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Understanding Severe Autism on the Spectrum Continuum

Autism spectrum disorder is truly a wide continuum of strengths and areas of need. While many individuals with autism have limited support needs and are able to live independently, some cases of autism are so severe and require such high levels of support that assistance is needed 24/7. This article looks at how to recognize severe autism, and what can be done to alleviate the symptoms and challenges it induces.

Levels of Autism

The American Psychological Association classifies autism severity on three levels. Level 1 is mild and Level 3 is most severe. Many individuals on the autism spectrum, regardless of their level, will share a common issue: deficiency in social communication. However, many co-occurring conditions and symptoms can be diagnosed along with autism. The more severe the level of autism, the more co-occurring symptoms will be present. As a result, there will be more areas of need to address with therapy. Individuals with level 3 autism may have a few or many of the following symptoms or comorbid conditions:

  • Severe aggression
  • Self-injurious behavior, such as head banging, self-biting, or self-hitting
  • Insomnia
  • Irritability triggered by crowded places, bright lights, certain flavored foods
  • Elopement
  • Inability or reduced ability to speak
  • Intellectual Disability
  • Obsessive Compulsive Disorder
  • Bipolar Disorder
  • Depression
  • Anxiety
  • Severe outbursts
  • Speech/language disorders including apraxia

Teens and adults with more severe forms of  autism are sometimes placed in residential treatment centers or group homes due to their families’ inability to safely manage their needs in the family’s home. Families who are able to safely maintain their loved ones in the family’s home may find it difficult to participate in their communities due to stigma surrounding severe autism. Having a loved one with severe autism can be incredibly stressful on the entire family, including parents and siblings

As it can with all levels of severity, early intervention can positively impact a child with level 3 autism. Applied Behavior Analysis therapy, as well as other empirically-supported interventions, may assist the individual learn new skills, as well as improve potentially harmful behaviors such as aggression or self-injurious behavior.

A Board Certified Behavior Analyst (BCBA) may recommend many interventions and strategies for treating symptoms of severe autism and helping maintain an individual’s safety, depending on the specific needs of the individual. The BCBA will conduct a thorough assessment of the individual’s strengths and needs to develop an individualized treatment plan that highlights specific areas of need.

Unlike other variations of autism, severe autism is often detected rather easily and quickly. As such, we encourage parents to seek assessment and diagnosis once they recognize the warning signs in their child. We also encourage families of individuals diagnosed with severe autism to research the National Council on Severe Autism.

We wish every family all the best on their autism treatment journey!