Levels ASD description

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Being diagnosed Level 1, the description bothers me. My level is based on okay speech.
'Social impairment apparent even with supports in place' seems to fit also. Frustrating -don't know how to write the rest...

It sounds like you think you should be level 2?

The levels are a crude index. Each one is very big and covers a broad range.

There is a very great range of symptoms in autism. Those three levels have to cover that entire range. The means the whole range of IQ, the whole range of verbal and communicative ability and the whole range of restricted/repetitive behaviors. So each level is going to have people who are much more functional at the high end and much less functional at the low end.

Level 1 does not mean "doesn't have a problem" or "problems are not serious" but "requiring support" that means you won't get by in life without some degree of support for ongoing issues related to your autism.

At the more functional end of level 1, you are going to have some very functional people and at the low end people who are right on the edge of a level 2. You will probably have different diagnosticians and practices that will tend toward a higher or lower classification for the same symptoms.

A visual way of expressing this could be:

Reality seems varied, like this:


But the levels system breaks things into light, medium and dark--like this:


This is bound to produce a feeling of things being off.

Sometimes a person in level 1 needing more support might look at a person in level 1 needing less support and think, "that person can't really be autistic if I am at level 1"

At other times a person in level 1 might see that they seem very like people with level 2 ASD and not like mild level 1 people and think, "I should really be level 2"

Both of these perceptions would be consequences of the very broad range of functional ability covered by each level, not a real error in categorization.

The basic nature of the system also means it will be difficult for professionals to assign people to one level or another when they are near the edge of those categories. The errors in a such a simple system will cover a wider range of difference than would be seen in a five or seven level system. It may be that an inability to precisely define levels made a three level system the only workable solution at the time the DSM 5 was formulated.

yes, though borderline level 2.
Thanks, this reply is clear (well understood) for me.

The img(s) help too -gets through my language problems.

I agree that the levels classification is flawed. Also just want to add that I went to a presentation by one of the people who developed the DSM-5 ASD criteria (Dr. Catherine Lord) and she said that they didn't want to include any levels of severity in the criteria, but the DSM committee asked them to do so.

If you ask me, in essence, any type of labeling of symptoms or ability to function of someone diagnosed with any diagnosis is always going to be flawed at least somewhat, but only in the sense that Adamantium brought up. Different professionals may categorize the same person at a different level, especially if they're borderline. (I think that's one of the reasons that the diagnosis of intellectual disability is controversial.) So in that sense, yeah, it should expected to be slightly flawed, just like other assessments are in psychology and psychiatry, due to most assessments being behavior based and the fact that someone's behavior may change from session to session. (And if the DSM committee really insisted on adding the severity levels - no offense or anything, I'm just the kind of skeptic that likes to get information from people like that first hand - I can totally understand why, because they seem to be replacing the low/moderate/high functioning labels for support purposes.) The only way I see to eliminate the flaw would be neuroscientists uncovering undeniable evidence of the biological basis of autism. That's what I hope to do one day. All fingers crossed!

Well, there is this recent study. Very fascinating stuff.

http://www.sciencedaily.com/releases/20 ... ceDaily%29

Thanks! I knew research was in the works, but I hadn't heard of that study yet. What I'm hoping can be uncovered is structural differences though. Hopefully something similar to the differences found in studies of schizophrenic patients. I mean, if our brains are supposed to be "abnormal" (I'm using this loosely), there has to be a biological reason for it, right?

I still think it would be better for them to profile characteristics/symptoms rather than to slap one huge diagnostic label based on vague criteria.

This way you could have an autism profile, where specific sensory sensitivities are measured and gauged, stimming is measured as a frequency or eccentricity (or both) etc.

Professionals could then see what you need help with, and it would also aid your understanding.

So like, you're saying someone would be diagnosed with ASD and then they would be profiled and all their symptoms would be measured and compared against others with an ASD diagnosis to try to figure out someone's "functioning level"? (For the record though, I don't find the criteria for the labels all that vague when you consider they're related to the low, moderate, and high functioning labels which had no criteria at all. Plus, what the public sees in articles, for example, isn't always what's outlined in the DSM or what professionals are taught about labeling patients/clients. And apparently you can be diagnosed between these levels? I've heard of someone being classified as level 1.5. And since they're support labels, it sounds like it may be possible for someone to move between them.)

When it comes to psychological/psychiatric assessment, simpler is likely to be better. I agree that it would be more comprehensive to do all of that, but with assessments being expensive and sometimes extremely long, what you're suggesting would likely turn out to have more cons than pros. :/