What is the difference between severe & profound autism?

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I sort of already know, but I'd like to know in greater detail.

You mean high functioning autism (HFA) and low functioning autism (LFA), right? It ranges in severity, and no two people have the same symptoms. No one is really textbook autism, either (as in no one has every symptom of autism).

I don't believe there is a difference. When describing autism, profound is a synonym for severe.

I think you might be mixing autism up with mental retardation. "Severe" and "Profound" are not descriptions for autism at all; they are two categories of mental retardation (also known as "intellectual disability", and a lot of other names, because society seems to have decided that "ret*d" should be an insult). Occasionally people use "severe" or "profound" to discuss autism, but those aren't medical terms--they're only ways to say that the person is very autistic, and they mean about the same thing.

"Severe" is the category of MR that's generally diagnosed in people who can master basic self-care (washing, dressing, etc.), and who can get up to kindergarten or occasionally first-grade material in school--simple counting, writing their names, naming colors, etc. They generally have some kind of genetic problem or prenatal injury; so they often look unusual. In adulthood, most will be unemployed, though some will be able to work in sheltered workshops. They will live with families or in group homes, and need help every day. Usually they get about 20-40 on an IQ test. They make up less than 5% of the cases of MR.

"Profound" is the most extreme category of MR. People with profound MR usually have other medical problems that require full-time care and usually involve physical as well as mental disabilities. In any case, profound MR means anything from being practically unable to learn (such as the case of an anencephalic infant) to being able to do very simple tasks if coached through them, and learn things like cause-and-effect, how to recognize friends and parents, and say a few useful words. In adulthood, they will need full-time care, probably nursing care, and will live with family or in a nursing home; but many won't live into adulthood because of the serious medical problems they often have to deal with. The profound category is pretty hard to test, but in general, professionals assume an IQ of 20 or lower based on parent surveys and behavior. They account for about 1% of the cases of MR.

Autism can be associated with mental retardation, though. If a doctor saw those same delays--global delays--in a person with autism, then he'd just diagnose both things. Autism/MR is a pretty common combination.

The difference between someone who's very autistic without MR and someone who has severe or profound MR is generally that the person with just the autism will be able to learn things at the average or higher level, in the areas where autism doesn't prevent it. So you wouldn't expect average social skills; you mightn't even expect average self-care or average speech; but then you might see that this person is able to understand grade-level math and read grade-level texts, and that tells you they are probably just very autistic. It's kind of the way a dyslexic tenth-grader might still be unable to read; but you can't say he's mentally ret*d because other areas aren't affected. Autism is much more global than that, but if it's just autism, then you'll see deficits in the skills that autism affects and fewer deficits in the less-affected areas.

Sometimes they can't tell them apart. Some autistic people were thought to be autistic/MR, and then found to have no MR at all, or less than the doctors thought. Usually that happens when a very autistic person learns to communicate somehow, and can show what they have learned or can learn.

Anyways, autism/MR is going to be a different brain than MR alone; autistic people learn differently, period.

Edit: I took some time writing this, lots of replies in by now.


I imagine that severe and profound in autism were adapted from the concept of mental retardation.

If you stumble upon a description of differences in mental retardation, it often talks about different levels. Depending on the IQ score, some specialists categorise into 4 levels: "mild", "moderate", "severe" and "profound". Besides IQ, the person's adaptive skills, much as in autism and their overall ability to function in everyday life matter in. As with autistic people, one person with an IQ score in the moderate range may function better or worse than someone with the same IQ score.

I'm not sure how specialists handle that categorisation. I found some really look at how well the person truly functions besides their IQ, but I suppose there might be others who will just decide on the functioning on the IQ.

That sounds a bit like categorising of autistic people is done and there are indeed some people who perceive different levels beyond moderate autism - severe autism and profound autism.

If you happen to hear about it, you should probably ask what they mean by it. Does the autism look "worse" to than than that of others with "severe" autism? Does someone assume that the autistic person is likely severely or profoundly mentally ret*d? Or do they mean to say that while some people with LFA (if they think that LFA is always the same as severe autism!) have found a way to communicate and interact that others understand, this "profoundly" autistic person does neither communicate, nor seems to interact much in a way his or her parents or other people understand even when trying hard?

But they could also mean that self-injuring behaviours are hard to control or that people are susceptible to be attacked in meltdowns. Or even that the person seems very unresponsive, but you can't tell whether it's the autism, whether they may be sick, whether they are mentally ret*d, whether they're under a lot of medication and even while necessary, something about the doses or medications used isn't well-adjusted yet - or whatever else gives people this impression of unresponsiveness.

If it gets down to "doesn't interact in a way we understand, can hardly seem to communicate at all, doesn't react to lots of stimuli or reacts in unforeseeable ways" someone may talk about "profound" autism.

At this stage, if you can't understand much of why this person is like this, it's usually hard to know whether this person's autism really is profound or severe, moderate or perhaps even mild. There could be other disorders from mental to physical that this person has (or has acquired) and you can't tell! They can't tell you nor do you understand much of what they do and why they do it.

That sure must be tough. It has a bit of scary aspect too, if you realise they could be sick and you won't notice or will notice rather late when they got even sicker. How would you tell even just a flu if it didn't get down to horrid fever yet?

Welll... kind of. And kind of not.

You have only got one brain, after all. And if that brain fits into both the Autism and Mental Retardation categories, then it's not like you've got two things on top of each other, affecting you separately. They mix together and become a unique thing, because they're part of the same person.

It is a lot like ADHD and autism, though. Autistic brains are much more likely to function in ways that fit the definition of ADHD, just like they are more likely to function in ways that fit the definition of mental retardation. Or you could say that ADHD brains are more likely to function in ways that fit the definition of "Autism".

In other words, the labels don't really have independent existence of their own. They are terms that are used to describe some of the many traits a human brain can have. It's like how you might describe a fruit as "red" and "round"; but the fruit itself isn't really a Red Fruit combined with a Round Fruit; it's an apple, which means a lot more than Red, Round Fruit ever could. And it doesn't really mean that an apple is a great deal more like an orange than like a pear, because an orange is round too...

So yeah, you can describe many of the same brains by using "Autistic" and "MR" together; but they're labels--shorthand--and not too much more than that.

"Severe" and "profound" refer to the degree to which someone is affected by an illness/disorder/injury. Generally you start with mild, then moderate, then severe, and then profound (you can also describe someone as mildly-moderately affected, or moderately-severely affected, etc.). For instance, someone who has aphasia might have mild impairment in receptive language, and moderate impairment in expressive language. Profound indicates a greater degree of involvement than severe.

As one example of how these terms are used by professionals, there is something called the "FIM" scale (the Functional Independence Measure) which is uses similar terms to describe how much assistance someone needs. It is used in rehabilitation hospitals to track patient needs and progress. If I were to assign someone a FIM score for their expressive communication skills for example, I would give them a score of "independent" if they are able to communicate 100% independently, "modified independence" if they can communicate independently with modifications, such as when given extra time or using an assistive device, "supervision" if they require cueing/assistance less than 10% of the time, "min" (mild) if they require cueing/assistance 10-25% of the time, "mod" if they require cueing/assistance 26-50% of the time, "max" (severe) if they require cueing/assistance 51-75% of the time, and "dependent" (profound) if they require assistance more than 75% of the time. So someone profoundly affected by a disorder/condition would be able to perform less than 25% of a task, such as toileting, eating, dressing, etc, while someone who is severely affected might be able to perform up to 50% of the task independently (okay, technically 49%).

I hope that gives you an idea of how the terms "severely" and "profoundly" differ. Basically, "profound" indicates the greatest degree of impairment, while "severe" indicates a great deal of impairment, but not maximum impairment.

There isn't a difference between severe and profound Autism. These are just terms used to measure the severity. There are three "levels" of Autism the lowest (or most severe) is Severe and profound it literally just means they need quite a lot of attention and care.