The Three Levels of Autism: Insights and Implications for Support
Updated on October 8, 2024 Listen to the PodcastDo you know why “autism” is officially called “autism spectrum disorder” (ASD)? It is because experts have officially identified many kinds of behavior connected to autism. It helps to think of them as a range (or spectrum) because some people with autism lead high-functioning lives, while others require constant care. The type and intensity of care greatly affects parents and caregivers, so when thinking about support needs, it’s essential to first understand where the person fits on the autism spectrum.
Overview of Autism Spectrum Disorder (ASD)
The behavior of an individual with autism is sometimes noticeable, and sometimes not. Therapy and support can make a huge difference in helping autistic adults with their everyday activities. The bigger challenge is identifying symptoms of autism in children. For the benefit of the child, it is critical to recognize autism as early as possible (the average age of diagnosis is 5 years old), and begin therapy right away. But this can be tricky, as there are many types of behavior that indicate autism.
Definition and Characteristics of ASD
The American Psychiatric Association’s definition of ASD is “a complex developmental condition involving persistent challenges with social communication, restricted interests, and repetitive behavior.”
That’s a pretty general statement, so let’s take a closer look at some of these behaviors:
Social: Difficulty making or keeping friends, lack of eye contact and physical gestures, poor understanding of feelings
Interests: Intense focus on certain subjects, and a lack of interest in what others are doing
Repetition: Dislike of change, repetitive physical movements, extreme need for order
These behaviors might seem familiar, because there are many other conditions that are closely associated with ASD. Here are some well-known examples:
Asperger’s Syndrome. A person with Asperger’s is often intelligent and independent. What sets them apart is an intense focus on certain subjects that they have a hard time getting away from. This limits their behavior in social settings.
Pervasive Developmental Disorders (PDD). This is a step up from Asperger’s in terms of severity, and shows up as difficulties with communication, social interaction, and limited interests.
Childhood disintegrative disorder. This is a rare condition where a child at first seems high-functioning, and then loses skills. Many such children also have seizures.
Like many aspects of psychiatry and psychology, terms and definitions change over time. Nowadays, all of these conditions are categorized as being part of ASD. In other words, experts tend not to describe children as having Asperger’s anymore–they are simply autistic.
Common Misconceptions About Autism
One of the consequences of autistic children being on a spectrum and behaving in widely different ways is that there is a lot of misunderstanding about it out there. Here are a few of the most common misconceptions:
Girls don’t get autism. For every four boys who are autistic, there is one girl. And, because ASD is less common in girls, physicians tend to misdiagnose girls by misinterpreting their behavior as something other than autism.
Autistic people are mentally disabled. In countries where tailored support plans are not available, autistic people can end up with intellectual disabilities. However, diagnosis and treatment in modern countries avoids this problem.
Vaccines cause autism. There is no evidence to prove that inoculation and autism are connected. However, it’s true that the rate of diagnosis has gone up in recent years. This is partially due to increased awareness and the reclassification of problems (like PDD) as autism.
The Three Levels of Autism: An Overview
The first thing to understand when diagnosing someone with autism is that the individual is no longer described as “mild” or “severe”. Instead, a child with autism is described according to their level of support needs. Classifying them in this way allows a variety of experts and caregivers to speak the same language. When defining and carrying out support needs, the “level” approach is more effective than talking about behavior, which depends greatly on individuals and can even change over the course of the day.
Level 1: Requiring Support
This level of autism describes children who are relatively independent. Still, the parent/caregiver role can be substantial, depending on the types of behavior and the success of therapy.
Characteristics of Level 1 Autism
Children with Level 1 ASD often have a tough time communicating. It is difficult for them to understand body language, social cues, and the proper way of having a conversation. Similarly, Level 1 children can speak in full sentences but run into trouble during long talks. Level 1 individuals also tend to enjoy very specific activities and have difficulty with organization and planning.
Common Challenges
Dealing with an autistic child requires tailored support plans that include the needs of parents. Especially when the child is young, parents can be overwhelmed. They should be proactive in finding resources to help them cope, on top of attending to the needs of their child.
Strategies and Support
There are three main areas of support:
Inside the Home: A good starting place is with other parents. They are an excellent source of advice regarding schooling, healthcare, specialized equipment, public resources, and so on.
Outside the Home: Parents must act as advocates for their child by approaching teachers and healthcare professionals. Through these sources, parents can develop tailored support plans and discover therapy programs.
Treatment: Professionals can design treatment routines for autistic children that include therapies such as applied behavior analysis (ABA), speech/language, and occupational.
Level 2: Requiring Substantial Support
Level 2 ASD is typically more intense than Level 1. Children with Level 2 autism are even more limited in their abilities, and so require a higher level of care.
Characteristics of Level 2 Autism
Socially, Level 2 ASD children act in ways that might seem inappropriate. For instance, they can continue talking about something even when their counterpart is clearly not interested. They may turn away or walk off during a conversation. When it comes to communication, Level 2 children face difficulty completing sentences and have a limited vocabulary. Repetitive physical movements are noticeable, and a severe reaction may result when there is a change in routine or environment.
Common Challenges
Parents are critical in noticing autistic behavior as soon as possible and starting the diagnosis process. It’s also important for a parent to become their own “expert” about the child’s behavior. When dealing with caregivers, parents can discuss the triggers specific to their child.
Strategies and Support
Inside the Home: Close monitoring is essential to get an early diagnosis, learn about the child’s behavior, and ensure that the child is sticking to what they learn in therapy.
Outside the Home: Educational institutions are particularly valuable for Level 2 autism. Special routines that support reading, social interaction during breaks, and modified assignments are important to access.
Treatment: ABA and other therapies are used here as well, but this time to work on more fundamental skills such as hygiene, dealing with environmental stimuli, and understanding both verbal and non-verbal communication.
Level 3: Requiring Very Substantial Support
Children with Level 3 autism have difficulty with basic tasks and require constant monitoring and support from caregivers.
Characteristics of Level 3 Autism
Children with Level 3 autism, in some cases, never engage in eye contact, have minimal ability to communicate, and greatly prefer being alone. If they can communicate, it might be only to express things that they want. When under stress (which can be triggered by apparently trivial things), a Level 3 person sometimes acts aggressively or destructively.
Common Challenges
Anxiety can be a major challenge for families with a Level 3 child. Avoiding the triggers that cause stress is always important, while parents also need ways to deal with the stress caused by constant caring and periodic outbursts.
Strategies and Support
Inside the Home: The intensity of caring for a Level 3 autistic child is made easier by dividing the work among multiple people, and government support programs can help here.
Outside the Home: Parents need to work closely with the relevant institutions to ensure that their child gets the care that they need.
Treatment: Each of the therapy types discussed above are relevant here. Communication therapy can focus on sign language or electronic devices. Occupational therapy might tackle self-care, basic physical coordination, and the assessment of environmental stimuli.
Diagnosis and Assessment of Autism Levels
The diagnosis of autism almost always begins with the parents. Once you suspect something, it’s time to talk to a professional.
The Role of Healthcare Professionals
The first step is to discuss your concerns with a pediatrician, who can refer you to a child psychologist or psychiatrist. They sometimes recommend seeing specialists like neurologists (to check for the potential of seizures), speech-language pathologists, and occupational therapists.
Diagnosing Autism
There are a variety of assessment types that a professional can recommend. These include the Autism Diagnosis Interview, Autism Diagnostic Observation Schedule, Childhood Autism Rating Scale, and Gilliam Autism Rating Scale.
Support and Resources
Once a child is diagnosed, the next step is to create a tailored strategy that covers the patient’s home life, their time outside the home, and therapy.
Tailored Support Plans
The behaviors mentioned above do not begin to describe the full variety of autistic activity. In reality, autistic children demonstrate a huge range of behaviors, and so support plans must be individualized. This is also true when considering that each person will react in different ways, and improve at different rates, after therapy.
Types of Available Support
Thankfully, parents of autistic children often have access to a wide number of support resources. Although they differ according to where you live (and perhaps your insurance plan), they usually take five forms:
Community. Autism is not a rare condition, so chances are that other families near you are facing the same challenges. Common types of support groups include advocacy organizations, autism associations, and social skills programs.
Healthcare. In addition to the hospitals and clinics in your area, you can often get support from national health agencies and centers for therapy (such as ABA).
Specialists. Some areas have organizations that help parents in the early recognition of autism, while others assist autistic people to live independently, particularly as they get older. There is also a wide range of online services that can guide you from initial diagnosis to therapy and help you to build tailored support plans.
Schools. You should inquire if your local K-12 institution offers support for autistic kids, especially in developing Individual Education Plans (IEPs).
Technology. Many innovative companies have developed technologies that help both autistic people and their caregivers to cope more easily. A good example is the Autism Tracker Device, a small wearable device that enables the caregiver to detect a child’s location and speed of travel, receive an SOS signal, and communicate directly.
Challenges and Considerations Across the Spectrum
Caring for children with autism can be – but does not need to be – an intense job. The higher the level of autism, the greater the resources required. But as we’ve seen the concept of autism evolve over the years, we are all learning more about this condition and improving how we approach it.
A Common Thread
Hopefully, most people with autism are diagnosed as children. In their early years, parents and other caregivers take on most of the burden. Yet autism has no cure, only treatment. As the autistic person grows older, the caregivers change, with the declining abilities of parents being the most noticeable part of this (and perhaps the most stressful to the autistic person).
Societal and Personal Considerations
So, even though an autistic person will face challenges over the course of their lives, society is making it easier on them. Parents, physicians, schools, entrepreneurs, and officials are all cooperating to make life more comfortable for all of those concerned.
Living with Autism
It’s not just the child who needs to cope with autism, it’s the parent as well. As you read about resources available these days, it’s clear that there is a huge range of tools to make things easier all around.
Learn More About Levels
Perhaps the most important takeaway regarding autism is that there are three distinct levels, along with a large number of behaviors within each level. If your child acts in a certain way, what does it mean? Knowing where to place that behavior on the spectrum is essential for choosing the right treatment.
Keep Growing, Together
People with autism are remarkably capable of learning. It’s your role to develop your knowledge and treatment skills alongside them. With the right type of support, autistic children can lead full and rewarding lives.
