Each individual with autism spectrum disorder is unique. Every individual on the autism spectrum receives the same diagnosis: autism spectrum disorder (ASD). But autism is a spectrum disorder, meaning that a person can have mildly, moderately, or severe autism.
The level of disability and combination of symptoms can vary dramatically on the autism spectrum which makes it essential for every individual with autism to get a proper diagnosis and the treatment they need. What’s more, while everyone with autism has certain core symptoms, many people also have additional associated symptoms such as intellectual or language impairments.
The idea of breaking down autism spectrum disorder into three distinct levels is relatively new. While the levels categorize people with autism by how much support they need, there are not any guidelines for what that support should look like. Individuals get different levels of autism spectrum disorder diagnosis depending on the support they need.
By providing an autism spectrum diagnosis with a functional level, at least in theory, it should be possible to draw a clear picture of an individual’s abilities and needs.
There are three different levels of autism, which range from mild to severe. According to the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5), professionals s categorize autism spectrum disorder by assigning levels 1, 2, or 3 to two of the domains of symptoms. One severity score is for impairment in social function, while a second severity score is for restrictive, repetitive behaviors.
To help professionals better describe individual cases of autism, the creators of DSM-5 developed three levels of support. They are expected to diagnose people with autism at level 1, level 2, or level 3. These levels reflect individuals’ ability to communicate, adapt to new situations, expand beyond restricted interests, and manage daily life. People at level 1 need relatively little support, while people at level 3 need a great deal of support.
While the idea of autism levels of support makes logical sense, it is not always easy for professionals to assign a level. What’s more, the assignment of levels can be somewhat subjective. It is also very possible for an individual to change levels over time as their skills improve and other issues decrease.
Level 1 Autism: Requiring Support (Formerly Known as Asperger’s Syndrome)
While still in use, the term Asperger’s Syndrome does not appear in the most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM; American Psychiatric Association, 2013), and is now subsumed under the broad category of Autism Spectrum Disorder. Those diagnosed in the past with Asperger’s would now be identified as having Level 1 autism means requiring minimal supports.
Level 1 is the least severe autism spectrum disorder diagnosis. This is the mildest level. People at this level generally have mild symptoms that don’t interfere too much with work, school, or relationships. This is what most people are referring to when they use the terms high-functioning autism or Asperger’s syndrome.
People with level 1 autism have noticeable issues with communication skills and socializing with others. They can usually have a conversation, but it might be difficult to maintain a back-and-forth banter. Others at this level might find it hard to reach out and make new friends.
They can find it difficult to initiate conversations with other people and they may respond inappropriately or lose interest quickly. As a result, it can be challenging for them to make friends, especially without the right support. They may also show inflexible behaviors. It can be difficult for them to cope with changing situations or contexts, such as new environments. They may need help with organization and planning.
They are usually highly articulate, in speech and in writing. They tend to be attentive to detail, with strengths in rote memory and a systematic, logical approach to problem-solving. They may have intense interests around a general theme with more specific, related interests having varied since childhood, which can be highly motivating if they are in a related program. They are also likely to be straightforward, loyal and honest.
Individuals with autism may experience excessive anxiety associated with everyday events. Many are hypersensitive to environmental stimuli, such as noise, harsh lighting, and crowds. They may exhibit rigid, inflexible, rule-bound behavior. They can experience profound anxiety in response to unfamiliar settings, unclear expectations, and (seemingly minor) changes. Other observed areas of difficulty include time management and organization, concentration, fine motor skills, and processing speed.
According to the DSM-5, people who receive a diagnosis of level 1 autism require support. Those individuals often maintain a high quality of life with little support. This support usually comes in the form of behavioral therapy or other types of therapy. Both of these approaches can help improve social and communication skills. Behavioral therapy can also help develop positive behaviors that might not come naturally.
Individuals with level 1 autism, without proper support, will display noticeable impairments in social communication. Common behaviors in individuals with level 1 autism include inflexibility in behavior and thought; difficulty switching between activities; and problems with executive functioning which hinder independence.
Symptoms of Level 1 Autism
- They have decreased interest in social interactions or activities
- They have difficulties initiating social interactions, such as talking to a person, clear examples of atypical or unsuccessful responses to social overtures of others.
- They have an ability to engage with a person in full sentences and engages in communication but may struggle to maintain a give-and-take of a typical conversation
- They show inflexibility of behavior which causes significant interference with functioning in one or more contexts.
- They show obvious signs of communication difficulty
- They are trouble adapting to changes in routine or behavior
- They have difficulties in planning and organizing
Individuals with level 1 autism, without proper support, will display noticeable impairments in social communication. Common behaviors in individuals with level 1 autism include:
- Inflexibility in behavior and thought
- Difficulty switching between activities
- Problems with executive functioning which hinder independence
- Atypical response to others in social situations
- Difficulty initiating social interactions and maintaining reciprocity in social interaction
Theory of Mind in Specialized Treatment Programs for Level 1 Autism
Utilizing the theory of mind is one of the most effective ways in order to treat level 1 autism. Theory of Mind and adaptive skills-based treatment that targets executive function, emotional regulation, cognitive flexibility, social communication skills, and anxiety reduction. These are all critical aspects in the field of Level 1 treatment, particularly in specialized treatment programs.
Theory of Mind is the ability to accurately predict or attune to the thoughts, intentions, feelings, and perspective of another person. Individuals with autism have delays in this particular development. As a toddler, a normally developed child will transition into a phase of cooperative play in which theory of mind begins to develop.
Ideally, the child begins to be aware of the needs and feelings of those around them. When the theory of mind does not develop, early adolescence is marked with delays in social maturation, social/emotional problem solving, and cognitive flexibility all of which play a crucial part in the adaptive function.
Enrolling a teen in a specialized program that both understands and executes the Theory of Mind can help these individuals with autism spectrum disorder become more aware of other perspectives in addition to learning social skills and adaptability.
Wilderness Adventure Therapy as Treatment for Level 1 Autism
For teens with level 1 autism, a credible wilderness adventure therapy program, such as Vantage Point by Aspiro can be a highly effective treatment option in helping these individuals improve their social skills, establish healthier patterns, and learn how to make smooth transitions.
Short-term wilderness adventure therapy programs such as Vantage Point should be considered as an intervention, foundation, and starting point for level 1 autism treatment. When students first begin treatment in a specialized program like Vantage Point, they participate in a variety of adventure activities, service, and community involvement. This helps lay the foundation for them to establish a connection with the people and the world around them. This is especially effective in a short-term specialized treatment program because of the novel and new environment.
Specialized Residential Programs as Treatment for Level 1 Autism
Teens with level 1 autism, a smaller residential program such as Daniel’s Academy or Black Mountain Academy can be a highly effective treatment option in helping these individuals improve their social skills, establish healthier patterns, and learn how to make smooth transitions.
Long-term programs such as Daniel’s Academy and Black Mountain Academy provide students with ongoing reinforcement, application, and long-term efforts to solidify new skills. A long-term residential program is able to teach teens with autism spectrum disorder these skills on a long-term basis through project-based learning systems as a way to collaboratively solve problems that have real-world applications.
High Functioning Autism and Level 1 Autism
With the release of DSM-5, instead of separate diagnoses, there is just one big group of people diagnosed with autism spectrum disorder (ASD). But, people on the autism spectrum are still very different from one another. So, in order to clarify these differences, the DSM-5 also includes functional levels. People who are bright and verbal are generally given the diagnosis of level 1 ASD.
Still, the distinction does not offer a clear characterization of what level 1 autism actually is. For example:
- People with level 1 autism can show affection, complete daily tasks, and use age-appropriate language, reading, and math skills. On the other hand, they can’t hold eye contact, maintain a conversation, engage in play, or pick up on social cues.
- People with level 1 autism can have significant speech and language delays but they are able to take part in an inclusive academic program because of their age-appropriate academic skills.
- People with level 1 autism can have relatively mild speech and social delays but they have severe sensory issues which make it impossible for them to take part in an inclusive academic program.
- People with level 1 autism can have severe anxiety, learning disabilities, and sensory challenges but they have age-appropriate speech and exceptional abilities in music, math, and engineering.
With a level 1 autism diagnosis, the possible combinations of strengths and challenges are almost endless. This not only makes the characterization of behaviors difficult but also can leave you confused as to what level of skilled support is needed.
An Educator’s Guide to ASD (Level 1 Supports)
The guide contains information that will help teachers in the general education classroom and others to:
- Become familiar with autism spectrum disorder and how it affects a child
- Identify evidence-based academic and environmental strategies in order to promote classroom success
- Foster successful peer relations and social interactions
- Effectively communicate and collaborate with parents during the individual education program process
The new autism educational resource combines relevant content from the current guide with new information, such as:
- Description of changes in diagnostic terminology and culturally accepted terms
- Legislative history
- Behavior-based strategies, visual supports, and assistive technology
- Evidence-based academic and environmental strategies
- Strategies and planning related to transitioning to adulthood
How are the Levels of Autism Diagnosed?
There is no specific blood test, imaging test, or scan that can diagnose autism spectrum disorder. Instead, a professional will take into account many factors. These factors include behavioral symptoms, communication issues, and family history in order to help rule out any potential genetic conditions.
Next, they will ask a variety of questions about an individual’s daily habits and aspects of their social life. They may refer to that person for psychological testing. Diagnosis is based on the level with which the symptoms are most consistent.
You should keep in mind that levels of autism spectrum disorder are not black and white. Everyone on the spectrum may not clearly fit into one level. But they can provide a useful baseline to help doctors come up with an effective management plan and set achievable goals.
If you think that you or your child may have autism spectrum disorder, you should discuss your concerns with your family doctor. Maybe you may consider making an appointment with an autism specialist.