Compensation for autism and ADHD after birth injury

Autism is a developmental disability which affects around 700,000 adults and children in the UK. Autism affects people in different ways and to different degrees across a wide spectrum, which is why it is sometimes called autism spectrum disorder or ASD.

Common challenges associated with autism or ASD include difficulties in communication, social interaction, patterns of behaviour and flexibility of thinking. Some children with autism also have sensory difficulties (hypersensitivity to noise or touch), problems with coordination and learning disability.

Attention deficit hyperactivity disorder or ADHD is a neurodevelopmental disorder that affects 2.6 million adults and children in the UK. Children with ADHD are often restless or hyperactive, or have difficulties with concentration and attention, and may act on impulse without first thinking about the consequences of their actions. Some people with ADHD may also have anxiety, problems with sleeping, and learning difficulties.

Until recently, most doctors believed that autism/ASD/ADHD were caused mainly by DNA sequencing and were primarily genetic conditions. In recent years, medical and scientific understanding of the causes of ASD / ADHD and other neurocognitive disorders has moved on and continues to develop rapidly.

Recent scientific studies have identified that other factors can also influence why some family members develop ASD / ADHD traits, whereas other members of the same family with very similar DNA do not. In some cases, the difference is a birth injury.

Many doctors and medical scientists now believe that a hypoxic injury to the baby’s brain around the time of birth can trigger autism and/or ADHD in children who would not otherwise have developed the condition, or would have had it more mildly, despite any genetic predisposition.

This means that some children only develop autism/ASD or ADHD traits because of a birth or neonatal injury to their brain. A lack of oxygen (hypoxia) around the time of birth, a stroke or a severe infection affecting the newborn baby’s brain can all cause a child to develop ASD / ADHD traits later in their childhood or teenage years.

If the injury was caused by medical or maternity negligence, we can help the child make an ASD/ADHD birth injury compensation claim.

Hypoxic birth injury is damage to the brain that is caused by a lack of oxygen, such as during delays in delivering a baby with heart rate abnormalities or fetal distress.

This kind of birth injury is also known as birth asphyxia or hypoxic ischaemic encephalopathy (HIE). It causes severe and often permanent damage to the baby’s brain and is commonly associated with severe disability and cerebral palsy.

Hypoxic birth injury is often treated by whole body cooling, ideally within six hours of birth.

For many years, the NHS has routinely treated newborn babies who have suffered hypoxic ischaemic encephalopathy (HIE) during their birth with therapeutic hypothermia or ‘cooling’. Babies with moderate or severe HIE from lack of oxygen during birth are at risk of developing permanent disability. Cooling can significantly reduce that disability, but it must be started no later than six hours after the birth, and very carefully managed to safely cool the baby’s body temperature to between 33.5° and 34.5° C for a period of 72 hours.

Cooling reduces brain swelling and intracranial pressure, slows down brain cell metabolism, reduces the damaging compounds released by the brain cells after a hypoxic event and increases the repair of brain cells, reducing the extent of the damage to the developing brain.

For many babies with severe neonatal hypoxia, cooling has prevented the severe physical disability or cerebral palsy that could be expected from their brain injury, enabling them to meet their milestones and develop physically with only minimal (or no) obvious disability. However, we are now discovering that some of the children who avoided severe physical disability from their birth injury as a result of their neonatal treatment with cooling later develop attention and behavioural problems which are diagnosed as neurocognitive disorder, such as autism or ADHD. It is possible before cooling treatment was available, in most cases the link between children’s birth injuries and their later development of autism/ADHD was not recognised because many of the ASD/ADHD traits that might have been caused by their birth injury, such as difficulties with communication, were masked by their severe physical disability.

Scientific understanding of these conditions is still developing, but currently our medical experts advise that unless there is strong evidence to the contrary, the ASD/ADHD traits which develop in later childhood and teenage years can be attributed to the child’s hypoxic birth injury.

Babies who have had other types of brain injury, such as from a stroke or meningitis, can also go on to develop ASD/ADHD or similar neurodevelopmental and neurocognitive disorders which severely affect their development and behaviour.

If your child has autism or ADHD and needed cooling after their birth, their condition may have been caused by a hypoxic birth injury or neonatal brain injury. If the brain injury was caused by negligent mistakes in the maternity or neonatal care, your child could be entitled to substantial compensation.

Parents and families of babies who have received cooling after hypoxic birth injury or HIE may not be warned about their child’s risk of neurodevelopmental disability from autism spectrum disorder (ASD) or ADHD later in childhood or teenage years.

If your child was cooled following a birth injury, and you are concerned about autism or ADHD, you should contact us for free, confidential advice as early as possible.

Compensation from a birth injury ASD/ADHD claim ensures that the child or teenager has the necessary support to meet all their additional needs arising from their neurodevelopmental disability. The type of help and support that can be provided, and the difference that compensation can make, depends on their age and state of development when we start the claim. The sooner the family come to us, the greater the difference we can make to their child’s development and their ability to live independently in later life.

Each child or teenager’s condition and its impact on their life will determine their individual needs and the help that can be achieved from their compensation. In most cases, the claim will include provision for a case manager to work with the family to coordinate the care, supervision, and support that the young person needs now and throughout their life to be active and participate in a way that is safe for themselves and others around them. Ultimately, this could mean living semi or fully independently in their own or their family’s home or in supported residential care.

For younger clients who come to us earlier in childhood, compensation can help pay for:

• support with special educational needs (SEN);
• neuropsychological and behavioural support;
• support with development and becoming independent;
• a safe and supportive home environment;
• additional support for the wider family.

For teenagers and young adults, additional help is aimed at reducing the impact of their vulnerability:

• providing care, supervision and support with all aspects of daily living;
• providing a safe and suitable home and living environment;
• therapeutic support and behavioural strategies to increase their ability to participate as fully as they can in work, leisure and social activities.

Depending on the extent of any additional physical disability or learning difficulties caused by their birth injury, the claim may also include compensation for:

• additional costs of suitably adapted accommodation;
• therapies (physiotherapy, occupational therapy, speech and language therapy);
• adapted vehicles, specialist equipment and assistive technology;
• Court of Protection deputyship to help protect and manage their money.