Understanding Severe Autism on the Spectrum

Autism spectrum disorder (ASD) represents a wide continuum of strengths and areas of need. While many individuals with autism have more limited support needs and are able to live independent lives, some cases of autism are so severe and require such high levels of support that assistance is needed at all times. Although most people are more familiar with mild or moderate forms of autism, severe autism exists and often requires support from highly trained professionals.

The American Psychological Association classifies autism severity on three levels: level 1 is mild, level 2 is moderate, and level 3 is most severe. Across the autism spectrum, many individuals will share one or more common skills deficits in the areas of social interaction, communication, and repetitive/restricted patterns of behavior. The more severe the level of autism, the more co-occurring symptoms will be present, and the more severe these symptoms are likely to be. As a result, there will be more areas of need to address with treatment, such as ABA. Individuals with level 3 autism may have a few or many of the following symptoms or comorbid conditions, such as:

• Challenging behavior:

  • Self-injurious behavior (SIB), such as head banging, self-biting, or self-hitting

  • Severe aggression, such as biting, hitting, kicking, or pulling hair

  • Elopement or running away

  • Pica, or consuming inedible objects

• Mood instability or disorders:

  • Irritability, which can be triggered by stimuli in the environment

  • Severe outbursts or tantrums

  • Bipolar Disorder

  • Depression

• Communication issues or disorders:

  • Inability or reduced ability to speak

  • Apraxia

  • Echolalia or repeating certain words or phrases

• Other diagnoses or symptoms:

  • Intellectual Disability

  • Anxiety

  • Obsessive Compulsive Disorder

  • Food selectivity

  • Ritualistic behavior/rigidity

Individuals with more severe forms of autism are sometimes placed in residential treatment centers or group homes due to their families’ inability to safely manage their needs in the family’s home. Families who are able to safely maintain their loved ones in the family’s home may find it difficult to participate in their communities due to stigma surrounding severe autism. Having a loved one with severe autism can be incredibly stressful on the entire family, including parents and siblings

Severe autism is often detected rather easily and quickly. We always encourage parents or other caregivers to seek help if they have concerns about their child’s development or once they suspect their child may have autism. Early intervention is critical, and can positively impact future outcomes for a child with level 3 autism. Empirically-supported interventions, such as ABA, may help the individual learn new skills, as well as reduce potentially harmful behaviors such as aggression or SIB. Early intervention for challenging behavior is also critical to help prevent the behavior from worsening over time.

At Inspire ABA, we have extensive experience in the assessment and treatment of severe autism, including severe challenging behavior that may be exhibited by some individuals on the autism spectrum. Please contact our team today so we can help.

We also encourage families of individuals diagnosed with severe autism to research the National Council on Severe Autism.