called 'intellectual disability'.

Modelling

A technique used in behavioural therapy that utilises video and other media. The service user observes target behaviour on the video or computer screen, and repeats it.

Reinforcement

A technique used in behavioural therapy to teach 'rules' of social engagement through providing prompts for behaviour.

NICE has accredited the process used by the Centre for Clinical Practice at NICE to produce guidelines. Accreditation is valid for 5 years from September 2009 and applies to guidelines produced since April 2007 using the processes described in NICE's 'The guidelines manual' (2007, updated 2009). More information on accreditation can be viewed at www.nice.org.uk/accreditation
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