Does anyone else like the USA level system (or is it just me)

I don't often find myself preferring the USA medical or clinical systems, so this is a new one for me, but...

I have to say, for me, having a simple way to say my level of autism quickly would be extremely helpful (I'm wondering if this is just because I still have speaking and language challenges).

I understand that they are limited and don't give a true picture of the level of support needs that exist for autistic people, and everyones experince differs and can not be placed into 3 simple boxes, but I think there is a place for them.

For me, the levels would allow me to quickly say to people, mainly professionals, what my support level is (not my support needs, just the level).  It would reduce misunderstanding, conflict, frusutration and gaslighting, and it would reduce the trauma I experience.

I also feel the levels should be updated, as I believe there are more than 3.

I think at least 4 should be introduced, I think:

Level 4 - Profound Autism and High Need (with or without intellectual disability)

Level 3 - Early Developmental Delays and Significant Need (with or without intellectual disability)

Level 2 - No Early Developmental Delays and Moderate Needs (similar to the old Asperger's profile)

Level 1 - Not meeting diagnostic criteria but recognised Neurodivergent brain writing - low or no support needs (I think it's important that this is clinically recognised as it could help people manage their mental wellbeing better with better understanding and better treatment options).


Parents
  • Personally I prefer to use low/high support for labels, but my brain really likes the neat organization of using levels to categorize. So I’m really torn about it, honestly. So I stick with low/high support, but I don’t get offended if someone else uses the level system.

  • I think low/high works if you fit either one of those categories, what if you are neither low nor high but in the middle (like the USA level 2).

    This is where I think low/high levels fail. I think everyone knows what high needs mean (in theory anyway), and low need again is a concept that is also easier to grasp (even if I think sometimes low needs are unfairly trivialised).

    Neither of these describes or aligns with people like me, who are neither low nor high; we are somewhere in the middle.

    This is my point about the current system working well for some but not others.

    Most people just assume I'm low need because I'm high masking (which I can understand), but this means I have to then explain that I have higher needs, which often is greeted with scepticism until I explain the significant developmental delays I had in childhood and the hangover of these into adulthood. 

    People generally get it in the end, but only after I've had to overshare my personal details just to get understanding and acceptance. This is both exhausting and soul-destroying in equal measures.  Having a label/level (level 2) would remove the whole trauma of having to do this over and over again.

    I am keen to try to understand why others don't like labels and levels. I know some people are passionate about labels being minimal, and I need and want to understand why.  Do labels cause them heartache and exhaustion (like the lack of them does for me) or is it just more about identity and how they want the world to view them (are they just more comfortable with it just being high or low)??


  • You bring up a lot of great points why the point system is better than the support system, and I’m ashamed to say that I don’t have as many points why I somewhat prefer the support system. I especially understand that there does need to be a medium, as there are some that need more support than I but would not necessarily need “high” support.

    Do labels cause them heartache and exhaustion (like the lack of them does for me) or is it just more about identity and how they want the world to view them (they are more comfortable with it just being high or low)??

    I think between these two options I fall more under the latter. Level 1 makes it sound like I need no help at all whereas low support shows that I do need some support. So it’s more of I would personally like to be viewed as low support rather than level 1. I hope that makes sense? I’m not sure if I do make sense lol

  • That makes total sense to me.

    I totally get how frustrating it is when people think you're low support and immediately trivialise your needs. This is normally where I start with people before I overshare, and the conversation changes.

    Low need (level 1s) defo need understanding and support, I'm sick of the level of gaslighting that occurs for people with low need (level 1), it's horrendous and sad TBH.

    I think there needs to be another category below low or level 1s (or maybe a whole new grading system, who knows).

    I have older and younger high-needs autistic relations and several low-needs autistic relations (all diagnosed), and it seems I'm the only level 2 in my family.

    However, there are several family members whose brain wiring aligns more with neurodivergence than neurotypical; they are unlikely to meet the diagnostic criteria, but they struggle for connection and understanding every day.  I think they need to be acknowledged and have their own category. This would stop them from being linked to low need (level 1), which will hopefully reduce the scepticism and gaslighting of low need/level 1s experience.  But also, they should have the right to connect with like-minded people and be considered part of the neurodivergent community. I think we need to embrace them and celebrate them just as much.

    I also think there are bigger issues, as from my experience, this non-need group do have needs that present similarly to neurotypical levels.  However, neurotypical treatment options (that are normally the standard route for them) often don't work particularly well.  An example is anxiety, treated with mood stabilisers, which just made the person's mood worse.  When treated with a low ADHD dose, the anxiety went away with no side effects. 

    I've also seen family members just become happier with themselves now that they understand they are neurodivergent, they give themselves more grace, time and forgiveness and carry less guilt and burden.  They then start trying strategies instead of becoming overemotional or defensive.  Honestly, my diagnosis has had such a positive ripple effect for my wider family its been amazing and uplifting to watch (it's this group that seemed to have got loads from it TBH and without any intervention or support, just self-awareness).

Reply
  • That makes total sense to me.

    I totally get how frustrating it is when people think you're low support and immediately trivialise your needs. This is normally where I start with people before I overshare, and the conversation changes.

    Low need (level 1s) defo need understanding and support, I'm sick of the level of gaslighting that occurs for people with low need (level 1), it's horrendous and sad TBH.

    I think there needs to be another category below low or level 1s (or maybe a whole new grading system, who knows).

    I have older and younger high-needs autistic relations and several low-needs autistic relations (all diagnosed), and it seems I'm the only level 2 in my family.

    However, there are several family members whose brain wiring aligns more with neurodivergence than neurotypical; they are unlikely to meet the diagnostic criteria, but they struggle for connection and understanding every day.  I think they need to be acknowledged and have their own category. This would stop them from being linked to low need (level 1), which will hopefully reduce the scepticism and gaslighting of low need/level 1s experience.  But also, they should have the right to connect with like-minded people and be considered part of the neurodivergent community. I think we need to embrace them and celebrate them just as much.

    I also think there are bigger issues, as from my experience, this non-need group do have needs that present similarly to neurotypical levels.  However, neurotypical treatment options (that are normally the standard route for them) often don't work particularly well.  An example is anxiety, treated with mood stabilisers, which just made the person's mood worse.  When treated with a low ADHD dose, the anxiety went away with no side effects. 

    I've also seen family members just become happier with themselves now that they understand they are neurodivergent, they give themselves more grace, time and forgiveness and carry less guilt and burden.  They then start trying strategies instead of becoming overemotional or defensive.  Honestly, my diagnosis has had such a positive ripple effect for my wider family its been amazing and uplifting to watch (it's this group that seemed to have got loads from it TBH and without any intervention or support, just self-awareness).

Children
No Data