Levels Of Autism: What The Dsm
The diagnostic criteria for autism spectrum disorder themselves are fairly straightforward:
- Persistent deficits in social communication and social interaction across multiple contexts this may refer to differences in body language, different ways of communicating with others that neurotypical people find hard to understand, and a different way of expressing or feeling emotions.
- Restricted, repetitive patterns of behavior, interests, or activities this can refer to physically repetitive movements or the repitition of sounds , a need for rigid routines, being really interested in a particular topic or a few, and things like wanting or needing to eat the same foods every day.
- Symptoms have to show up in childhood, even though they may not have been recognized as autism.
- Symptoms affect daily functioning in a negative way.
- Another diagnosis couldnt better explain the symptoms.
Theres quite a few more specifiers, terms that further describe any given autistic persons personal autism, such as with or without intellectual or language impairment.
The levels of autism are quite interesting:
Rather than referring to levels, its also common to hear talk of low-functioning vs high-functioning autism.
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What Are The Dsm
In 2013, the American Psychiatric Association released the fifth edition of its Diagnostic and Statistical Manual of Mental Disorders .
The DSM-5 is now the standard reference that healthcare providers use to diagnose mental and behavioral conditions, including autism.
By special permission of the American Psychiatric Association, you can read the full-text of the new diagnostic criteria for autism spectrum disorder and the related diagnosis of social communication disorder below.
Also see: Answers to frequently asked questions about DSM-5 criteria for autism
Autism Exists On A Spectrum
The Diagnostic and Statistical Manual of Mental Disorders, fifth edition , states that autism is a spectrum. This means that individuals have different support needs and strengths.
Many providers describe autistic people as high functioning or low functioning, but these terms are generally considered inaccurate because an individual can seem high functioning in one area but struggle in others. Additionally, someone who was previously higher functioning might struggle due to increased stressors or burnout.
Typically, autistic people talk about levels of support needs in various areas, as this reflects what the individual needs in order to have their best life rather than how their functioning impacts the people around them. Although limited, the levels associated with a diagnosis of autism spectrum disorder can help with understanding the individuals needs and how to best support them.
When someone is diagnosed with autism, the provider who conducted the evaluation will often provide information about their level in order to inform treatment plans and needed areas of support.
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How Do Kids Get Autism
Genetics. Several different genes appear to be involved in autism spectrum disorder. For some children, autism spectrum disorder can be associated with a genetic disorder, such as Rett syndrome or fragile X syndrome. For other children, genetic changes may increase the risk of autism spectrum disorder.
Theories And Empirical Research
is a study and theory of relationships especially within hierarchies. Social harmonyÃ¢the central goal of ConfucianismÃ¢results in part from every individual knowing his or her place in the social order, and playing his or her part well. Particular duties arise from each personâs particular situation in relation to others. The individual stands simultaneously in several different relationships with different people: as a junior in relation to parents and elders and as a senior in relation to younger siblings, students, and others. Juniors are considered in Confucianism to owe their seniors reverence and seniors have duties of benevolence and concern toward juniors. A focus on mutuality is prevalent in East Asian cultures to this day.
The mindfulness theory of relationships shows how closeness in relationships may be enhanced. Minding is the âreciprocal knowing process involving the nonstop, interrelated thoughts, feelings, and behaviors of persons in a relationship.â Five components of âmindingâ include:
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Restricted Interests And Behaviors
Restricted interests, behaviors, and routines are very common among people with autismand among people in general. Autistic people may carry these qualities to an extreme .
But many people with autism are as flexible as many “typical” people who prefer sameness and routine. Similarly, it can be hard to distinguish between a “normal” fascination with video games and an “autistic” fascination the differences lie more in how the fascination is expressed than in the fascination itself.
That is: a person with autism may find it difficult to talk about anything except the favored interest, discuss the interest in a rapid monotone, and assume that others are as interested in the topic as they are.
When Should I See My Doctor
If you think your child has ASD, see your doctor. Early intervention offers the best outcomes for children with ASD, whether their traits are obvious or subtle.
There may be different signs of autism at different ages.
- In the first year, your baby with ASD might not be interested in other people. They may not make eye contact with you. They may not smile or gesture like other babies.
- As toddlers, children with ASD might not respond to their name. They might focus on one or 2 activities repetitively, like lining up toys. They may not be interested in playing with other children. They might develop unusual ways of speaking.
- Older children with ASD might have difficulties in social situations, following instructions or making friends.
You might receive an autism diagnosis as an adult. You may spend your life feeling like you dont quite fit in. You may have difficulties with relationships, work and social situations. You may also have mental health conditions like anxiety or depression.
Autism Awareness Australia provides information about signs of autism in people at different ages.
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Understanding The 3 Different Levels Of Adult Autism
Autism spectrum disorder, or ASD, is complex and nuanced.
Usually, there is not just one but several issues that affect a person with ASD. These can include symptoms related to the condition. Additionally, there also can be secondary symptoms. These are typically connected to other mental health issues that also go along with autism.
To break down the symptoms of autism into more distinct categories, researchers have created a system. There are three categories, or levels, of autism. The criteria for these categories is formalized in the fifth edition of the Diagnostic and Statistical Manual, or DSM-5.
Of course, nobody likes being labeled. And these classifications are not meant to discriminate. Rather, they help to better focus the care, attention, and services needed to best help someone with autism.
Lets take a closer look at all three.
What Is Pervasive Developmental Disorder
Pervasive Developmental Disorder is also known as atypical autism. PDD is typically reserved for those who meet some but not all, of the criteria for the other two types of ASD. Those affected with PDD-NOS experience milder or fewer symptoms. Quite typically, those with PDD-NOS only suffer from social and communication challenges. These people tend to be the highest-functioning autistic types. They simply do not fit into any of the other categories or types of ASDs.
Many young children are diagnosed with PDD-NOS after showing mild symptoms of autism. It may turn out after observation periods that the child is truly categorized within a level one or two. It might turn out that the child does not even have autism at all.
The autism experts at Applied Behavioral Analysis Programs state the following:
Usually a person is diagnosed with Pervasive Developmental Disorder if they exhibit social and communication challenges, but simply do not exhibit other symptoms of Aspergers, like obsessions over certain topics, developmental delays, or awkward mannerisms. People with Pervasive Developmental Disorder typically live mostly ordinary lives and are considered the highest-functioning of all autism subtypes, but can have issues relating to people, language skills, accepting change in surroundings or routines, and dealing with their own emotions.
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Level 2 Asd: Requiring Substantial Support
Level 2 ASD is the middle-range of autism in terms of severity of symptoms and needs for supports.
People who qualify as having Level 2 ASD need more support than people with Level 1 ASD. They have more difficulty with social skills. Their challenges in social situations may be more noticeable to other people around them as compared to those with Level 1 ASD.
People with Level 2 ASD may or may not communicate verbally. If they do, their conversations may be very short or only on specific topics or they may need extensive support in order to participate in social activities.
The nonverbal behavior of people with Level 2 ASD may be more atypical from the majority of their peers. They may not look at someone who is talking to them. They may not make much eye contact. They may not express emotions through tone of voice or through facial expressions in the same way that most other people do.
People with Level 2 ASD struggle more than those with Level 1 ASD regarding their restrictive or repetitive behaviors. They may have routines or habits that they feel they must do and, if these get interrupted, they become very uncomfortable or upset.
Know That Medical Issues Can Be Involved
I wish I had known about the invisible medical issues of autism right from the start. For years, I had no idea that gastrointestinal dysfunction, including constipation, acid reflux, inflammation and pain, could dramatically affect my sons sleep patterns, mood, irritability, aggression, attention, and even communication. Our son had to power through those problems all by himself on a daily basis, and it breaks my heart that we never suspected the cause of many of his struggles.
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Impairment In Social Skills
Someone with severe autism has extreme difficulty interacting with other people. The child or adult might completely exclude interacting with others and prefer to be alone. The individual may not be aware of what others are saying or doing, and it may take significant effort to gain his or her attention.
Challenges For Individuals With Level 1 Autism
Some of the biggest challenges for individuals with level 1 autism is the expectation that they be the same as everyone else. While those with a level 2 or 3 diagnosis may receive accommodations, individuals with level 1 autism are often expected to conform to social norms. Many assume that because they may be intelligent and able to communicate, that they dont have the same challenges as others on the spectrum.
People with level 1 autism may be very aware of their own difficulties and the negative reactions of others. Yet they are unable to control the fact that they have sensory issues, lack social awareness or experience anxiety and depression. Like others on the spectrum they may experience difficulty with transitions or change, and may struggle to maintain effective social communication.
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B Restricted Repetitive Patterns Of Behaviour Interests Or Activities
B1. Stereotyped or repetitive motor movements, use of objects, or speech
These characteristics are usually associated with severe autism, that is ASD Levels 2 and 3 and are not usually observed in those who have ASD Level 1 or Aspergers syndrome.
B2. Insistence on sameness, inflexible adherence to routines or ritualized patterns of behaviour
Parents are often concerned that routines and rituals are imposed in daily life, with the person who has Aspergers syndrome showing great agitation if prevented from imposing and completing a routine or ritual. Variety is not the spice of life for someone who has Aspergers syndrome. There is a determination to maintain consistency in daily events, and high levels of anxiety if routines are changed. From my clinical experience, the imposition of routines and rituals may actually be a mechanism for coping with high levels of anxiety, as they are soothing and relaxing. Specific events have may been associated with, or perhaps have led to, anxiety and are to be actively avoided, hence the tendency to insist on sameness.
B3. Highly restricted, fixated interests that are abnormal in intensity or focus
B4. Hyper- or hypo- reactivity to sensory input
What Are The Different Types Of Autism
Prior to the 2013 transition, the levels of autism were explained using terminology that classified people with autism into different phenotypes, or groupings of symptoms, of the disorder, rather than the severity. This caused some misunderstandings and confusion surrounding autism spectrum disorder as it was generally non-specific and open to interpretation. You may have heard of some of the specific terms previously used for autism, which included:
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What Are The Levels Of Autism
Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.
Language note: Although individual preferences exist, surveys of the autistic community consistently show that autistic people prefer identity-first language rather than person-first language . This article reflects that community language preference.
Autism Spectrum Disorder Level : Requiring Support
According to the DSM-5, individuals on level 1 autism require support. They can live by themselves and maintain a high quality of life with little support. Usually, this support is taken in the form of behavioral therapy or other types of therapy, depends on the individuals need. Both of these approaches can help improve social skills and communication skills. Also, behavioral therapy can help develop positive behaviors of individuals that might not come naturally.
Theory of Mind is one of the most effective ways in order to treat level 1 autism. Both ToM and adaptive skill-based treatments target executive function, emotional regulation, cognitive flexibility, social communication skills and reduction in anxiety. These aspects are very important in the field of level 1 treatment.
Individuals with level 1 autism have noticeable impairments, communication problems and problems in socializing. They can have a conversation, however, it might be difficult to maintain a back-and-forth conversation. Some of them at this level might find it hard to reach out and make new friends.
At this level, individuals may show decreased interest in social interactions or activities. They might have difficulties initiating social interactions and communications, such as talking to a person. They are able to engage with a person but they may struggle to maintain a give-and-take of a typical conversation. Some of them who attempt to make friends are seen as odd and typically unsuccessful.
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What Are The Three Levels Of Autism
Levels of autism spectrum disorder are defined in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition . The 5th edition criteria for autism diagnosis provides three clear levels based on the patients requirements for support. These levels of autism allow specialists to make more refined diagnoses, allowing for more effective treatment plans and helping caretakers better understand individuals symptoms and needs.
Level : Requires Very Substantial Support
Level 3 is the most severe form of autism. Children in this category will have many of the same behaviors as those with levels 1 and 2, but to a more extreme degree.
Problems expressing themselves both verbally and nonverbally can make it very hard to function, interact socially, and deal with a change in focus or location. Engaging in repetitive behaviors is another symptom of level 3 ASD.
A person with ASD level 3 will have a very limited ability to speak clearly and will rarely start interactions with other people. When they do, they will do so awkwardly. Someone with level 3 will also respond only to very direct social approaches from other people.
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Difficulty With Verbal Communication
A child with HFA will typically have no problems understanding language. Learning individual words, grammar rules, and vocabulary may not be an issue for them.
The use of language to communicate, however, can be problematic. Someone with HFA may have difficulty understanding sarcasm, metaphors, or idioms. This is known as “pragmatic” language.
In addition, some people with HFA may struggle to speak when under stress or overwhelmed.
Why This Terminology Is No Longer Used By Doctors
The spectrum illustrates a broad range of developmental delays and symptom severity.
ASD includes people who have a few mild autistic traits to those who need help with day-to-day functioning. It represents every intelligence level, as well as varying degrees of communication and social abilities.
The differences between one type and another type can be subtle and difficult to determine.
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How To Be Openly Autistic
This article was written by Luna Rose. Luna Rose is an autistic community member who specializes in writing and autism. She holds a degree in Informatics and has spoken at college events to improve understanding about disabilities. Luna Rose leads wikiHows Autism Project.There are 16 references cited in this article, which can be found at the bottom of the page. This article has been viewed 27,786 times.
Being publicly open about being autistic can be a big decision. Youre choosing to be authentic, to embrace yourself even if others disapprove, and show by example that it is possible to be happy and autistic at the same time.
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