Autism Spectrum Disorder and Autism are often used interchangeably to mean the same thing. In reality, these terms mean something different, and it's important to understand the distinction. Read mor
Autism spectrum disorder (ASD) refers to the varied and wide-ranging levels of autism that exist. Individuals with autism can present symptoms ranging from mild to severe and display a wide variety of characteristics. Autism can look very different from person to person. That’s why it’s referred to as a spectrum.
Autism is a spectrum disorder because of the wide variety of characteristics that each individual with autism can display. Often, it is referred to as low-functioning or high-functioning autism during conversations between educators and parents or others who work closely with children who have autism. But that’s a brief and inadequate description because each child with ASD has unique characteristics that puts them in a different place on the spectrum.
The range of abilities on the spectrum is like a rainbow, with the lower-functioning characteristics of autism on one end of the rainbow and the higher-functioning characteristics of autism on the other end. In between are all of the variables of autism, from low to high, with some abilities on the higher end of the spectrum and others on the lower end. Autism does not present consistently from one child to another — rather, common traits that qualify them as on the spectrum.
Are there different levels of autism?
With such a wide range of characteristics that fall under the umbrella of autism spectrum disorder, you might wonder how many kinds of autism there are and how they are categorized.
Autism has been defined into five different types:
Childhood Disintegrative Disorder
Childhood Disintegrative Disorder is a rare neurological disorder that affects children who have normal development for the first three to four years and then suffer a reversal in language, motor, and social skills within a matter of months.
Classic Autism
Classic autism is a neurological impairment that affects social interaction, communication, and speech. It restricts imagination and sometimes causes repetitive motor behavior patterns and rigid inflexibility that makes any changes in routine or environment very difficult for a person with autism.
Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS)
A child that is diagnosed with PDD has a developmental delay, and usually shows many traits of higher functioning/moderate autism but doesn’t meet all the criteria for autism. Many children who are diagnosed with PDDs outgrow the symptoms with time.
Aspergers (Level 1)
Asperger’s is considered low-spectrum autism. In 2013, Asperger’s Syndrome was removed from the Diagnostic and Statistical Manual, 5th Edition (DSM-5 is a diagnostic tool used by doctors) and placed under the umbrella of autism spectrum disorders. Some “aspies” were unhappy about that — they enjoyed being grouped with a long list of brilliant minds who were suspected of having Asperger’s. From Hans Christian Andersen to Jerry Seinfeld to Wolfgang Amadeus Mozart to Tim Burton — the list is impressive, and so are many of the accomplishments of those with Asperger’s.
Rhett Syndrome
A neurological disorder with severe physical impairments, Rett Syndrome is primarily found in girls. As research progressed, it was discovered to be a genetic mutation that can look very similar to autism for a short time when a child is developing. In 2011, Rett Syndrome was removed from the Diagnostic and Statistical Manual, 5th Edition (DSM-5 is a diagnostic tool used by physicians) and it is no longer considered an autism spectrum disorder.
The Controversy with Rhett and Aspergers
Both Rett and Aspergers are controversial because they are considered autism spectrum disorders but they both stand alone on their own. Rett has been removed because the autism symptoms only appear for a small window of time, and it is almost exclusive to girls. Asperger’s has been merged into the spectrum rather than standing apart as its own diagnosis — mostly because it was felt that “aspies” should be included in ABA services and be eligible to receive insurance coverage — so it was necessary to put them under the ASD umbrella. The DSM has evolved from listing 5 types to 3 levels to include Rett's and Asperger’s as spectrum disorders.
Levels of Autism
According to the DSM-5, there are 3 levels of autism with corresponding levels of required support.
Level 1 - (Requiring Support)
As mentioned above, this is the level that someone with high-functioning autism or Asperger’s would fit into. Level 1 autism requires the least amount of support. Socially, they might find it difficult to initiate a conversation, maintain a conversation, or stay interested in what the other person is saying and may not respond as others would expect. They might find it difficult to manage in new situations or environments. Someone in this category may struggle with time management, organization skills, and planning. It’s also common for a person with low-spectrum autism to have rigid or inflexible habits, schedules, or behavior patterns.
Level 2 - (Requiring Substantial Support)
Someone with moderate autism would have a harder time with communication than someone who is considered to be on level 1. This person may only be able to communicate with short sentences, limited topics, incoherent speech, odd facial expressions, and sometimes inappropriate responses and gestures. People with level 2 autism are more visibly distressed in social situations and have a much more difficult time with change. They find daily life difficult to cope with, and the prospect of living and working independently without support is unlikely for them. However, some do very well in transitional programs with mentors and living in adult assisted living while working a part-time job.
Level 3 - (Requiring very substantial support)
People with level 3 autism are extremely limited in verbal and nonverbal communication. Because of their inability to communicate, they can’t interact with other people, establish friendships, or join peers in activities. These people are usually highly focused on their own behaviors, which are almost always repetitive — hand flapping, waving, clapping, flailing, rocking, spinning, or flipping objects — to the point where they cannot focus on anything else. If anyone tries to shift their attention, it distresses them. People with level 3 autism do not like change in their routine, food, activities, or people they are exposed to. Any sort of change causes distress. It is unlikely for a person with level 3 autism to become independent, communicate fluently, or mitigate the repetitive behaviors that characterize individuals on the high end of the spectrum.
Mild to Severe Forms of Autism
Terms like low-spectrum autism, mild autism, or high-functioning autism usually refer to level 1 autism which requires some support with communication, social skills, and behavior. As the levels progress, the necessity for support increases. People with level 2 autism might need more support in learning effective communication skills and how to behave in certain social settings. People with level 3 autism usually depend on a substantial amount of support, and this support would most likely extend throughout their lifetime.
That is precisely why it is called a spectrum disorder. By definition, a spectrum classifies something (or suggests that it can be classified) in terms of its position on a scale between two points. The two extreme opposite points of the autism spectrum are mild and severe. Everything between those two points is open to variations in the characteristics or deficits that you may see in a person with autism.
Does Autism Run in Families?
We have learned a lot about autism since it was first diagnosed in the 1940s by Dr. Kanner. There is still a lot we don’t know but one thing that seems to be true about autism is that it does have some genetic tendency to run in families. To put it very simply without summarizing entire studies, the average risk of a subsequent child being born after one child with ASD has been born into a family is 10% based on group averages. This is a very loose number, but the point is that it has been well-established that the tendency is there.
It is not unusual for therapists who work in the field to serve families who have more than one sibling who has been diagnosed with ASD.
Conclusion
As autism research continues, sometimes we see changes that can seem a little confusing. Are there 5 autistic types or are there 3 types of autism? To put it simply, the three levels of autism include all the disorders that were mentioned in the five types. By placing Aspergers and Rett Syndrome under the umbrella of spectrum disorders, it is easier for families to receive referrals for applied behavior analysis (ABA) services. If these disorders were not categorized as autism spectrum disorders, chances are that these children would not receive essential support services.
There are 3 levels of autism, but the many specifics of autism and varieties of characteristics differ from one child to the next and from one end of the spectrum to the other. The answer to this question may change as research continues and we continue to learn more about our loved ones on the spectrum.
If you think your child might have one of these diagnoses, the best thing to do is contact your pediatrician or find a provider who can give you a proper diagnosis.
Read the Studies:
https://medlineplus.gov/genetics/condition/autism-spectrum-disorder/#inheritance
https://www.biologicalpsychiatryjournal.com/article/S0006-3223(20)31384-6/fulltext
https://my.clevelandclinic.org/health/articles/autism
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