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.).

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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?

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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

Broad Autism Phenotype (BAP)

Greetings Earthlings! 🙂

Today we’re going to discuss a type of autism that lies just outside the spectrum- the broad or broader autism phenotype (BAP).

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What on earth is that when it’s at home?!

BAP is a term used to describe a wider range of individuals just beyond the spectrum who have difficulties with language, personality, and exhibit a number of social and behavioural traits at a higher level than the average neurotypical, but not so high as to be diagnosed with autism.

In other words, this means that you have “a touch of autism” or “not quite autism (NQA)”. The individual has a high number of mild traits, but not enough to interfere with daily life.

So what do we know about BAP?

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Relatively little- it doesn’t even have a Wikipedia page!

This intermediate description is most commonly associated with family members (parents, siblings, and other extended family members) of those with ASD diagnoses (14–23%), but it can also be found in the general population as well (5–9%).

Interestingly, evidence of an intermediate autism phenotype has existed since the late 1970’s (the term itself was coined in 1994), but it is only in recent years, with the expansion of the spectrum, that it has become a source of research interest for scientists seeking to understand the range of ASD’s that lie beneath the spectrum rainbow.

Broader autism phenotype

Much of the research in this area involves using the BAP to better understand autism- in particular it’s severity and genetics. By analyzing autism traits in families through the prism of BAP for example, researchers may be better able to identify the specific genes which underpin ASDs, paving the way for better therapies for autists.

Apologies for the shortness of this post dear Earthlings, but there is sadly very little information out there about BAP. Perhaps in the future there may be new research that will shed greater light on this subject 🙂

Have a good weekend everyone! 🙂

Aoife

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