Theme : Stigmatized Experiences
Negative labelling by schools
Six participants reported that they experienced stigma at school as their children with ASD were perceived and labelled as having low learning abilities. Some parents expressed that their children with ASD were even asked to leave their school because most teachers were not knowledgeable enough to teach children with ASD. In addition, the schools reiterated that teachers teaching children with special needs should be kind and patient, which are not qualities shared by all teachers. Some participants were told to provide additional support such as hiring a shadow teacher to assist their childrens learning if they continued to study at schools.
The school has started to find some reasons to reject us. There were a few signs at the end of the second semester. My wife is the main contact. In fact,… I felt that the school wanted us to withdraw from school . The school said something like this: “If you want to attend class, we had many similar cases… Maybe you can find a shadow teacher to sit next to him. But you need to understand that the cost is high.” The school told us many things like this. .
I must explain to the school clearly. My son has autism… He is now studying in a school for people with mild intellectual disability. Do you mind teaching him? Nine out of ten schools said no. Its very difficult to find a teacher who is kind and patient. They may charge us more money for teaching him. Difficult! .
Peer rejection and bullying
Social Communication And Interaction Skills
Social communication and interaction skills can be challenging for people with ASD.
Examples of social communication and social interaction characteristics related to ASD can include
- Avoids or does not keep eye contact
- Does not respond to name by 9 months of age
- Does not show facial expressions like happy, sad, angry, and surprised by 9 months of age
- Does not play simple interactive games like pat-a-cake by 12 months of age
- Uses few or no gestures by 12 months of age
- Does not share interests with others by 15 months of age
- Does not point to show you something interesting by 18 months of age
- Does not notice when others are hurt or upset by 24 months of age
- Does not notice other children and join them in play by 36 months of age
- Does not pretend to be something else, like a teacher or superhero, during play by 48 months of age
- Does not sing, dance, or act for you by 60 months of age
The 3 Levels Of Autism Explained
Autism is a diagnosis that often carries a certain connotation. Those who are unfamiliar with the nuances of autism spectrum disorder may assume that all children on the spectrum participate in repetitive behaviors, dont make eye contact, and are largely non-verbal. While these signs can certainly be present, there are many children who fall within the spectrum whose symptoms are far milder and even those whose symptoms are more severe. Its a wide and diverse range of possible complications, and despite what some may think, children within the spectrum do not all fall into neat little categories. For that reason, the classifications of ASD have changed significantly over the years.
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Level 1 Autism: Requiring Support
Autism Spectrum Disorder Level 1 is commonly known as high-functioning and often was referred to as Aspergers in the past. It is therefore considered to be the mildest form of Autism. Adolescents often have challenges with communication and social skills learning within this level. They may miss social cues or struggle with back-and-forth conversation. It is common for adolescents to struggle with friendships at this level. Organizing and planning may be difficult or task initiation. A unique thing to understand about this group is that they often are diagnosed later in life as their milder symptoms are not as noticeable or obviously problematic. Additionally, they typically have enough social awareness to realize they are missing social dynamics, and do typically want friendships. However, while they miss some social cues and interactions they often are aware they are different and not always staying up with their peers. This becomes more prominent in adolescence and leads to anxiety and depression, distress and frustration, and can lead to school avoidance and anger outbursts.As noted by the DSM 5 and other research the struggle can be seen in initiating, continuing, and properly ending social engagement. There is also difficulty understanding appropriate boundaries of what to share or not share, reading and providing nonverbal social cues, and properly evaluating the nuance of communication .
Challenges Of Identifying High
High-functioning individuals with ASD pose particular challengesâboth for identification and for determining eligibility for services. These individuals often have either verbal or nonverbal intelligence within or above the average range and appear to succeed in some or most academic subjects, particularly in early school years. As a result, many are not diagnosed until later school age, adolescence, or even adulthood.
Long-term outcomes for these individuals show that challenges with social engagement and social communication can significantly affect their ability to adjust to social demands in later academic and community settings and in the workplace . These findings suggest the importance of providing intervention to address the gap between cognitive potential and social adaptive functioning.
School-age Children
Determining eligibility for educational services requires using a variety of strategies for gathering information, including
- standardized measures of social adaptive functioning,
- naturalistic observation across a range of settings, and
- caregiver/teacher interviews or questionnaires.
Regardless of the assessment measures or tools used, the clinician needs to be aware of any subtle signs and symptoms consistent with a diagnosis of ASD.
Adult Diagnosis
For a comprehensive discussion of individuals with ASD as they transition into and through adulthood, see IACC, 2017.
Consistent with the WHO framework, treatment is designed to
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Understanding Challenges Of Moderate To Severe Autism
Children with moderate to severe autism face similar yet different challenges.
Understand what type of autism your child has as you create a plan that nurtures and equips your loved one to reach his or her full potential and live a life of safety, comfort, and dignity.
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Ways Low Functioning Autism Differs From High
No two children with ASD will experience the same symptoms. Rather, doctors place children on a spectrum according to severity.
Aspergers syndrome is now considered related to by distinct from autism. Children with Aspergers syndrome are the highest functioning on the spectrum. Children with limited communication skills and behavioral regulation have low functioning autism.
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What Are The Levels Of Asd
ASD is divided into three levels:
- Level 1. People at this level may have symptoms that dont interfere too much with their work, school, or relationships. This is what most people are referring to when they use the terms high-functioning autism or Aspergers syndrome.
- Level 2. People at this level require some outside support on a daily basis. Examples of outside support include speech therapy and social skills training.
- Level 3. People at this level require substantial outside support on a daily basis. In some cases, support may include full-time aides or intensive therapy.
Is Aspergers A Type Of Autism
Aspergers syndrome was initially considered different from autism spectrum disorder. However, in 2013 the DSM-5 categorized Aspergers and all additional types of autism under autism spectrum disorders. All Aspergers symptoms currently fall under ASD.
Autism and Aspergers syndrome are no longer considered different diagnoses. A previous Aspergers diagnosis is now regarded as autistic.
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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.
Level 2 Requires Substantial Support
Individuals who have level 2 ASD will have more obvious issues with verbal and interpersonal communication. They also find it hard to change tasks or move on from one thing to the next.
Children diagnosed with level 2 usually perform repetitive behaviors that can cause problems with functioning in certain situations. Sometimes they pace back and forth or repeat words or phrases over and over again.
Often, those who are in the level 2 range speak in short, simple sentences and struggle with nonverbal communication.
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How Are Levels Of Autism Diagnosed
The DSM-5 outlines the three functional levels of autism. It provides guidelines that providers use to determine how much support a person with ASD needs.
Autistic people who need the least amount of support to function in their daily lives receive a level 1 diagnosis.
Support needed for a person with level 1 autism might include:
- Building self-control
- Understanding non-verbal communication
- Reducing anxiety
How much support people with mild autism need depends on many factors and varies from person to person.
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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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The Autism Diagnosis Process
Now, you are probably wondering: but how do I know that these unique symptoms are autism? To be diagnosed with autism , the Interagency Autism Coordinating Committee explains that there have to be a couple of certain symptoms across multiple contexts of social interaction and communication.
These contexts include:
- Is it difficult for them to hold a back-and-forth conversation?
- Are their responses to social situations unnatural?
- Have they spoken few or no words by age two?
- Are they using words strangely or in an unnaturally flat voice?
- Are they not responding to their name even though their hearing is fine?
- Deficits in nonverbal communication.
- Is their body language abnormal?
- Is eye contact a challenge?
- Do you see them commonly rocking or flapping as a way to calm themselves?
- Do you notice an abnormal over or under-sensitivity to sensations?
- Deficits in developing and maintaining relationships.
- Are they having a hard time making friends?
- Is imaginative play a stretch when playing with other children difficult?
- Do they tend to line up toys instead of playing with them?
- Do changes to a game overly upset them?
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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Pervasive Developmental Disorder Not Otherwise Specified
Pervasive Developmental Disorder Not Otherwise Specified is a mild type of autism that presents a range of symptoms. The most common symptoms are challenges in social and language development.
Your child may experience delays in language development, walking, and other motor skills. You can identify this type of autism by observing the child and noting what area the child displays a deficit in, such as interacting with others. PDD-NOS is sometimes referred to as subthreshold autism, as it is a term used to describe an individual that has some but not all symptoms of autism.
Behavior For Moderate To Severe Autism
Communication and intellectual challenges cause children with moderate autism to exhibit many unusual behaviors. They may flap their arms, rock, hit, bite, scratch, or become obsessed with an object when theyre bored, upset, happy, frustrated, overwhelmed, or unable to share their thoughts or feelings.
While these and other behaviors are a way of communicating, they can be scary and dangerous to family members, onlookers, and the child. Certain behaviors will remain quirks for life, but therapy, communication strategies, and other tools can help children learn to cope and communicate better so they remain safe.
The behaviors of children with severe autism are similar to those exhibited by children with moderate autism to a greater degree. Typically difficult to manage, these behaviors can include a variety of self-soothing, stimulating, or communicative behaviors like rocking, flapping and jumping as well as aggression toward others and self-abuse.
Beneficial therapy can help children with severe autism cope and communicate, but they may continue to exhibit these behaviors on some level throughout their lives.
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How Often Asd Occurs
CDCs Autism and Developmental Disabilities Monitoring Network has been estimating the number of 8-year-old children with ASD in the United States since 2000.
ASD occurs in all racial, ethnic, and socioeconomic groups. It is more than 4 times more common among boys than among girls.
Levels Of Autism: Common Symptoms Per Level
The different levels of autism categorize the severity of social skills and behaviors of children with autism. According to the Diagnostic and Statistical Manual of Mental Disorders , autism is categorized by doctors as level 1, 2, or 3 according to the two areas of functioning â social communication and restricted, repetitive behaviors.
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In 2013 Doctors Stopped Diagnosing 4 Different Types Of Autism
Until 2013, there had been four separate diagnoses within the category of autism: autistic disorder, Asperger’s syndrome, childhood disintegrative disorder, and pervasive developmental disorder . The change was made because these distinct diagnoses were not always made consistently and may have limited treatment options for some individuals on the spectrum.
The American Psychiatric Associations revision to the Diagnostic and Statistical Manual of Mental Disorders , published in May 2013, did not include four subtypes of autism. According to the DSM-5, anyone on the autism spectrum should be diagnosed simply with autism spectrum disorder. The revised diagnosis represents a new, more accurate, and medically and scientifically useful way of diagnosing individuals with autism-related disorders, the APA noted in a statement released with the DSM-5 revision.
The change was made in part because these diagnoses were not consistently applied across the board, according to the APA. Doctors approached each of these diagnoses differently. Rolling the diagnoses into a single category offered a more cohesive approach to treating autism.
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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