Autism
A lifelong difference in how people communicate, relate and experience the world. Not caused by parenting or vaccines, and not something to cure. Support aims at wellbeing, communication and life on the person’s terms.
Go deeper: Autism in children · Autism in adults
The autism support ladder
Not a ladder out of autism: these are supports to choose from, based on what the person needs and wants. Many families use several at once.
- Step 1 · Self-careSensory and daily-life supportsNoise-cancelling headphones, sunglasses, quiet breaks, visual schedules and warning before changes.
- Works
- Not tested well in trials, but low risk; many autistic people find daily life much easier
- Cost
- Free, up to about $50–400 for good headphones
- How long
- As needed, for life
- Watch for
- What the person tells you works for them. They’re the expert
Turning the world’s volume down is a perfectly good strategy.
- Step 2 · Allied healthPlay-based programs that coach parentsFor young children: a therapist coaches parents to build communication through everyday play.
- Works
- Small to moderate gains in social communication in trials; among the best-supported early supports
- Cost
- About $150–250 a session privately; NDIS early childhood support may help
- How long
- Weekly sessions over months
- Watch for
- Good programs are fun, follow the child’s lead and respect their cues
Therapy that looks a lot like playing. That’s the point.
- Step 3 · Allied healthSpeech pathology and other ways to communicate (AAC)Helps with understanding and expressing needs, including picture boards, devices or sign.
- Works
- Small to moderate gains in communication in trials. AAC doesn’t stop speech developing
- Cost
- About $180–250 an hour; Medicare rebates for under-25s with a paediatrician or psychiatrist plan; NDIS may fund
- How long
- Months to years, tailored to the person
- Watch for
- The myth that AAC replaces talking. It doesn’t
Every way of communicating counts.
- Step 4 · Allied healthOccupational therapy and psychologyOT for daily living and sensory needs; CBT adapted for autistic people for anxiety, which is common.
- Works
- Adapted CBT: moderate to large drop in anxiety in trials (mostly vs waitlist). Sensory integration: mixed results
- Cost
- About $180–280 a session; Medicare rebates with a GP mental health plan or the under-25 autism items
- How long
- Often 8–20 sessions
- Watch for
- Choose clinicians experienced with autistic people
Treat the anxiety, not the autism.
- Step 5 · PrescriptionSlow-release melatonin for sleepFor children with ongoing insomnia after sleep routines have been tried.
- Works
- About 45 minutes more sleep a night and asleep about 25 minutes sooner than a dummy treatment
- Cost
- About $150 a month privately, or $25 on the PBS ($7.70 concession) for children who meet the criteria (authority needed)
- How long
- A few weeks to judge; review regularly
- Watch for
- Morning drowsiness, headache. Over-the-counter melatonin products vary a lot in dose
Bedtime routine first. The tablet is a helper, not a replacement.
- Step 6 · SpecialistMedicines for severe distress or aggression (risperidone or aripiprazole)Started by a specialist, after looking for causes such as pain, sensory overload or anxiety.
- Works
- About 5–7 in 10 children improve (vs about 1–3 in 10 on a dummy treatment)
- Cost
- Under the $25 PBS co-payment for eligible children, about $15–25 a script, plus specialist fees
- How long
- Reviewed regularly; lowest dose for the shortest time
- Watch for
- Weight gain, sleepiness, raised blood sugar and cholesterol. Needs regular checks
Look for the reason behind the distress first. Medicine is a backup, not the plan.
Save your money
Popular, heavily marketed or often asked about, but the evidence is weak or says no.
- Special diets and supplementsGluten-free, casein-free and others don’t help autism and can cause poor nutrition.
- Chelation, hyperbaric oxygen, bleach (MMS or CDS), stem cellsNo benefit, and some have caused serious harm or death.
- Facilitated communicationTested and found to reflect the helper’s words, not the autistic person’s. Use proper AAC instead.
- Compliance-focused programsIntensive behaviour programs (such as some ABA) have low-quality evidence, and many autistic adults report harm. Avoid any program that stops harmless stimming, ignores distress, or doesn’t let the child say no.
What you can do
- Learn about autism from autistic people as well as professionals.
- Ask about Medicare rebates (for under-25s, after a paediatrician or psychiatrist referral), the NDIS, and school or work adjustments.
- For free, independent advice, call Autism Connect on 1300 308 699.
See your GP if
- You’re worried about a child’s development, such as late talking, little eye contact or shared play, or not responding to their name
- You’re an adult who wonders whether you are autistic
- Anxiety, low mood, burnout, sleep, eating or gut problems are affecting you or your child
See a doctor promptly if a child loses words or skills they already had. Call 000 if someone is at immediate risk of harm. Suicidal thoughts are more common in autistic people: call Lifeline on 13 11 14 (24/7).
Support lines
If you or someone else is in danger right now, call your emergency number. To talk to someone, any time:
- Australia: Lifeline 13 11 14 (24/7, or text 0477 13 11 14), Suicide Call Back Service 1300 659 467, Beyond Blue 1300 22 4636, 13YARN 13 92 76 for Aboriginal and Torres Strait Islander people. Emergency: 000.
- Young people in Australia: Kids Helpline 1800 55 1800 (24/7, ages 5 to 25) or headspace (ages 12 to 25).
- New Zealand: call or text 1737. Emergency: 111.
- UK and Ireland: Samaritans 116 123. Emergency: 999 (or 112).
- US and Canada: call or text 988. Emergency: 911.
- Anywhere else: findahelpline.com lists free helplines in more than 100 countries.
Common questions
What are early signs of autism in children?
Late talking, little eye contact or shared play, and not responding to their name can be signs. See your GP if you’re worried about a child’s development.
Can adults be diagnosed with autism?
Yes. Many people, especially women and girls, are first diagnosed as adults.
Do vaccines cause autism?
No. Autism is not caused by vaccines or parenting.
Do special diets help autism?
No. Gluten-free, casein-free and other diets or supplements don’t help autism, and can cause poor nutrition.
Is autism genetic?
Largely, yes. Large family and twin studies suggest about 80% of autism likelihood comes from genes, usually many small genetic differences rather than one gene. It often runs in families, and parenting doesn’t cause it.
What are the levels of autism?
Levels 1, 2 and 3 describe how much support someone needs day to day, from “requiring support” (level 1) to “requiring very substantial support” (level 3). They describe support needs at the time of assessment and can change with age and circumstances.
Is autism a disability?
Autism is a lifelong difference in how people communicate, sense and process the world, and it’s recognised as a disability under Australian law. Many autistic people see it as part of who they are, while also needing supports or adjustments.
Can autism be cured?
No, and the aim isn’t to cure it. Support with communication, sensory needs, learning and mental health can make a big difference. Avoid products sold as autism cures, such as chelation or bleach (“MMS”), which are dangerous.
Helpful resources
- Raising Children Network: Autism therapies guideGovernment-funded guide to therapies for autistic children, to help you sort the useful from the hype. Free.
- Reframing AutismAutistic-led charity with free articles, podcasts and a welcome pack for newly identified autistic people and families.
Evidence and more information
- Autism CRC: National Guideline for the assessment and diagnosis of autism (2023)
- Autism CRC: National Guideline for supporting autistic children and their families (2022)
- Autism CRC: Evidence for interventions for autistic children
- Healthdirect: Autism
- Amaze: Medicare for autistic people under 25
- PBS: Melatonin 5 mg modified release
- NEJM: Risperidone in autism (RUPP, 2002)
maladywise.com/autism/