Clinically recommended ADOS-4 thresholds are also recommended for community cases: 7+ for subthreshold and 10+ for definite cases. Further work on adult population screening methods is needed.

Purpose -People with autistic spectrum disorders (ASD) may offend as a result of social skills deficits, co-morbid mental health problems, abuse of drugs and alcohol, or because of their special interests. The purpose of this paper is to illustrate these issues by describing a patient in whom all of these factors contributed to fire-setting behaviour.Design/methodology/approach -This paper briefly summarises the literature in relation to ASD and offending, then describes the case of a young man with Asperger syndrome who set a fire in his home.Findings -The paper concludes that late diagnosis and the consequent lack of intervention may increase the risk of offending. Adults with ASD who offend can benefit from treatment in specialist secure units and the prognosis following such treatment may be good.Originality/value -The paper highlights the risk of offending in people with ASD, the factors which may contribute to offending, and possible approaches to treatment.

Purpose -The purpose of this paper is to describe the characteristics of adult male autistic spectrum disorder (ASD) patients admitted to low secure services and to compare them with non-ASD patients. Design/methodology/approach -Case-control study of admissions to two ASD units and one non-ASD unit at a tertiary referral centre. Subjects were compared on demographic, personal, clinical and offending behaviour variables. Findings -In total, 51 ASD and 43 controls were studied. Median age at diagnosis of ASD was 21 years (range 6-56). The ASD group were younger (median age 27 vs 33 years) and more likely to be single than controls. Their age at first contact with psychiatric services was lower and proportionally more were admitted from prison and courts. Almost three-quarters had psychiatric comorbidity, most commonly schizophrenia, but unlike controls, personality disorder and drug and alcohol disorders were uncommon. Lifetime sexually inappropriate behaviour and physical violence were less common, as was non-compliance with medication. However, 78 per cent had a lifetime history of physical violence and a third had a conviction for GBH or homicide. Offending behaviour was sometimes atypical in nature and some had convictions for unusual offences such as harassment and stalking.Research limitations/implications -The age difference between cases and controls is likely to have confounded the results. Findings cannot be generalised to the NHS. Originality/value -This group of ASD patients in low security differed in several important respects from their non-ASD counterparts, which highlights their differing treatment needs, strengths and weaknesses.

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