People with autism who have low support needs (previously called high-functioning autism or Asperger's syndrome) may not need as much support as other autistic people; however, they may still find some day-to-day activities a challenge. Since autism is a spectrum disorder, this means people have a wide range of needs and abilities.
Autistic adults and children with low support needs share traits that can lead to differences with their neurotypical peers. Support strategies can help to manage traits like sensory overload, not understanding social cues, and difficulty controlling emotions.
© Verywell, 2017
Autism With Low Support Needs
Autism with low support needs describes people with autism traits that appear mild. The official diagnostic term is autism spectrum disorder (ASD) Level 1.
The severity of autism spectrum disorder is described by a level from 1 to 3, based on how much support a person needs:
- Level 1 requires some support.
- Level 2 requires substantial support.
- Level 3 requires very substantial support.
Is Asperger's the Same as Low Support Needs?
Asperger's syndrome is no longer used as a diagnosis or a way to categorize autism. It was removed from the Diagnostic and Statistical Manual of Mental Disorders in 2013 when a new edition (DSM-5) was published. Now, people with autism labeled as “high functioning” are usually diagnosed with Level 1 ASD. The Asperger's term is still used in research literature.
People with autism now are evaluated on the basis of support needs. In the autism community, functioning labels are discouraged because they can be misleading. A person can be able to function independently in some areas but require significant support in other areas.
People labeled as high-functioning can often have significant needs that are overlooked. It's preferred to describe people in terms of their support needs rather than function.
Level 1 Autism Traits
The symptoms of autistic adults and children with low support needs vary but generally fall into certain categories:
- Experiencing sensory overload: Noise, crowds, bright lights, strong tastes, smells, and being touched evoke a strong response and can make outings (movies, shopping malls) difficult. The pattern remains in adulthood, so coping skills are important.
- Missed social cues: It's common for body language, vocal tone, and other communication tools to be missed or misread.
- Anxiety or mood disorders: These are often co-occurring, possibly due to the social rejection and discrimination autistic people often face.
- Challenges with organization or planning: Problems with executive function can include sticking to schedules, managing household tasks, or completing a long-term project. Changes can be more disruptive than in neurotypical people.
- Difficulty controlling emotions: People with autism can feel extreme emotions and occasionally experience "meltdowns." The level of anger, sadness, or fear may seem a mismatch to the setting.
- Differences in verbal communication: People with Level 1 autism may do well at tasks like grammar rules and vocabulary. But they may not understand idioms (figures of speech) or sarcasm, and take things literally. They may find talking harder when feeling stressed, or not understand the pattern of a back-and-forth conversation
Repetitive actions and self-stimulating behaviors (stimming or stims), as well as a limited focus on specific interests, can occur. These can be disruptive to social relationships.
Some people with Level 1 autism only experience mild challenges in their lives because of these symptoms. Others find that these symptoms make certain aspects of their lives more difficult to undertake without help.
Diagnosis
Diagnosis of autism spectrum disorder often starts with early screening in childhood. A diagnosis can be made in a child as early as 18 months, with an autism diagnosis from a trained professional considered very reliable by age 2.
However, the autism traits in some people with low support needs may go unrecognized or they are attributed to another cause. They may mask these traits well and not receive a formal autism diagnosis until adolescence or adulthood.
Getting an autism diagnosis as an adult can be a difficult and lengthy process. The first step is to find a psychologist or psychiatrist who works with autistic adults. Sometimes, a mental health professional can diagnose autism in adults by asking questions and observing responses.
A more formal autism evaluation includes questionnaires and tests, such as:
- ADOS-2: The ADOS-2 is a standard autism diagnostic test. Certain components can be used specifically for adults. A professional administering the test will observe how you respond to certain prompts. They evaluate both what you say and how you behave.
- 3Di-Adult: The Developmental, Dimensional, and Diagnostic Interview-Adult Version (3Di-Adult) is used in adult autism. It evaluates communication, social skills, and traits like a focus on specific interests or repetitive behaviors.
In some cases, additional forms are filled out by people who know you well, like your partner, relative, close friend, or employer (with your consent).
Self-Diagnosis
Getting diagnosed with autism as an adult is not always possible because there are many barriers, like cost and access. Within the autism community, there is growing acceptance of self-diagnosis, especially for people who have less access to a formal diagnosis.
Treatment
It’s important for healthcare providers to be a part of an autistic person’s support network. People with low support needs still face challenges. They also may have co-occurring mental health disorders and physical health conditions, like gastrointestinal disorders, that require care.
Depending on the type of support an autistic person needs, treatments like speech-language therapy and social skills training can address some of the challenges they’re facing and empower them with resources they need in their lives.
Educators and professionals should be made aware of the invisible challenges for autistic people with low support needs. These include sensory issues, emotional regulation, social skills, executive function, verbal communication, and mood disorders.
It’s also important to remember that autistic children with low support needs grow into adults with low support needs, even among adults who are mostly independent.
Support for Level 1 Autism
Autistic people with low support needs often still need help. Their needs can change over time, or with a specific setting. Like neurotypical people, they may need more help when stressed, sick, or hurt, or when facing significant life changes,
Some people may need help with certain tasks, like organizing their budget, staying on top of personal care and appointments, and finding employment, even though they don't need help with other skills. A support network of family, friends, and community members is crucial.
The Autistic Self Advocacy Network and the Autism Research Institute are among the organizations that can help connect autistic adults with information and resources.
People with autism may not always recognize that they need more help, but their loved ones may pick up on signs that they're not coping well. Some clues include:
- They let chores go unfinished and pile up (after previously having ways to keep up with them).
- They’re spending more time involved with their specific interests as an “escape.”
- They’re doing more self-stimulatory behaviors (stimming) to try to feel better.
- They're having trouble with social relationships or experiencing emotional meltdowns.
Black-and-white thinking can also make it harder for an autistic person to accept that their needs have changed and no longer “fit” the label they were given. Even if it’s only temporary, the “mismatch” can be very distressing and confusing. They need to feel safe about asking for and accepting more support when they need it.
Summary
Even though functioning labels like “high-functioning autism” and “Asperger’s” are less common today, many providers still use them to talk about people living with autism and the support they need to live their lives.
Someone with low support needs likely still needs help, even if it's not as much or as often as other autistic people. It’s important to have a support network that includes caregivers, mental health providers, and healthcare providers.