What is the difference between HFA, moderate and severe?

[claw4]

Ds has a dx of general ASD, he is quite high functioning in some areas, not so high functioning in others.

Is it learning difficulties, or just difficulties, behaviour, functional ability etc? Is there a criteria?

No criteria. People make it up according to their own agendas.

DS is 'severe' according to the SENCO When I complain thar DS hasn't made adequate progress, but 'high functioning' according to the HT when I subsequently complain that his 1:1 is working with other children in another class.

That sounds about right Star!

What got me questioning this is that school SENCO commented to a expert that my ds 'wouldnt be considered 'severe' enough' for the ASD unit attached to school.

Academically ds is ok, he has good use of language, although his social use is impaired, concrete and literal. Social skills the same, he wants to interact, just cant do it appropriately. He is well behaved, although often confused. He struggles with PE and coordination, lots of sensory difficulties. His social imagination is limited.

Although i would and by probably by anyone elses standards say that his eating is 'severe', his anxiety is 'severe', repetitive behaviours could be classed as 'severe' ie the constant scratching.

So im assuming the ASD unit, is ony for children who are behind academically or show challenging behaviour.

So what? You already know she talks bollocks.

Ask her for the published criteria and insist that this includes definition of severe as well as required evidence. If you can be bothered that is!

Ha! tell like it is, that made me laugh.

I will bear that in mind, its not something that i am going to question immediately as i also need a statement to access. I have recently been asked for my 'parents view' for forthcoming AS team meeting, i will let her get over that first.

I was just wondering myself, where i would class ds.

The same as everyone else I guess, according to your agenda!

I mean all classifications are correct aren't they?

I see what you mean, i suppose i class him as exactly as i said in my OP, HF in some areas, severe in others!

Different for everyone, just wondered if there was an official or even unofficial standard criteria, similar to the difference between Aspergers and more general ASD. I was told ds's early speech delay, was the difference between those and also his functional ability.

Thanks.

dd1 has a dx of general ASD (she was dx'd at 2, though, and the paed said she didn't want to make predictions, as no one knew where on the spectrum she was. at that point i was , as then dd1 was severe. very severe, by all criteria)

dd1 undoubtedly has some learning difficulties. it is hard ot gauge exactly how severe these are, due to her age, her language disorder and her unwillingness to be tested (she turns the test into a social experiment of ehr own and gives deliberately wrong answers to see what the ed psych will do )

however, in the areas we can track and translate across (a very rough and ready home-done guide), she is about 18 months/2 years behind, and catching up all the time - it seems to be her language disorder holding her back, she certainly ha the ability ot learn, iyswim. academically, she could be differentiated for in a ms classroom - her numeracy and literacy are behind, but she can manage a good part of it all (when explained well, differentiated for properly etc)

nevertheless, she is in a school that caters for 'severe ASD', and she will stay there as long as we can fight for the place. beause what does need managing is her anxiety, her stress levels, and her tendency to extreme passivity when anxious (ie she would sit down, shut up, not bother anyone but not learn anything either!). now that she is int he 'right' environment, she is learning, and comfortable, and doing really well.

we were told several times that she was not 'severe enough' for:

the SN nursery placement
the ASD base
any amount of 1:1

when we started to prove that she could actually learn, the argument flipped - she could only be put into a SN PMLD school (ie they accepted what we said, but not fully - they were placating us with a 'hmm, yes, we see you think your dd can progress, but thee is no proof of this in a school setting. she'd best go to the generic special school, as the differences in her behaviour between home and school are extreme'(not in a bad way - she reacted and interacted at home, and withdrew at school))

when we bit the bullet and put her into the school we knew would work for her (luckily we could just about afford this), and it did work, the acceptance from the LA ws comlpete - 'oh yes, she is clearly in a place that works for her now'/

but initially, we were laughed out of the room for wanting such an extreme placement - 'oh, but she is not nearly 'severe' enough to go there. that's for children with serious challenging behaviours and learnign difficulties' etc etc.

it's all horseshit, tbh, and only goes to show that mostly, the people tellign you these things don't even know their arse from their elbow.

oh, and I guess dd1 would be seen as 'moderate' these days. in general.

she is social, flexible, no real behavioural issues. she is clearly disabled, but can get by well enough (for a 7 year old! ), but still not with children - she is far too confused by them, and cannot keep up linguistically.

Thanks Silver, I have added a watch to this thread, so i can refer back to it in future.

To be honest i havent seen much improvement since ds received his dx at 5 and half, he is now 8.

I have found his dx report highlighted all his difficulties in order to give him a dx and since then they have done nothing but play them down (other than private experts)

For example the specialist SALT who gave dx, identified that ds's basic language was quite well developed and his formal assessments were average, but his social use of langauge was quite impaired. All NHS SALT (his colleague) who was sent into school following dx to supply a programme) has done is to keep reassessing his average scores, where he never had a problem in the first place.

He has difficulties with things such as seperating fantasy from reality, rigid thinking, talking to someone and them actually understanding what the hell he is talking about.

Every other expert who has been into school including LA experts, has commented about his conversation not making sense to them. But as long as he scores on average centile during formal assessments, he doesnt have a problem!

My son is 11 and in mainstream. He transfers to secondary in Sept. he is classed as high functioning. Good reader. Very good vocabulary. Socially, he struggles massively.

He has a place at a local high school with asd unit attachment, because his academic work has been horribly affected by high anxiety and now, OCD.

Hotheadpaisan..... Welcome to my world.

All throughout ds' life, at every turn, I've been told "it's only mild", "he's very bright", "he's not THAT bad" and "he's not bad ENOUGH to qualify for this, that, whatever. Now, at 11, he needs to go to a high school with asd unit attachment. I can't get I'm out of the bloody house and there are days I'd like to hand him over to his dad, my ex whose only bit of input after asd diagnosis was "I hope you're happy ow he's got a label!", and see how he gets on with it! Ds goes to see his dad every fortnight. He's a mess before he goes and an even worse mess on return. Oh, and his dad left 4 weeks after diagnosis. He couldn't cope with "it".

I should add, my son has a Statement, because I pushed for it. He has DLA and mobility because I again, battled for it. We had a Blue Badge, cause I'd collected so many bloody parking tickets in trying to get ds as close as possible to his destination, but he's now been deemed "not bad enough" once again.

The fight goes on. And on. And on.....

Severe autistic behaviours I have seen (from teenagers):
Non verbal or verbal communication limited to a few phrases to get needs met
Not toilet trained
Pica
Smearing
Aggression as a firm of communication, trigger unknown
Self injurious behaviour
Little or no interest in engaging with other people or activities/toys

Obviously not a clinical diagnostic list, but enough to give you an idea I hope?

I would say in regards to severe that there is severe autism, severe spikes within autism and very severe autism. DS2 is non verbal, has very limited communication ability, no awareness of safety and in nappies he is however the least autistic (in the strerotype of autism) child I have met, no meltdowns, very mild stimming and loves noise, lots of people and his favourite place in the world in the supermarket. He has severe problems but at present (primary age) mild autistic behaviours. It comes in all shapes and sizes.

I think it is relates to your own experience, my ds is almost non verbal, attends a special school, has learning difficulties, not toilet trained, smeares, has no sense of time and is happy in his own world but likes to interact with people and tries to communicate. I see children at his school who I would consider much more severe than ds - shut off from the world, violent, no social skills etc

To me high functioning means kids who are able to go to mainsteam, join out of school activities and can deal with everyday life using coping mechanisms.

We all have our own scale!!!

it depends i guess if you are looking at functional ability or academic ability.
My ds may be condsidered as moderate in terms of functional ability but severe in academic terms

his latest report from psych has his adaptive behaviour as very severe.. but i dont see him like that at all.. amybe we are just used to working around his little ways.

My dd13 is diagnosed with mild to moderate ASD. I'm guessing the mild is because of her average/above average academic ability and early speech and moderate as her functional ability is quite poor. It's creating major problems with finding the right school for her and getting any social services support! Not enough coping skills to deal with mainstream but too bright for special school!

This would be my position for ds (11) in Sept. we visited a special school and it wouldn't have been the right setting for him. The big secondary in our catchment was all wrong too. The high school he's actually going to (mainstream, with integrated asd unit attachment) is (hopefully) just right.

It's like "The Three Bears"!

I read that the high functioning/low functioning definition relates to someones IQ but that the description of mild/moderate/severe relates to how much autism impacts their life. So you could have a child with a high IQ but their autism impacts them quite a lot. So they could be high functioning but have moderate autism. On the other hand they could have a low iq with fewer ASD symptoms and be MLD (moderate learning difficulties) with mild autism. It made sense to me but I'm sure there are people who would disagree

Running, that tallies with my experience too.

My list isn't a definitive one that all people with ASD must show, btw, more examples I observed of the 20-30 people I have met with that diagnosis...

" Severe autistic behaviours I have seen (from teenagers): Non verbal or verbal communication limited to a few phrases to get needs met
Not toilet trained
Pica
Smearing
Aggression as a firm of communication, trigger unknown
Self injurious behaviour
Little or no interest in engaging with other people or activities/toys"

Without wanting to be picky, purple, that list isn't specific to ASD, is it? Many learning disabilities will affect a child to the extent that they display those behaviours.

I think the real unravelling comes when you separate out the autism itself from any associated or incidental learning difficulties.

I'm just a support worker giving what may or may not be useful information, Lougle. I'm not a psychiatrist, I haven't done extensive research into hundreds of cases, I've just worked with people.

I'm also being very general because of confidentiality.

I've only ever seen you post comments trying to show how wrong I am. This is not a thread about me, it's a discussion to try and help others. So I would respectfully request that you concentrate on expressing your own experience and opinion without trying to critique mine