Mild Autism in Adults and Children

Mild autism is an unofficial term commonly used to refer to a diagnosis of autism spectrum disorder level 1. Mildly autistic people require the least amount of support and are often able to hide their symptoms. However, they may struggle with social interactions, reading social cues, understanding body language, and deciphering facial expressions.

Because these symptoms can be subtle, mild autism is often missed during early intervention screenings in childhood. As a result, people with the condition tend to be diagnosed at an older age, possibly adulthood.

This article discusses mild autism in adults and children. It describes the signs, how they are often overlooked, and how they may eventually be diagnosed.

What Is Mild Autism?

The term "mild autism" can be confusing unless you know that autism is a spectrum disorder with symptoms ranging from least to most severe.

People with mild symptoms of autism, those with severe challenges, and those in between are all diagnosed with ASD. However, their diagnoses are further classified by level. There are three, each of which are defined by the amount of support a person may need.

Level 1 autism describes people who need the least support to function in their daily lives. This is what some call mild autism.

In general, people with ASD have challenges with social communication, usually resist changes in their routine, and can be hypersensitive to noise, smell, touch, and other sensory experiences.

People with mild autism may have advanced academic abilities, but struggle with social skills, sensory challenges, or organization. Children and adults can exhibit different signs.

Support needed for a person with level 1 autism might include:

• Building self-control
• Controlling emotions
• Being flexible
• Developing back-and-forth communications skills
• Understanding non-verbal communication
• Reducing anxiety

How much support people with mild autism need depends on many factors and varies from person to person, even though they have the same level-1 diagnosis.

Mild Autism Symptoms in Children

Children with mild autism can have many typical behaviors. When symptoms do appear, they can be slight and easy to overlook, or considered simple differences in personality or temperament.

• Doesn't make eye contact: Kids with autism may seem very shy and look away from people when speaking or being spoken to, either often or consistently.
• Seems distant: They can sometimes seem to be "in their own world" and may not seem to hear people who are speaking to them.
• Attached to routine: A specific way of doing things often brings feelings of security. Any change to this routine can cause them to react in an emotional way.
• Poor adapting to change: Age-appropriate schoolwork or tasks may not be problematic, but a child may have a hard time changing activities or trying new ways of doing something.
• Difficulty seeing another's perspective: It may be hard for an autistic child to understand what other people are thinking or feeling.
• Challenges adjusting to different social situations: Autistic children might become upset in new social situations and not understand social "rules" and expectations.
• Trouble developing and maintaining relationships: Autistic children often struggle with imaginative play, making friends, or sharing interests.
• Repeating the same actions, activities, movements, or words: Autistic children may line up objects or do other activities over and over again, even if there is no obvious reason for doing so.
• Limited range of interests, but in-depth knowledge: An autistic child might only care about a few things, but they'll know everything there is to know about them.
• Extremely sensitive or indifferent to sensations: An autistic person can be extremely sensitive (hyperreactive) to the feel of material on their skin, be unable to stand loud noises, or have strong reactions to other sensory experiences. Others may not notice changes in sensation (hyporeactive), such as extreme heat or cold.
  

Some of these symptoms may be more obvious than others. It's also important to consider that symptoms can be affected by the child's location (e.g., at home or school), as well as who is with them (e.g., friends and family or strangers).

Autism symptoms may become more obvious as a child gets older. For example, an autistic preteen might be unable to keep up socially with their peers. This isn't always the case, however.

Mild Autism Symptoms in Adults

People with mild autism symptoms may not receive a diagnosis until they become adults—or at all. Signs of autism in adults may be difficult to see because many people with mild autism adopt coping skills to suppress their symptoms, making them less obvious.

Some symptoms of autism in adults include:

• Difficulty relating to others: You may have a hard time putting yourself in "other people's shoes."
• Difficulty making and maintaining friendships: Adults with autism have trouble understanding and following social rules, and can sometimes be seen as "rude" or inconsiderate. This can make it difficult to establish and maintain friendships.
• Difficulty with back-and-forth communication: An autistic person can find it hard to hold a conversation and use or understand body language, eye contact, and facial expressions.
• Trouble expressing yourself verbally: You may say things that seem blunt, or have trouble describing what you are thinking or feeling.
• Strong need for planning and routine: Adults with autism like structure and may have a rigid routine. They may have a need to plan out the details of everything they do.
• Disliking change: Change can make an adult with autism feel very uncomfortable or emotional.
• Experiencing anxiety in social situations: You might have difficulty adjusting to a new social situation or to situations where there is a lot of sensory input, such as a crowded store.
• Having intense interests in very specific subjects: Adults with autism can become "hyperfixated" on certain subjects or activities.
  

Why Mild Autism May Go Undiagnosed

People with mild autism symptoms are more likely to fly under the radar and not be diagnosed until they are older. There are several reasons for this, some of which include one's sex, adopting masking strategies, difficulty with diagnosis, and more.

Sex

Females are more likely to have milder autism symptoms that go undiagnosed until they are older. Autistic girls are less likely to engage in repetitive behaviors and don't act out as much as autistic boys.

They're also more likely to be seen as shy and withdrawn. If caregivers and teachers consider these behaviors "expected" for girls, it can contribute to the delay in autism diagnosis.

Masking and Coping Skills

Masking is when someone suppresses or covers up symptoms they are having in order to "fit in" better with those around them. Examples of this include imitating the way others speak or carry themselves, and practicing statements before saying them.

People with mild autism are often better able to mask their autistic traits than those with more severe autism. They can be successful in their efforts, though this usually ends up causing distress. 

They also tend to adopt coping skills to help them in settings like school and work. For example, a child may fidget with something under their desk throughout the day to feed their need for stimulation. This may go unnoticed or not be paid much mind if it is.

Difficulty With Diagnosis

Mild autism can be hard to diagnose in anyone. But since children typically have several grown-ups monitoring them (caregivers, teachers, coaches, healthcare practitioners, and so on), getting to the point where an evaluation is actually done may be harder for adults.

Usually, a person will need to see a psychologist or psychiatrist who specializes in adult autism. This might not happen if someone is unaware they are exhibiting signs or they do not want to acknowledge them.

Misdiagnosis

Sometimes a person may get a diagnosis—just not an autism diagnosis.

Adults with mild autism may have been previously misdiagnosed with:

• Anxiety 
• Depression 
• Obsessive-compulsive disorder 
• Psychosis 
• Personality disorders
• Other neurodevelopmental disorders 

These mental health diagnoses in adults with undiagnosed autism may actually be a sign of autistic burnout.

How Mild Autism Is Diagnosed

Pediatricians, school staff, and parents may notice signs of autism in a child that prompt an evaluation. This is done by an ASD specialist such as a child psychologist, child psychiatrist, pediatric neurologist, or developmental pediatrician.

Adults who may have autism must be evaluated by a psychologist or psychiatrist, but this requires them to take the initiative to make that appointment.

Diagnosing Mild Autism in Children 

The specialist will go over your child's medical and developmental history. Your child's intelligence, behavior patterns, and social and communication skills can be tested.

Tests used to help diagnose autism can include:

• An IQ test
• Autism Diagnostic Interview (ADI)-Revised
• The Autism Diagnosis Observation Schedule (ADOS)

If your child is in school, you can also inquire about having your child evaluated through the school district. 

Diagnosing Mild Autism in Adults

The process of getting an autism diagnosis as an adult can be difficult and may vary from provider to provider.

Your healthcare provider will likely assess you based on:

• Their observations about your symptoms
• Your own observations about your symptoms
• Screening questionnaires such as the Ritvo Autism Asperger Diagnostic Scale–Revised (RAADS–R)

Support services for adults with autism can be lacking, and people have strong emotions after being diagnosed.

Mild Autism Treatment

The recommended treatment for people with mild autism usually depends on age. Autistic children and teens need different support than autistic adults.

As with any level of ASD, the most helpful treatments for mild autism often involve a variety of therapies. The type of support that's needed, as well as how much is needed, may change over time.

Treatments for Children

Autistic children often need a very structured routine. Their caregivers can work with a team of professionals to ensure their child has the support they need at school and at home.

An education plan that's tailored to an autistic child's needs is also necessary. They may also benefit from:

• Social-skills training
• Mental health counseling
• A special diet
• Therapy to help build motor skills
  

Possible treatments for mild autism include:

• Behavioral therapy: This type of therapy uses rewards to teach autistic children expected or preferred behaviors.
• Play or developmental therapy: This therapy uses play-based activities to build an autistic child's emotional and communication skills.
  
• Speech therapy: Speech therapy for children with mild autism is usually focused on conversation skills and learning to understand body language.
• Occupational therapy: Occupational therapy is often helpful for sensory challenges that many autistic children face.
• Physical therapy: Many autistic children have low muscle tone and struggle with physical activities.
• Specific condition treatment: Autistic kids also need to be treated for any other physical or mental health conditions they have. For example, seizures, gastrointestinal disorders, sleep disorders, anxiety, and obsessive-compulsive disorder commonly co-occur with autism.

Treatments for Adults

Structure and predictability are also important for autistic adults. Examples of what this might include are:

• Accommodations at work, such as scheduled breaks, written (rather than verbal) instructions, and earplugs or headphones to reduce sensory overload.
• Cognitive behavioral therapy (CBT) to develop coping skills, which in turn helps them manage relationships and deal with frustrations at work and in life.
• Occupational therapy that focuses on problem-solving skills, building self-esteem, managing sensory challenges, and taking charge of home and finances.
• Speech therapy to help build communication skills and the ability to interpret body language.

As with autistic children, autistic adults also need treatment and support for any other conditions they have—for example, going to therapy or taking medication to help them cope with anxiety.

Summary

Mild autism is level 1 autism spectrum disorder. It means a person does not have severe symptoms and needs a lower level of support than someone else with autism.

People with mild autism still have a hard time communicating and interacting with others. They can also find it difficult to change their routine and can be sensitive to sounds, pain, tastes, or other sensations. But generally, they are able to carry out the tasks of daily living well.

There's no separate diagnosis for mild autism, but providers may categorize an autistic person as having level 1 autism if they have mild symptoms.