What Is Mild Autism?

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Autism is as a spectrum disorder, meaning that people with it can experience different symptoms that range from least to most severe. Mild autism falls at the lowest end of this range. Those who have it have symptoms, but they are not significant enough to require high-level support.

Mild autism is not an official medical term, so doctors don't use it when making an autism diagnosis. However, some therapists, teachers, parents, and others might use it to explain how significantly a person is affected by this disorder. Their definitions may vary.

For example, sometimes the term is used when a person is clearly has autism but has well-developed spoken language and other skills. Other times, people are said to have mild autism when they have advanced academic abilities but struggle with social skills, sensory issues, or organization.

Mild autism is also called high-functioning autism (HFA) or "being on the lower end of the spectrum." You may also hear some call mild autism by its former official name, Asperger's syndrome.

This article will explain what mild autism is and how the definition has changed over time. It also explains the signs of mild autism and provides information on treatment options.

An Evolving Definition

The meaning of mild autism has changed over the past few decades. This is part of the reason why, today, different people use the term in different ways.

In the 1980s

Autism was known as infantile autism in the 1980s. It was considered a severe and disabling disorder.

No differences were made between people with mild symptoms and those with serious ones. People with autism were not expected to succeed in school, make friends, or hold a job.

In the 1990s

In 1994, a new version of the guidebook doctors use to diagnose mental and developmental disorders was published. The Diagnostic and Statistical Manual of Mental Disorders (DSM-4) added the diagnosis of Asperger's syndrome.

People who had autism and who could communicate and were intelligent were diagnosed with Asperger's syndrome. They were said to be "high-functioning." This means someone has better social and communication skills than other people with autism symptoms.

In the 2010s and Through Today

A new version of The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was published in 2013. This is the manual doctors use today.

Asperger's syndrome is no longer a diagnosis in the DSM-5. Instead, the manual provides just one diagnosis for all people with autism symptoms: autism spectrum disorder (ASD).

People with ASD have problems with social communication. They may resist changes in routine and be hypersensitive to noise, smell, touch, and other types of sensory experiences. These problems can range from mild to extreme.

People with mild symptoms and those with severe speech delays or sensory issues are all diagnosed with ASD.

The DSM-5 does identify the "level of support" a person with autism might need. These functional levels range from 1 to 3 based on the severity of one's autism, with 1 describing people who need the least support because their symptoms are mild.

However, few people outside of the medical community refer to someone as having level 1 autism. Often, the terms Asperger's syndrome or mild autism are still used.

Recap

Mild autism is a synonym for high-functioning autism. Some people also still use the term Asperger's syndrome to describe those who have mild symptoms. Doctors, however, call mild autism level 1 autism.

Mild Autism Symptoms

Every person diagnosed with ASD has some specific developmental and sensory problems. Even people with mild autism may have symptoms that get in the way of normal activities and relationships.

Symptoms of autism include:

  • Problems with back-and-forth communication: It may be difficult to hold a conversation and use or understand body language, eye contact, and facial expressions.
  • Difficulty developing and maintaining relationships: Children may struggle with imaginative play, making friends, or sharing interests.
  • Repeating the same actions, activities, movements, or words: They may line up objects or do other activities over and over again, even if there is no obvious reason for doing so.
  • Self-stimulating behaviors: This is also called stimming. They may rock back and forth, hum, pace, or flap their hands in ways that seem unusual to others.
  • 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.
  • Being extremely sensitive or indifferent to sensations: A person may 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. On the other hand, some may not notice changes in sensation (hyporeactive) such as extreme heat or cold.

With mild autism, some symptoms may seem barely present, while others may be quite noticeable.

For example, someone with mild autism may:

  • Be able to speak, but have trouble with back-and-forth conversation
  • Try to make friends, though they may not be successful because they appear "odd" to others
  • Do age-appropriate schoolwork or tasks, but have a hard time changing activities or trying new ways of doing something

Symptoms can vary from person to person. It's also important to consider that they may be affected by where the person with autism is (home or school, for instance) and who is with them.

How Autism Is Diagnosed

If you or your pediatrician think your child is showing symptoms of autism, you'll be referred to a specialist who treats ASD. Specialists may include child psychologists, child psychiatrists, pediatric neurologists, or developmental pediatricians.

The specialist will review your child's medical history. Your child may be given tests to evaluate intelligence, behavior patterns, social and communication skills, and developmental history. These can include:

Before the DSM-5, a child had to show delays in social interaction and communication before age 3 to be diagnosed with autism. Now, there's a little more flexibility. The symptoms just have to be present from an "early age."

This can still be too strict for people with mild symptoms. For them, signs may not be obvious until they're older and clearly unable to keep up socially with others their age. A later diagnosis is especially common with girls.

Girls with autism are less likely to engage in repetitive behaviors and don't act out as much as boys. They're more likely to be seen as shy and withdrawn, which parents and teachers may consider "expected" for girls in general, meaning they go undiagnosed longer.

Mild autism may actually go unnoticed for many years, so some people are not evaluated until they're adults. Adults usually see a psychologist or psychiatrist who's an expert in ASD. They may be given a special test to asses their symptoms called the Developmental, Dimensional and Diagnostic Interview-Adult Version (3Di-Adult).

Levels of Autism

The DSM-5 outlines the three functional levels of autism. It provides guidelines doctors use to determine how much support the person with ASD needs. People who need the least amount of support to function in everyday life receive a level 1 (mild autism) diagnosis.

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.

Recap

A specialist will assess a child with signs of autism by running tests to rule out other possible causes. If ASD is diagnosed, the level of support needed will be determined. A low level means a level 1 ASD (mild autism) diagnosis. Sometimes mild signs are missed, especially in girls. People who are diagnosed with ASD as adults usually have mild autism that goes unnoticed for years.

Treatment

Treated for people with mild autism depends largely on their age. Children and teens need different types of support than adults.

Treatments for Children

Children often need a very structured routine.  Parents may work with a team of professionals to ensure a child has the support needed at school and at home.

Children with ASD require an education plan tailored to their individual needs. They may also require social-skills training, mental health counseling, a special diet, and help building motor skills.

As with any type of autism, appropriate treatments for mild autism may involve a variety of therapies. What type of support is needed may change over time, but can include any of the following:

  • Behavioral therapy: This type of therapy uses rewards to teach expected or preferred behaviors.
  • Play or developmental therapy: This therapy uses play-based activities to build emotional and communication skills.
  • Speech therapy: With milder autism, speech therapy is usually related to conversation skills and body language.
  • Occupational therapy: Occupational therapy is often helpful for sensory issues.
  • Physical therapy: Many children with autism have low muscle tone or struggle with physical activities.
  • Drug therapies: There are medications that treat symptoms such as anxiety and mood disorders, which may be associated with mild autism.

Some children with autism also need to be treated for related problems such as seizures, gastrointestinal issues, sleep disorders, obsessive-compulsive disorder, and other issues. These problems are not part of autism, but they're more common among this group.

Treatments for Adults

Structure and predictability are also important for adults with high-functioning autism. Supports might include:

  • 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 help a person help manage relationships and deal with frustrations at work and in life
  • Occupational therapy that focuses on problem-solving skills, building self-esteem, and taking charge of home and finances

Summary

Asperger's syndrome, high-functioning autism, and mild autism all generally mean the same thing—that a person's autism symptoms are not severe. There's no separate diagnosis for mild autism, but doctors do categorize people with autism spectrum disorder by level. Level 1 means their symptoms are mild.

People with level 1 autism struggle with communicating and interacting with others. They may also have problems changing their routine or be sensitive to sounds, pain, tastes, or other sensations.

Even within this group, though, symptoms differ from person to person. The type of therapies a person needs depends on their individual symptoms. As they mature or as their symptoms change, a person's treatment plan may need to change as well.

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