High vs Low functioning Autism – or is it mild Autism?

“What does high functioning autism mean?”  vs “What does low functioning autism mean?”

At Amazing K, we do not refer to the functioning level of a child but rather the support level of the child.  So, a diagnosed high functioning autistic child may in our autism school and autism early intervention centre be placed in a low support need class, but they may also be placed in a high support need class. 

I realise that this statement may seem confusing so let me try to clarify.

According to the Diagnostic and Statistical manual of Mental Disorders 5 (DSM-5) medical professional categorise autism by assigning levels 1,2 and 3 to two of the domains of their symptoms.  The first severity score is for impairment in social function whilst the second score is for restrictive and/or repetitive behaviour and the severity of these symptoms. 

Amazing K doesn’t look at it this way because autism education, autism early intervention or autism treatments need to address all development challenged the child has.  Not just the DSM-5’s criteria for diagnosis.  For us Autism is not about “autistic symptoms” for us Autism Education is about a “whole child approach to intervention” and overall childhood development.

We determine the support need level (the class) of a child based on a many different criteria which includes but is by no means limited to:

  • The age of the child (most 2-4-year-old autistic children are high support need learners) irrespective of their ability to speak or not.  We also know that most 2 and 3-year-olds have not as yet development social communication and play skills irrespective of whether they are autistic or not;
  • The overall development delay of the individual child which includes communication, cognitive skills, personality traits, emotional skills, motor planning, basic concepts and body concepts to name but a few;
  • The overall behaviour of the child from a focus and concentration perspective;
  • The learner’s ability to regulate from a sensory perspective (particular in a group setting);
  • Frequency of tantrums and other disruptive behaviours that may be present;
  • The overall ability of the child to independently feed themselves, help themselves with toileting, wiping, washing hands etc.
  • The overall ability of the child to transition without anxiety or frustration;
  • The overall ability of the child to successfully and age appropriately complete tasks giving to them;
  • Imitation skills and the ability of the child to take and follow instruction given;
  • Eloping difficulties and the Childs ability to express emotion, read emotional cues and see danger.
  • Age will again come in slightly later when a verbal 6-year-old may be placed in a high support need class based on difficulties with writing, cutting, colouring, focus, concentration, ability to understand own emotions and express them appropriately.

So basically, a diagnosed low functioning, non-verbal autistic child can be placed in a LOW support need class if they can concentrate, take instruction, are independent from an eating and toileting perspective and if that child has the ability to work academically at the level the class requires. 

A high functioning able to speak child with great eye contact can be placed in a HIGH support need class because they are not able to sit still, complete activities without frustration, have continued meltdowns or behaviour outburst etc.

Ilse Kilian-Ross

Ilse Kilian-Ross is the owner of Amazing K, a registered ECD and Partial Care Facility in Johannesburg. Amazing K is a private adhd school, autism school and therapy centre for children from age 2 - 6 years where learners receive the best of both the schooling and therapy world. The autism school offers Individualized Education Programs, Speech- and Augmentive Alternative Communication (AAC) therapy as well as a full and adapted Academic Curriculum.