My experience living with Medium Support Needs

"Being MSN or level 2 is a state of being independent and dependent at the same time'

I want to write about my experience living with medium support needs. It is an experience that is not frequently talked about in the broader autism community as I only hear about low support needs or high support needs either by autism parents of high support needs autistics or low support needs content creators. I consider medium support needs to be the “middle child” on the autism spectrum as it is frequently overlooked and underrepresented. This is why I am going to talk about my experience.

Although I was diagnosed in the 90’s before support needs labels and autism levels (in the U.S. and other countries that use the DSM V, autism is broken down into three support levels: 1,2,3) were a thing, I was told by my therapist that I was level 2 or moderate support needs. For the longest time, I thought I was low support needs but when I saw and listen to the experiences of other low support needs autistic people, I couldn’t relate to a lot of them. They had a higher level of independence and were able to achieve a lot of neurotypical adult “milestones” even though it caused a lot of burnout and mental health issues. I also know some low support needs autistic people in real life and they are at a higher level of independence than myself.

Being moderate support needs (MSN), my struggles are more than navigating a neurotypical world like how it is for most low support needs autistic people. I don’t just need support when I am in burnout. It impacts day-to-day functioning. While I don’t need 24/7 care and can dress, use the toilet and bathe myself, I cannot function in society without significant supports. I need help with grooming, cooking, cleaning, budgeting etc. Not only do I need help with home living tasks but need help with socializing, going out in the community as I don’t drive and need help learning public transportation routes. I can only mask for short periods of time before I get overwhelmed. I have a lot of classic stereotypical traits like hand flapping, jumping etc. I socially withdraw and get easily overstimulated. My executive functioning abilities and fine motor issues significantly impact my independence.

Being MSN or level 2 is a state of being independent and dependent at the same time. While I am fully verbal and have accomplished some things like completing postsecondary education (though I faced a lot of mental health challenges) and can sort of work part time, I require support services through the government and that is something I am always going to need. My strengths and challenges are very perplexing to people as there are things that I do really well but struggle significantly with daily living and social skills.

One thing I want people to know is that medium support needs is a spectrum. Some MSN people are closer to low support needs while others are close to high support needs. Some people have partners and can drive but maybe they are unable to work and their partner has to act like a “caregiver” to them. Some of us are late diagnosed but others are early diagnosed. But, the one thing most of us can agree is we need more representation in the broader autism community.