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"For those with high functioning Asperger's they can work out what they have to do – to remember to smile, to ask, 'How are you?

But there was an additional reason why it was unexpected – both her children are girls.

Autism is an overwhelmingly male diagnosis – it has been described as the "extreme male brain".

The effect of starvation on brain function impairs set-shifting – the ability to think flexibly and to multi-task instead of focusing on one thing – and the ability to read other people's minds.

"They become more socially isolated, withdraw more and more into their own world and become cut off and lonely," she says.

She asked very complicated questions, constantly seeking and clarifying her perception of the world.

I had to be very careful with expressions like "he will bite your head off" because she would understand it literally and be frightened." "She was my first child and I assumed all children were like this.People with eating disorders find it difficult to change self-set rules and learnt behaviour once fixed in the brain.They also see the world in close up as if looking through a zoom lens, and get lost in the detail.With hindsight, Nicky Clark says early signs of autism were present in both her children.The elder one, though very bright, had a love of routine and was not interested in fantasy games like other children.Anorexia has been called the female Asperger's (the mild version of autism).


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