The doctor tells you that your child has autism. If your first question involves low-functioning autism, you're not alone. Plenty of parents want to know exactly where their children land on the autism spectrum.
While parents may toss around the term low-functioning autism often, experts don't. Some feel that there are more accurate ways to describe autism. Others find that it's too difficult to get a clear picture of a child's functional status with this term.
If you find your child struggles with everyday activities, and you would characterize the difficulties as severe, you could be dealing with low-functioning autism. Therapy might help.
How Many People Have Low-Functioning Autism?
Autism spectrum disorder (ASD) is associated with three severity levels. People with Level 3 autism need a significant amount of help with everyday activities, and they have very poor communication skills. Parsing data for those traits makes prevalence clear.
Autism Speaks says about a third of people with autism are nonverbal, and about 31% of kids with ASD also have an intellectual disability. At first glance, it seems obvious that a child with an inability to speak or problem solve would have low-functioning autism. But the reality is more complex.
Experts explain that people who appear nearly neurotypical are often considered high-functioning. By contrast, people thought of as low-functioning have disabilities that are visually and aurally obvious. Each person with autism spectrum disorder has strengths and challenges, and they are often location dependent.
A child with ASD might do just fine in:
- School. The child can complete assignments on time, sit quietly throughout the day, and avoid bullying.
- Church. The child can sit quietly through a sermon.
- Cars. The child can ride in the backseat of a car calmly.
But that same child could struggle with meltdowns at home. If an unexpected person appears or the routine changes, the child feels overwhelmed.
An assessment of high-functioning autism might make sense at school. At home, the term doesn't fit as well.
Researchers often use IQ tests to put kids into high-functioning and low-functioning groups. Those results are also arbitrary, experts say. Some kids with autism can't complete standard IQ tests, and others struggle to follow instructions. They may be incredibly intelligent, but that doesn't appear in the test results.
Autism advocates explain that verbal ability is an unreliable indicator of functional status. Plenty of people with ASD who aren't verbal use other tools, such as scripts or picture cards. They are certainly communicating, but since that isn't an accepted mode of speech, it is overlooked and devalued.
What Are Typical Symptoms?
Few tools give accurate representations of functional ability. Some parents rely on their observations to guide their child's treatment plan.
Experts explain that behaviors vary greatly between high-functioning and low-functioning kids. Children on the low-functioning side of the spectrum exhibit behaviors that make daily life challenging.
Every person with ASD has social, communication, and sensory difficulties. But people with severe forms of ASD have significant difficulties with:
- Language. They may not use verbal tools at all.
- Senses. They often grow overwhelmed when exposed to bright lights, crowds, or loud noises.
- Repetitive movements. They may rock back and forth, moan, slam doors, or bang their heads.
A child who can't speak and has a low IQ could struggle with:
- Expressing desires and dreams. A child like this might throw tantrums, flap hands, or self-harm in frustration.
- Problem solving. A low IQ makes learning tough. Children in new situations could freeze rather than finding a solution.
- Connecting. Expressing love, calling for attention, or otherwise reaching out to others could be challenging for children like this.
Children with severe forms of ASD often have other health challenges, including allergies, asthma, epilepsy, digestive disorders, sleeping disorders, and genetic conditions such as fragile X syndrome.
Therapy Options for Low-Functioning Autism
There is no cure for autism, but it is not a hopeless or helpless condition. Therapy helps children with autism learn a lot about how to function in the world around them.
When we think about therapy, we often think about people lying on a couch and talking about the past or the future. Therapy for children with ASD is much different.
Autism experts are adept at building therapies that children both understand and enjoy. To an outsider, a therapy session might look a lot like play. The therapist sits at the child's level and pulls out tools like blocks and notes and crayons. They work together with plenty of breaks for play and giggles.
Applied behavior analysis (ABA) therapy is the gold standard for children with autism, including those on the low-functioning spectrum. This umbrella term stands for many types of therapy, experts say. For low-functioning kids, it often involves discrete trial training.
- Identification. Experts find one skill or task the child needs. Pointing at a needed object, making eye contact, and responding to their name all make good therapy targets. Bigger tasks, including brushing their teeth, are good targets for older kids.
- Breaking things down. The therapist determines how these big skills disintegrate into small pieces.
- Practice. The therapist gives the child prompts to practice that one piece over and over for mastery.
ABA involves rewards. Children get stickers, smiles, crackers, or some other prompt for completing the task well. If the child can't complete the task, the therapist looks for barriers. Is the room too loud? Is the chair uncomfortable? What does the child need?
ABA therapy works best when it's intense. Expect hours of therapy each week, with plenty of practice sessions between appointments. Children need to run their drills over and over again until the movements become habitual and constant.
Some children with low-functioning autism need other forms of therapy too. They may need:
- Physical therapy. Tight, spastic muscles make smooth movements impossible. A therapist could help to address those issues.
- Speech therapy. Therapists can help children find alternate ways to communicate. Or they can help children practice speaking in a quieter voice with some inflection.
- Occupational therapy. Some children need help holding implements, like spoons or pencils. Others need help with tasks such as tying shoes or using a toothbrush.
Children with low-functioning autism also benefit from regular physical contact. Co-occurring conditions like epilepsy and digestive disorders cause discomfort. Sometimes, they make focusing on therapy tough. A doctor can get to the heart of these issues, and that could bring relief.
Progress with children who have low-functioning autism can be slow. It's hard to stay patient and focused on the future. Many parents get upset at how slowly things seem to move.
Focus on the positive, experts say. Write down every small improvement you see, and refer to that list when you feel low or discouraged. Tiny steps can and do add up to something wonderful. Look for those moments of joy.
Get Support When You Need It
Raising a child with low-functioning autism isn't always easy. Many of these children need around-the-clock care, and that leaves you with little time to address your own needs and desires.
Connect with your local autism support group, and talk to other parents dealing with the same challenges. Reach out to your friends and family and give them concrete ways to help you. Build up your support system, so you'll be ready to help your child as much as you can.
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