What Is Severe Autism?

Explore the human side of severe autism with us. It's more than a label; it's about individuals with unique stories, strengths, and challenges.

steven zauderer
Steven Zauderer
June 29, 2024
min read

Understanding Severe Autism

Autism is a complex neurodevelopmental disorder that affects individuals in varying degrees. When it comes to severe autism, it refers to the more profound end of the autism spectrum. In this section, we will explore what severe autism is and the different levels of autism severity.

What is Severe Autism?

Severe autism is characterized by significant impairments in communication, social interaction, and behavior. Individuals with severe autism often require substantial support in their daily lives and may face challenges in various aspects of functioning.

Symptoms of severe autism can manifest early in childhood and may persist throughout an individual's life. While each person with severe autism is unique, common features include limited verbal communication abilities, difficulties in understanding and using nonverbal cues, and repetitive behaviors.

Different Levels of Autism Severity

Autism severity is commonly categorized into three levels based on the level of support an individual requires:

Autism Level and Description

Level 1

  • Requiring Support: Individuals with Level 1 autism require some support to navigate social situations and handle changes in routine. They may experience challenges in initiating and sustaining conversations and may display inflexibility in their behaviors.

Level 2

  • Requiring Substantial Support: Individuals with Level 2 autism require substantial support to communicate effectively, interact socially, and adapt to changes. They may exhibit more pronounced difficulties in social interactions and may engage in repetitive behaviors that impact their functioning.

Level 3

  • Requiring Very Substantial Support: Individuals with Level 3 autism require very substantial support across all areas of functioning. They may have severe impairments in verbal and nonverbal communication, limited social interactions, and significant difficulties in adapting to changes in their environment.

It's important to note that autism severity is not a measure of intelligence or potential. Individuals with severe autism can possess unique strengths and talents, and with appropriate support and interventions, they can lead fulfilling and meaningful lives.

Understanding the nature of severe autism and the varying levels of severity is crucial for providing appropriate support and interventions to individuals on the autism spectrum. By recognizing and addressing the specific challenges faced by individuals with severe autism, we can promote inclusivity, acceptance, and a better quality of life for all individuals on the spectrum.

Characteristics of Severe Autism

When it comes to severe autism, individuals may display a range of characteristics that significantly impact their daily lives. Understanding these characteristics is crucial for providing appropriate support and interventions. Here are three key features commonly associated with severe autism: communication challenges, social interaction difficulties, and repetitive and restricted behaviors.

Communication Challenges

One of the hallmark features of severe autism is communication challenges. Individuals with severe autism may have limited or no verbal language skills, making it difficult for them to express their needs, thoughts, and emotions. They may struggle with understanding and using spoken language, leading to difficulties in social interactions and everyday communication.

In addition to verbal challenges, individuals with severe autism may also experience difficulties with nonverbal communication. This can include challenges with understanding and using gestures, facial expressions, and body language. These communication barriers can often lead to frustration and may result in behaviors such as meltdowns or self-injury.

Social Interaction Difficulties

Social interaction difficulties are another common characteristic of severe autism. Individuals with severe autism may struggle to understand social cues, norms, and expectations. They may face challenges in initiating and maintaining conversations, interpreting others' emotions, and forming meaningful relationships.

The inability to engage in reciprocal social interactions can lead to social isolation and feelings of loneliness. These individuals may exhibit behaviors such as avoiding eye contact, not responding to their name being called, or appearing disinterested in social interactions. It's important to provide support and create inclusive environments that foster social connections for individuals with severe autism.

Repetitive and Restricted Behaviors

Repetitive and restricted behaviors are often observed in individuals with severe autism. These behaviors can manifest in various forms, such as repetitive body movements (e.g., hand-flapping, rocking), fixations on specific objects or topics, and adherence to strict routines or rituals. These behaviors can provide a sense of comfort and predictability for individuals with severe autism.

Additionally, individuals with severe autism may display intense interests in specific topics, often referred to as "special interests." These interests can be highly focused and may dominate their thoughts and conversations. While these behaviors can be seen as unique strengths, they can also interfere with daily functioning and social interactions.

Understanding and recognizing these characteristics of severe autism is essential for creating supportive environments and developing tailored interventions to meet the unique needs of individuals with severe autism. By promoting understanding and acceptance, we can ensure that individuals with severe autism are valued members of our communities.

Sensory Sensitivities in Severe Autism

Individuals with severe autism often experience sensory sensitivities that can significantly impact their daily lives. These sensitivities can manifest in various ways, including sensory overload and hypersensitivity to stimuli. Understanding and addressing these sensory challenges is crucial for providing appropriate support and interventions.

Sensory Overload

Sensory overload occurs when an individual with severe autism becomes overwhelmed by their sensory environment. Everyday sounds, lights, smells, and textures that may seem ordinary to others can become overwhelming and distressing for individuals with severe autism.

During sensory overload, individuals may exhibit behaviors such as covering their ears, shutting their eyes tightly, or becoming agitated or anxious. It's important to create a calm and quiet environment to help reduce sensory overload and provide a sense of comfort.

Hypersensitivity to Stimuli

Hypersensitivity to stimuli is another common sensory sensitivity experienced by individuals with severe autism. This means that they may have an exaggerated response to certain sensory input. For example, a seemingly harmless touch or a mild noise can be perceived as painful or extremely uncomfortable.

To better understand the hypersensitivity experienced by individuals with severe autism, let's take a look at some examples:

Type of Sensory Stimuli and Hypersensitivity Response


  • Overwhelmed by loud noises
  • Distressed by unexpected or sudden sounds


  • Discomfort or pain from bright lights
  • Difficulty focusing under fluorescent lighting


  • Avoidance of certain textures or fabrics
  • Sensitivity to light touches or pressure


  • Strong aversion to certain odors
  • Overreacting or becoming distressed by common smells

By recognizing and acknowledging the sensory sensitivities specific to each individual with severe autism, appropriate accommodations can be made to help them navigate their environment more comfortably. This may involve creating sensory-friendly spaces, using noise-cancelling headphones, providing visual schedules, or using alternative communication methods to reduce sensory overload.

Understanding the sensory sensitivities associated with severe autism is essential for caregivers, educators, and healthcare professionals to provide the necessary support and interventions that promote a more inclusive and accommodating environment for individuals with severe autism.

Co-occurring Conditions with Severe Autism

Individuals with severe autism may often experience co-occurring conditions that can impact their daily lives and overall well-being. Two common co-occurring conditions with severe autism are intellectual disability and anxiety and depression.

Intellectual Disability

Intellectual disability, also known as intellectual developmental disorder, is a condition characterized by limitations in intellectual functioning and adaptive behavior. It is estimated that approximately 70-75% of individuals with severe autism also have co-occurring intellectual disability.

Intellectual disability can vary in severity, ranging from mild to profound. It can affect an individual's ability to learn, reason, solve problems, and acquire new skills. The presence of intellectual disability alongside severe autism may impact the individual's overall cognitive abilities and may require additional support and accommodations in educational and everyday settings.

Anxiety and Depression

Anxiety and depression are common co-occurring conditions in individuals with severe autism. The challenges associated with communication difficulties, social interactions, and sensory sensitivities can contribute to increased levels of anxiety and depression.

Anxiety disorders, such as generalized anxiety disorder, social anxiety disorder, and specific phobias, are prevalent among individuals with severe autism. These individuals may experience excessive worry, fear, and difficulty coping with everyday situations. It is important to note that anxiety in individuals with severe autism may manifest differently compared to neurotypical individuals.

Depression, characterized by persistent feelings of sadness, loss of interest, and changes in appetite and sleep patterns, can also affect individuals with severe autism. The communication and social challenges faced by individuals with severe autism may contribute to feelings of isolation, which can increase the risk of developing depression.

It is essential for caregivers and individuals with severe autism to be aware of the potential presence of co-occurring conditions like intellectual disability, anxiety, and depression. Recognizing and addressing these conditions through appropriate interventions and support can greatly enhance the quality of life for individuals with severe autism.

Support and Interventions for Severe Autism

Individuals with severe autism often require specialized support and interventions to help them thrive and reach their full potential. These interventions are designed to address the unique needs and challenges associated with severe autism. Here are three key support and intervention strategies commonly used for individuals with severe autism: Individualized Education Plans (IEPs), Applied Behavior Analysis (ABA), and Speech and Occupational Therapy.

Individualized Education Plans (IEPs)

An Individualized Education Plan (IEP) is a customized education plan developed specifically for students with special needs, including those with severe autism. The purpose of an IEP is to outline the educational goals and objectives tailored to the individual's unique strengths and challenges.

The IEP team, which typically includes parents, teachers, and other professionals, collaboratively creates the plan. It identifies the student's current abilities, areas of improvement, and the accommodations and supports required to facilitate their learning. The IEP may include specialized instruction, assistive technology, modifications to the curriculum, and additional support services.

The goal of an IEP is to ensure that the student receives an appropriate education that addresses their individual needs, promotes academic progress, and supports their overall development.

Applied Behavior Analysis (ABA)

Applied Behavior Analysis (ABA) is a widely recognized and evidence-based approach used to support individuals with autism, including those with severe autism. ABA focuses on understanding and modifying behavior by applying principles of learning theory.

ABA interventions are highly individualized and target specific behaviors, such as social skills, communication, and daily living skills. These interventions are structured, systematic, and often involve breaking down complex skills into smaller, more manageable steps.

ABA techniques may include positive reinforcement, prompting, shaping, and fading. By using these techniques, individuals with severe autism can learn new skills, reduce challenging behaviors, and increase their independence and overall quality of life.

Speech and Occupational Therapy

Speech and Occupational Therapy are crucial interventions for individuals with severe autism to address communication and sensory challenges.

Speech therapy focuses on improving communication skills, including speech production, language comprehension, and social communication. Therapists use various techniques, such as visual supports, augmentative and alternative communication (AAC), and social scripts, to support individuals with severe autism in developing their communication abilities.

Occupational therapy aims to enhance the individual's functional skills and independence in daily activities. Occupational therapists work on sensory integration, fine motor skills, self-care skills, and adaptive behaviors. These interventions help individuals with severe autism develop the skills needed to participate in daily life activities and engage meaningfully with their environment.

It's important to note that interventions for severe autism should be tailored to the individual's specific needs and strengths. A combination of these interventions, along with a multidisciplinary approach involving parents, caregivers, and professionals, can provide comprehensive support for individuals with severe autism, enabling them to lead fulfilling and meaningful lives.

Embracing Individuals with Severe Autism

It is vital to recognize that individuals with severe autism have unique strengths and challenges. By promoting inclusion and acceptance, we can create a more understanding and supportive society. Here are two important ways to embrace individuals with severe autism:

Promoting Inclusion and Acceptance

Promoting inclusion means creating an environment where individuals with severe autism are welcomed and respected. It involves providing equal opportunities for participation in various aspects of life, such as education, employment, and community activities.

In schools, inclusion can be facilitated through the implementation of inclusive education practices. This involves providing appropriate support and accommodations to ensure that students with severe autism can actively engage in the learning process alongside their peers. It may include individualized education plans (IEPs), personalized teaching strategies, and collaboration with specialists, teachers, and parents.

In the workplace, promoting inclusion means creating an inclusive culture that values the contributions and abilities of individuals with severe autism. Employers can make reasonable accommodations to support individuals with autism in their job roles, such as providing clear instructions, minimizing sensory distractions, and offering flexible work schedules when possible.

In the community, fostering inclusion involves raising awareness and understanding about autism. It means encouraging acceptance and respectful interactions in public spaces, leisure activities, and social events. Community organizations can organize autism-friendly events and provide accessible resources to support individuals with severe autism and their families.

Celebrating Neurodiversity

Neurodiversity is the understanding and acceptance of neurological differences, including autism. It recognizes that autism is a natural variation of the human brain, and individuals with autism have unique strengths and perspectives to offer.

By celebrating neurodiversity, we can challenge stereotypes and promote a more inclusive society. This involves acknowledging and appreciating the diverse talents and abilities of individuals with severe autism. It also means recognizing their potential for growth and development, while providing support and accommodations tailored to their specific needs.

Celebrating neurodiversity can be achieved through initiatives such as autism acceptance campaigns, art exhibitions featuring the works of individuals with autism, and public discussions that highlight the strengths and achievements of individuals with severe autism.

By promoting inclusion and acceptance, and celebrating the rich diversity of neurodiversity, we can create a society that values and respects individuals with severe autism. It is through understanding, support, and inclusion that we can make a positive difference in their lives and foster a more inclusive and accepting world for all.


Let's shift our focus to the individuals behind the term. It's not just about a label; it represents real people with unique stories, strengths, and challenges. Understanding severe autism requires a nuanced perspective that goes beyond a mere classification.

In our shared journey, let's approach this with empathy, recognizing that each person's experience is deeply personal. Rather than defining individuals by the severity of their autism, let's celebrate their resilience and the distinct qualities that make them who they are.

Together, let's foster a world where compassion and acceptance guide our interactions, creating environments that support and uplift everyone, regardless of where they fall on the autism spectrum.


steven zauderer

CEO of CrossRiverTherapy - a national ABA therapy company based in the USA.

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