Symptoms of People at the High End of the Autism Spectrum
There is no official diagnosis called “mild autism.” But there are plenty of people of all ages who have been told by someone (a doctor, therapist, or well-meaning friend) that they have mild autism. What exactly do people mean when they use the term?
The Confusing History of Mild or High Functioning Autism
Back in 1980, “infantile autism” was defined, in all cases, as a severe and disabling disorder. No one with an autism diagnosis would be expected to succeed in school, make friends, or hold down a job. In 1994 a new disorder, Asperger’s Syndrome, was added to the diagnostic manual. People with Asperger’s Syndrome, while considered to be autistic, could be bright, verbal, and capable individuals. In 2013, the diagnostic criteria were changed again. Asperger’s Syndrome disappeared, and, in its place, the manual now includes just one diagnosis for all people with autism: autism spectrum disorder. People with autism spectrum disorder may or may not have severe speech delays, sensory processing challenges, strange behaviors, or other symptoms. While all people with autism spectrum disorder do have problems with social communication, these problems range from the extreme (non-verbal people with aggressive behavior) to the relatively mild (problems with reading cues, vocal intonation, body language, etc.).While the new autism spectrum disorder does include “levels of support,” the idea of describing some as having “level 1 autism” has not really caught on—largely because no one really knows what this means. Many people have continued to use the term “Asperger syndrome,” but even this term doesn’t mean quite the same thing as high functioning or mild autism.
People with autism spectrum disorder must have certain symptoms in order to qualify for the diagnosis. Even people with mild autism, therefore, have significant developmental and sensory challenges that are severe enough to get in the way of normal activities and relationships.While these symptoms must be present before age 3, it’s often the case that milder symptoms go unnoticed until a child is a bit older (especially for girls). If the symptoms appear for the first time after a child is 3 years old, they will not qualify for an autism diagnosis. They may, however, be diagnosed with a less severe Social Communication Disorder.If a child is truly autistic, his symptoms will include:
- Problems with back-and-forth communication that may include difficulty with conversation, body language, eye contact, and/or facial expressions.
- Difficulty in developing and maintaining relationships, often due to difficulty in imaginative play, making friends, or sharing interests.
- Preference for repeating the same actions, activities, movements, or words over and over again, even if there is no obvious reason for doing so (lining up toys over and over again is a classic example);
- Restricted interests that are often intense (a stereotypical example is an autistic child who is absolutely dedicated to a video game about which he knows everything there is to know);
- Hyper- or hyporeactivity to sensory input (either doesn’t notice or is overly sensitive to sound, light, smells, pain, touch, etc.)
What Do People Mean When They Say ‘Mild Autism’?
So, what does a practitioner, teacher, or parent mean when they say their child (or your child) has “mild” autism? Since there is no official definition of the term “mild autism,” every person using it has a slightly different idea of what it means.
- Sometimes the term is used when an individual is clearly autistic, but also has significant spoken language and other skills. For example, “Joey is very bright and does well in class, but because he has mild autism he has a tough time making friends.”
- The term may also be used euphemistically to describe a child whose challenges are by no means mild, but who has just a few spoken words. For example: “I’m so glad to see your child is using hand gestures to ask for juice; he may wind up with relatively mild autism.”
- The term may also be used to help explain treatment decisions. For example: “Your child has mild autism, so he may do better with play therapy than with intensive behavioral therapy.”
To make matters more difficult, a person with “mild autism” may have advanced communication skills and academic abilities, but have very delayed social skills, severe sensory issues, and/or extreme difficulties with organizational skills. As a result, the individual with “mild” autism may find a public school or work settings morechallenging than an individual with greater language challenges but fewer sensory or social problems.
How Do the Diagnostic Criteria Help Define Mild Autism?
The DSM-5 diagnostic criteria do offer some help with that question because they include three “functional levels” to describe the severity of autism.
People who are “mildly” autistic are generally considered to be level 1, meaning they need relatively little support to live a normal life.
But, of course, that’s misleading because many people with “mild” autism may need a great deal of support depending on the situation. For example, a person with “mild” autism may have great verbal skills but have no ability to read another person’s body language or emotions. As a result, plenty of people with “mild” autism get themselves into trouble with the opposite gender, with work or classmates, or even with the police.
Are There Treatments for Mild Autism?
As with any type of autism, appropriate treatments include:
- behavioral therapy (uses rewards to teach expected or preferred behaviors)
- play or developmental therapy (uses play-based activities to build emotional and communication skills)
- drug therapies (there are drugs that treat symptoms such as anxiety and mood disorders which may be associated with mild autism)
- speech therapy (with milder autism, speech therapy is usually related to conversation skills, body language, etc.)
- occupational therapy (often helpful for sensory issues)
- physical therapy (many children with autism have low muscle tone or are physically clumsy)
Some children with autism may also benefit from treatments from associated problems such as seizures, gastrointestinal issues, sleep disorders, and issues such as obsessive-compulsive disorder. These problems are not part of autism per se, but they are more common among autistic children.
A Word From Verywell
The bottom line is that the term “mild autism” is not especially useful, though it is fairly common. The reality is that “mild” symptoms can lead to serious problems in the areas of social communication, relationships, employment, and independence. They can also be associated with significant emotional challenges: Many people with “mild” autism are also struggling with anxiety, depression, obsessive-compulsive disorder, and other mental illnesses.To really understand autism’s challenges, avoid generalizing based on a term like “mild autism.” Instead, ask direct, specific questions about an individual’s verbal, social, sensory,and behavioral challenges. Then, ask about the person’s strengths, talents, and interests.