Levels of Autism

Greetings Earthlings! 🙂

Leading on from my previous posts about the different forms of autism (lesser known ASDs; Asperger’s Syndrome (AS); Broad Autism Phenotype (BAP) etc.), I’d like to talk about some changes in the classification of autism that have taken place since the introduction of the all encompassing ASD in 2013.

To recap- an autistic spectrum disorder (ASD) is an umbrella term to describe a range of neurodevelopmental disorders (such as AS, classic autism, PDD-NOS etc.).

spectrum

In 2013, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders or DSM-5 as it is more commonly known, changed the previous diagnostic criteria to effectively subsume all previous separate diagnoses under the one term- ASD. As such, these separate diagnoses no longer exist in the eyes of psychologists.

However, in using the umbrella term without these separate diagnoses, it is difficult to determine levels of functionality among autists.

So how do we break it down?

stone

Autism is now classified using 3 different levels:

  • Level 1 Autism: Requiring Support- These autists have noticeable issues with socializing and communication skills. This level is characterized by:
    • decreased interest in social interactions or activities
    • capable of social engagement but may struggle with conversational give-and-take
    • difficulty with planning and organizing
    • struggles with initiating social interactions, such as talking to a person
    • obvious signs of communication difficulty
    • trouble adapting to changes in routine or behavior
  • Level 2 Autism: Requiring Substantial Support- Symptoms for these autists are similar to level 1, but more severe as they often lack both verbal and nonverbal communication skills which can make daily activities difficult. These autists may also exhibit a number of behavioural problems
  • Level 3 Autism: Requiring Very Substantial Support- This level is where you will find the most severe cases of autism. These autists experience extreme difficulties with communication and also exhibit more signs of restrictive and repetitive behaviours than may be observed in the other levels.

The behaviours at each level can be broken down a little further than this, but these are the nuts and bolts of how autism is classified under this system.

Until recently, these updates have mainly applied to the American classification system, however in the last few weeks the global updated version of the “International Classification of Diseases” (ICD-11) now mirrors it’s US counterpart, dissolving all separate diagnoses of autism in favour of the all encompassing ASD.

So how do I feel about the dissolution of my own diagnosis?

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In many ways, this new classification system is a good thing as it will greatly benefit autists who experience greater challenges. It also allows clinicians more flexibility in that the clinician determines if a patient is on the spectrum using their best judgement rather than the patient fitting a specific combination of traits/reaching a set number of traits, which may benefit borderline/masking autists who are highly functioning enough to pass just under the diagnostic radar.

However, I am concerned for higher functioning autists. I would classify as Autism 1 under the new system, however, whilst I fit some of the bill for this level in my childhood, it does not describe me as well as my original diagnosis. In fact instead of benefiting an aspie, to my mind, it could in fact disable them further as the very word ‘autism’ infers a greater level of need than Asperger’s Syndrome.

Yes AS is a form of autism, but it is worlds apart from many of the lower functioning forms. If an employer for example were to hear the word’s ‘autism level 1’ or ‘high functioning autism’ rather than Asperger’s, this could have a serious disabling effect in their perception of the autist before them. Indeed, in recent years we have become a more inclusive society and are better educated about the spectrum, but for many the ‘A word’ still rings trouble.

On the other hand, the vagueness as to what classifies as support is concerning for autists at each level. Sure, this generalized approach widens the spectrum net, but we also cannot ignore the finer details and traits that ultimately determine the needs of the autist- every case is unique after all.

Hope you enjoyed this post dear Earthlings- enjoy the weekend! 😀

Aoife

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