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Low-support autism (LSA), also known as Low-support needs autism, is an autism classification where the patient requires a low amount of support to perform daily activities or a specified task. Support can consist of accommodations, a helper or caregiver, or anything else provided to assist the autistic patient with functioning. LSA is not a specific diagnosis or type of autism. It is not included in either the American Psychological Association's DSM-5 or the World Health Organization's ICD-10, neither of which subdivides autism based on support needs.

Characterization

An individual with low-support autism may exhibit differences in communication, emotion recognition and expression, and social interaction. They may have locomotive issues (clumsiness) and a language delay. They typically have restricted interests, as well as repetitive and self-stimulatory behavior. Individuals with LSA typically have higher intelligence quotients (IQs) but not always, and may even have an intellectual disability. Individuals with LSA are typically able to perform the following tasks:

  • Live alone.
  • Be employed.
  • Attend school or higher levels of education.
  • Speak, write and understand language.
  • Complete basic tasks (cooking, cleaning, using the bathroom, etc).
  • Have relationships.
  • Interact socially in a "typical" way.
  • Drive or use public transport.
  • Mask their symptoms of autism.

A low amount of support may be needed if the individual struggles with doing one or more of those tasks, or a different task. This support may include receiving advice, having accommodations, or having a helper. Some autistic people may not be able to do one or more of those tasks with low support, or be unable to perform the task(s) at all. In this case, they may be considered as having moderate-support autism (MSA) or high-support autism (HSA).

Comorbidities of Autism

Individuals with autism spectrum disorders, including low-support autism, risk developing symptoms of anxiety. While anxiety is one of the most commonly occurring mental health symptoms, children and adolescents with autism are at an even greater risk of developing symptoms.

There are other comorbidities, the presence of one or more disorders in addition to the primary disorder, associated with high-functioning autism. Some of these include bipolar disorder and obsessive compulsive disorder (OCD). In particular the link between autism and OCD has been studied; both have abnormalities associated with serotonin.

Observable comorbidities associated with autism include ADHD, sensory processing disorder and Tourette syndrome. Autism does not cause intellectual disabilities, but between 40 and 55% of individuals with autism also have an intellectual disability.[1]

Cause of Autism

Main article: Causes of autism

Although little is known about the biological basis of autism, studies have revealed structural abnormalities in specific brain regions. Regions identified in the "social" brain include the amygdala, superior temporal sulcus, fusiform gyrus area and orbitofrontal cortex. Further abnormalities have been observed in the caudate nucleus, believed to be involved in restrictive behaviors, as well as in a significant increase in the amount of cortical grey matter and atypical connectivity between brain regions.[2]

There is a mistaken belief that some vaccinations, such as the MMR (measles, mumps, rubella) vaccine, may cause autism. This was based on a research study published by Andrew Wakefield, which has been determined as fraudulent and retracted. The results of this study caused some parents to take their children off vaccines clinically proven to prevent diseases that can cause intellectual disabilities or death. The claim that some vaccinations cause autism has not been proven; multiple large-scale epidemiological studies conducted in Japan, the United States, and other countries do not support this link.[3][4]

Diagnosis

LSA is not a recognised diagnosis by the American Psychological Association (DSM-5) or the World Health Organization (ICD-10). LSA is occasionally, however, used in clinical, therapeutic, educational, or work settings to describe the typical amount of support the person needs, especially to complete a desired task (ex: to do their job).

Treatment

Main article: Autism rights movement

While there exists no single treatment or medicine for people with autism, there exists several strategies to help lessen the symptoms and effects of the condition. Many autism rights activists say that treatment for autism should center on improving the autistic person's quality of life, instead of making them copy neurotypical behaviors. They widely do not want a cure for autism.[5]

Augmentative and alternative communication

Augmentative and alternative communication (AAC) is used for autistic patients who cannot communicate orally. Patients who have problems speaking may be taught to use other forms of communication, such as body language, computers, interactive devices, and pictures.[6] The picture exchange communication system (PECS) is a commonly used form of augmentative and alternative communication with children and adults who cannot communicate well orally. Patients are taught how to link pictures and symbols to their feelings, desires and observation, and may be able to link sentences together with the vocabulary that they form.[7]

Speech-language therapy

Speech-language therapy can help those with autism who need to develop or improve communication skills.[8] According to the organization Autism Speaks, "speech-language therapy is designed to coordinate the mechanics of speech with the meaning and social use of speech".[7] People with autism may have issues with communication, or speaking spoken words. Speech-language Pathologists (SLP) may teach someone how to communicate more effectively with others or work on starting to develop speech patterns.[9] The SLP will create a plan that focuses on what the child needs.

Occupational therapy

Occupational therapy helps autistic children and adults learn everyday skills that help them with daily tasks, such as personal hygiene and movement. These skills are then integrated into their home, school, and work environments. Therapists will oftentimes help patients learn to adapt their environment to their skill level.[10] This type of therapy could help autistic people become more engaged in their environment.[7] An occupational therapist will create a plan based on the patient's’ needs and desires and work with them to achieve their set goals.

Applied behavioral analysis (ABA)

Applied behavioral analysis (ABA) is considered the most effective therapy for autism spectrum disorders by the American Academy of Pediatrics.[11] ABA focuses on teaching adaptive behaviors like social skills, play skills, or communication skills[12][13] and diminishing problematic behaviors like eloping or self-injury[14] by creating a specialized plan that uses behavioral therapy techniques, such as positive or negative reinforcement, to encourage or discourage certain behaviors over-time.[15] However, ABA has been strongly criticised by the autistic community, who view it as abusive and detrimental to autistic children's growth. [16][17][18] They say that there is strong evidence of ABA not being as effective as it seems, since it does not teach autistic people to understand what they are doing but rather only to copy certain things. For example They also point to ABA's origins, which involved electroshock "therapy", and verbal and physical abusive. The founder of ABA for autism is also widely criticized for attempting to make autistic people "indistinguishable from their (neurotypical) peers" and supporting other things such as queer conversion "therapy". Some studies appear to show a link between ABA and increased risk of suicide, abuse, and symptoms of PTSD in autistic adults who went through it, although more research is required.

Sensory integration therapy

Sensory integration therapy helps people with autism adapt to different kinds of sensory stimuli. Many with autism can be oversensitive to certain stimuli, such as lights or sounds, causing them to overreact. Others may not react to certain stimuli, such as someone speaking to them.[19] Many types of therapy activities involve a form of play, such as using swings, toys and trampolines to help engage the patients with sensory stimuli.[7] Therapists will create a plan that focuses on the type of stimulation the person needs integration with.

Medication

There are no medications specifically designed to treat autism. Medication is usually used for symptoms associated with autism, such as depression, anxiety, or behavioral problems.[20] Medicines are usually used after other alternative forms of treatment have failed.[21]

Criticism of -support labels

Some autistic rights activists disagree with the categorisation of individuals into -support labels, stating that an individual's support needs can fluctuate from day to day, and categories do not take this into consideration. Additionally, individuals with "moderate-support autism" are typically left out of the discussion entirely, and due to the non-linear nature of the autistic spectrum, individuals can be low-support in some areas while at the same time being moderate or high support in other areas. The terms "Support-flux autism" or "Fluctuating-support autism" have been suggested to account for the fluctuation of needs.

Similar terms

Low-support autism may be used to describe autistic individuals with similar behaviors as those defined in the outdated and inaccurate terms high-functioning autism, Asperger's Syndrome, Pervasive Developmental Disorder, type 1 Autism, and mild autism. However LSA

See also

References

  1. ^ Newschaffer, Craig J.; Croen, Lisa A.; Daniels, Julie; Giarelli, Ellen; Grether, Judith K.; Levy, Susan E.; Mandell, David S.; Miller, Lisa A.; Pinto-Martin, Jennifer; Reaven, Judy; Reynolds, Ann M.; Rice, Catherine E.; Schendel, Diana; Windham, Gayle C. (2007). "The Epidemiology of Autism Spectrum Disorders*". Annual Review of Public Health. 28 (1): 235–258. doi:10.1146/annurev.publhealth.28.021406.144007. ISSN 0163-7525. PMID 17367287.
  2. ^ Spencer, Michael; Stanfield, Andrew; Johnstone, Eve (2011). "Brain imaging and the neuroanatomical correlates of autism". In Roth, Ilona; Rezaie, Payam (eds.). Researching the Autism Spectrum. pp. 112–55. doi:10.1017/CBO9780511973918.006. ISBN 978-0-511-97391-8.
  3. ^ Klin, Ami (2006). "Autismo e síndrome de Asperger: Uma visão geral" [Autism and Asperger syndrome: an overview]. Revista Brasileira de Psiquiatria (in Portuguese). 28: S3–11. doi:10.1590/S1516-44462006000500002. PMID 16791390.
  4. ^ "A mercurial debate over autism". Nature Neuroscience. 8 (9): 1123. September 2005. doi:10.1038/nn0905-1123. ISSN 1546-1726. PMID 16127438.
  5. ^ Malia, Jen (30 July 2021). "Urging a new approach to autism: Stop looking for a cure and start listening". Washington Post. Retrieved 31 July 2021.{{cite web}}: CS1 maint: url-status (link)
  6. ^ "Augmentative and Alternative Communication (AAC)". American Speech-Language-Hearing Association. Archived from the original on 2019-08-15. Retrieved 2019-08-20.
  7. ^ a b c d "What Treatments are Available for Speech, Language and Motor Issues?". Autism Speaks. Archived from the original on 2015-12-22. Retrieved 2015-12-16.
  8. ^ "What is Autism, Asperger Syndrome, and Pervasive Developmental Disorders?". US Autism and Asperger Association. Archived from the original on 28 December 2015. Retrieved 16 December 2015.
  9. ^ for you/parents-and-cares/pc speech and language therapy.aspx "Speech and Language Therapy". Autism Education Trust. {{cite web}}: Check |url= value (help)[permanent dead link]
  10. ^ fact sheet.ashx "Occupational Therapy's Role with Autism". American Occupational Therapy Association. Archived from the original on 2019-01-03. Retrieved 2019-08-20. {{cite web}}: Check |url= value (help)
  11. ^ Myers, Scott M.; Johnson, Chris Plauché (1 November 2007). "Management of Children With Autism Spectrum Disorders". Pediatrics. 120 (5): 1162–1182. doi:10.1542/peds.2007-2362. ISSN 0031-4005. PMID 17967921. Archived from the original on 9 October 2019. Retrieved 20 August 2019.
  12. ^ "Applied Behavioral Analysis (ABA): What is ABA?". Autism partnership. Archived from the original on 2019-01-03. Retrieved 2019-08-20.
  13. ^ Matson, Johnny; Hattier, Megan; Belva, Brian (January–March 2012). "Treating adaptive living skills of persons with autism using applied behavior analysis: A review". Research in Autism Spectrum Disorders. 6 (1): 271–276. doi:10.1016/j.rasd.2011.05.008.
  14. ^ Summers, Jane; Sharami, Ali; Cali, Stefanie; D'Mello, Chantelle; Kako, Milena; Palikucin-Reljin, Andjelka; Savage, Melissa; Shaw, Olivia; Lunsky, Yona (November 2017). "Self-Injury in Autism Spectrum Disorder and Intellectual Disability: Exploring the Role of Reactivity to Pain and Sensory Input". Brain Sci. 7 (11): 140. doi:10.3390/brainsci7110140. PMC 5704147. PMID 29072583.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  15. ^ "Applied Behavioral Strategies - Getting to Know ABA". Archived from the original on 2015-10-06. Retrieved 2015-12-16.
  16. ^ https://neuroclastic.com/2019/03/28/invisible-abuse-aba-and-the-things-only-autistic-people-can-see/
  17. ^ https://childmind.org/article/controversy-around-applied-behavior-analysis/
  18. ^ https://www.spectrumnews.org/features/deep-dive/controversy-autisms-common-therapy/
  19. ^ Smith, M; Segal, J; Hutman, T. "Autism Spectrum Disorders". {{cite journal}}: Cite journal requires |journal= (help)
  20. ^ National Institute of Mental Health. "Medications for Autism". Psych Central. Archived from the original on 2015-12-13. Retrieved 2015-12-16.
  21. ^ Pope, J; Volkmar, F (November 14, 2014). "Medicines for Autism". {{cite journal}}: Cite journal requires |journal= (help)

Further reading

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