As the parent of a low-functioning autistic child, you and your family face specific challenges that other families don’t have to contend with.
Overcoming these challenges means finding helpful, high-quality resources to work with your autistic child.
This article specifically addresses the needs of families who are dealing with a low-functioning autistic child to provide resource options of which parents might not otherwise be aware.
Use this article as a guide to understand low-functioning autism and how it can be treated using ABA therapy and other treatment options that were developed to help autistic children overcome the limitations of their disorder.
What is Low-Functioning Autism?
Low-Functioning Autism, also referred to LFA, is a form of autism that is characterized by severe behavioral issues and cognitive troubles.
Children and adults with LFA demonstrate significant difficulties in all three primary areas of psychopathology, which are reciprocal social interaction, communication, and restrictive, stereotypic, repetitive behavior.
This means that individuals with LFA behave very differently from other children and they are likely to have trouble learning in a traditional classroom setting. Children with LFA may also have difficulties forming and maintaining traditional family and friend-type relationships.
Though no one knows for certain what causes LFA, it’s a common belief that multiple factors play a role in the development of this disorder. Genetic factors may be at play, as well as environmental factors. Many children with autism have been shown to have different kinds of brain abnormalities that contribute to their behaviors, and these abnormalities tend to be more pronounced in children and adults with LFA.
What is the difference between High-Functioning and Low-Functioning Autism?
High-Functioning Autism (HFA) and Low-Functioning Autism (LFA) are different degrees of a spectrum of the same developmental disorder. While children with HFA and LFA may occasionally have similar behavioral characteristics, these characteristics are much more pronounced in children with LFA.
Many times, children with HFA are able to live relatively normal lives, though they may need specialized tutoring, therapy, or other treatments to improve their quality of life. However, children with LFA will need to attend special schools and will have very different lives from average children.
It’s important to understand the differences between these two types of autism. Parents of autistic children must know that HFA and LFA does not determine a child’s:
- Sensory challenges
- Aggressive behaviors
- Anxiety levels
- Perseveration levels (the degree to which repetition occurs)
Most of these traits and behaviors vary among all children and individuals. Some HFA children are very aggressive, while some LFA children are quite docile.
Some LFA children are very talented, and some HFA children may perform well in other areas of life, but struggle with certain repetitive behaviors. The primary difference between these types of autism is the severity of a child’s struggle to learn (in a traditional way) and their ability to relate to other people, form relationships, and communicate with others.
The signs and symptoms of LFA are listed below to help you understand this disorder more clearly:
Signs of Low-Functioning Autism
Low-Functioning Autism tends to be somewhat easier to spot in children than High-Functioning Autism. Here are the most common and pronounced signs of LFA:
- Inappropriate social responses (such as laughing during a sad event, etc.)
- Delayed speech development
- Development of obsessive-compulsive behaviors (repetitive hand washing, ordering and arranging things, tapping/touching, etc.)
- Higher than normal anxiety levels
- Lack of interest in other children or in adults
- Trouble sleeping
- Trouble communicating needs like hunger, tiredness, thirst, etc.
- Dislike and avoidance of loud noises, bright lights, and other intense sensory experiences
- Regular “meltdowns” (sometimes called emotional outbursts)
- Difficulty with change and insistence on routines and “sameness”
- Avoidance of socialization
- Apparent lack of empathy
- Monotonous speech (speaking without intonation) or use of intonation in incorrect ways
- Misuse of facial expressions (or complete lack of facial expressions)
There are many different manifestations of LFA, and it’s essential for parents to acknowledge that every autistic child is different and therefore each child may display different signs and symptoms of autism as a disease.
If you believe that your child may have autism, visiting a doctor or psychologist for testing is the first step toward treatment and the ability to overcome whatever limitations your child may face due to their disorder.
Does autism worsen with age?
There has not been a lot of scientific studies done yet to show whether or not autism improves, stays the same, or worsens with age, but those that have been done have had interesting results. One of the largest studies that followed 300 children ages 2 to 21 demonstrated that only about 10% of these children showed significant improvements with their symptoms over time. Approximately 80% of the children showed little to no change at all by their teen years.
Of the studies that have been conducted, the children that showed the most improvement in their symptoms were tested and shown to have a high IQ from the beginning, and they also received intensive speech and communication therapy early-on to improve their communication skills. A strong ability to plan and complete complex tasks at a young age was also aligned with a later ability to understand other people’s thoughts and emotions more clearly with increasing age.
Thus, it’s uncommon for autism symptoms to worsen as a child grows older. But it is possible, with the right treatment and increased parental engagement, for a child’s symptoms to lessen as with increasing age as they reach adolescence and adulthood.
When should you have your child screened for autism?
Children can be screened for autism at any age, but the earlier they can be screened, the better. Doctors and psychologists may in some cases be able to detect autism in children as young as 18 months, although most children receive testing around age 2 and the final diagnosis is not proclaimed until the child is older. Most of the time, an autism diagnosis is reliable for children who are age 2 or older.
Below are some clear and early signs that your child may have autism:
- No smiling or happy expressions by 6 months of age
- No back-and-forth communication with parents or other children through sounds, movement, expressions, or other behaviors at 9 months
- No response to their name, babbling, or back-and-forth gestures like pointing, rocking, or showing at 12 months
- No spoken words at 16 months
- No original meaningful phrases (phrases that are 2 words or more and that were not repeated after someone else) by 24 months
If your child exhibits any of the above signs, it is best to take them to a developmental specialist for autism screening. The earlier a child receives a diagnosis and subsequent therapy, the more likely it is that their symptoms will improve.
Older children will exhibit more complex behaviors such as impaired speech and/or understanding, avoidance and misunderstanding of social situations, inappropriate behaviors, repetitive actions, difficulty communicating about wants and needs, and other symptoms. No matter your child’s age, if you suspect that they may have autism or other developmental disorder, a visit to a specialist is the first step.
When your child visits the doctor for a regular well-child visit, it is suggested that he or she receives a developmental screening at the same time. Ideally, have your child screened for autism at ages 9 months, 18 months, and 30 months. Children at 18 and 24 months should all receive a specific evaluation for ASD as well.
Further developmental evaluation done by a specialist may require the parents and other family members to undergo evaluations and questionnaires as well in order to produce a complete understanding of the child’s environment and behaviors. After the evaluation, the specialist will advise you about whether or not your child needs specialized therapy or treatment, and if so, which therapies and treatments will be most effective.
What are the most common comorbid conditions for a Low-Functioning Autistic child?
There are a number of conditions that Low-Functioning Autistic children may develop either as part of the presentation of their disorder or as a result of common autistic behaviors. These comorbid conditions are listed below:
Common Comorbid Psychological Disorders
Anxiety is common in children with Autism Spectrum Disorders. The severity of this condition is often related to age, level of cognitive function, and the degree to which the child is socially impaired.
Major Depression is one of the most common comorbid ASD disorders that children experience. It is most common in ASD individuals who are going through adolescence.
Bipolar Disorder, also known as Manic Depression involves extreme oscillating moods causing those with this disorder to experience episodes of mania followed by profound depression.
Gender Dysphoria is the experience of discomfort related to gender identity. It occurs in transgender individuals. Autistic children are more likely to develop this disorder.
- Non-Verbal Learning Disorder
Non-Verbal Learning Disorder often overlaps with Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorders. It is a learning disorder characterized by difficulties with motor, visuo-spatial, and social difficulties.
Obsessive Computer Disorder (also known as OCD) is characterized by the presence of recurrent (obsessive) thoughts and the compulsion to perform certain actions. Approximately 30% of ASD individuals receive a comorbid OCD diagnosis.
Obsessive Compulsive Personality Disorder (OCPD) is different from an OCD diagnosis (described above). This personality disorder involves an excessive concern with perfectionism, attention to detail, the need for mental control, and control over one’s relationships and environment. About 40% of individuals who are diagnosed with Asperger’s Syndrome are also diagnosed with comorbid OCPD.
- Schizophrenia and other types of psychoses
Childhood-onset schizophrenia is often preceded by a diagnosis of Autism Spectrum Disorder.
This personality disorder is characterized by a lack of interest in typical social relationships and a tendency toward a solitary and sheltered lifestyle. Individuals with Schizoid Personality Disorder are often secretive and emotionally cold with a detached or apathetic attitude toward relationships.
Children who are diagnosed with ASD may manifest unusual responses to sensory stimulation. Comorbidity rates for sensory disorders are somewhere between 42-88% with ASD.
Sleep Disorders are common in individuals with ASD perhaps due to abnormalities in circadian rhythms and melatonin production in the brain.
Tourette Syndrome is characterized by motor and vocal tics that typically develop during childhood. Some experts believe that genetic abnormalities lead to dopamine, glutamate, and serotonin production problems that cause this disorder.
- Intellectual Disability
Approximately 25-70% of autistic children meet the criteria for intellectual disability.
Attention Deficit Hyperactivity Disorder or ADHD is a disorder that involves hyperactivity and difficulty with sustained attention. ADHD and ASD commonly co-occur.
Common Physical Comorbid Conditions
At least 25% of children with ASD also experience gastrointestinal problems including abdominal pain, diarrhea, constipation, and bloating. These issues may lead to an increase in negative behaviors including self-inflicted injury.
- Developmental Coordination Disorder
Developmental Coordination Disorder is characterized by a delay in acquiring normal motor skills in terms of dexterity, balance, and general physical coordination that are normally present at a particular age.
Epilepsy is a disorder that involves seizures due to abnormal brain electrical activity that may start in early childhood or adolescence.
Fragile X Syndrome is a genetically-based intellectual disability caused by a defective piece of the X chromosome. It is diagnosed in 2 to 5 % of individuals with ASD.
Research has demonstrated that individuals with ASD may have abnormalities in the way they metabolize folate, a B-vitamin. Research has shown that a number of ASD children who take folinic acid experience marked improvements in their behavior and clinical status.
Imbalances in the way glutathione is oxidized and metabolized in the body has been correlated with folate metabolism pathways that tend to be abnormal in children with ASD. By alleviating oxidative stress in the brain for children with ASD clinical trials have demonstrated substantial improvement in symptoms.
Mitochondrial diseases can affect multiple organ systems in the body in children with ASD with varying levels of severity. Symptoms vary but can include seizures, cognitive regression, diabetes, visual or hearing loss, neuropathy, stroke, encephalopathy, or organ failure.
Neurofibromatosis Type I is a multi-system disorder caused by a genetic mutation of chromosome 17. Children with ASD are more likely to have this genetic abnormality than children without the disorder.
Research has shown that the role of neuroinflammation in ASD may be triggered by folate and glutathione metabolism issues that result in high levels of oxidants and inflammation in the brain.
Neuropathy is a weakness, pain, or numbness in the extremities caused by nerve damage. Neuropathy is sometimes asymptomatic. This is a common manifestation of mitochondrial disease and it often appears as a comorbid condition with ASD.
About 35% of individuals suffering from Asperger Syndrome are affected by tinnitus (a ringing or buzzing sound in the ears that’s not caused by an external sound).
Tuberous Sclerosis is a genetic disorder that results in the development of benign tumors in the brain and other organs of the body. It has a strong correlation with ASD. Approximately 1-4% of Autistic Children receive a diagnosis of tuberous sclerosis.
Various vitamin deficiencies are more common in ASD children than in the general population. Common deficiencies include vitamin D, vitamin B12, vitamin B9 (folate), vitamin A, Zinc, Magnesium, and Calcium.
ABA Therapy Help for Low-Functioning Autistic Children
Applied Behavioral Analysis or ABA therapy is a type of treatment for autistic children that aims to improve their social and communication skills as well as their learning abilities by using positive reinforcement. For children with autism spectrum disorder and certain other developmental conditions, ABA is considered to be the gold standard in therapy. At Hidden Talents, we use ABA therapy to help parents and children better understand how both positive and negative behaviors develop and are maintained through relational transactions.
Children with Autism Spectrum Disorder learn differently than other children. They have unique skills and strengths and through ABA, our staff will determine not only your child’s weaknesses but also what skills and strengths they possess to help them overcome the challenges they face. By using an approach that actively looks for the child’s strengths and weaknesses, we can create a customized intervention plan for targeted treatment designed to promote positive behavior modification under the watchful eye of our trained BCBAs.
ABA therapy usually is administered in phases. The process begins with intake and an evaluation of the child. The intake coordination team obtains and records the necessary information to make sure your child receives the appropriate type and level of care. We then verify eligibility and seek an assessment from the child’s insurance company. We conduct an assessment of the child after insurance coverage has been verified.
During the assessment process, the child’s social environment is evaluated including the school, family, and the child’s level of functioning. A treatment plan can then be created and ongoing services are requested for the child.
During treatment, children are assigned a team of BCBA and ABA therapists who work together to provide personalized and comprehensive treatment. Once the treatment plan is being actively implemented, therapists will track your child’s progress and make adaptations to the plan to ensure that progress continues. At Hidden Talents, we pay attention to each child and customize their treatment plan, making modifications as children change and grow to ensure that they’re always working to achieve new levels of success.