How much input should a patient with ASD Level 3 have in their care plan?

For individuals with Level 3 Autism Spectrum Disorder (ASD), who require very substantial support, involving them in healthcare decisions can be particularly challenging due to more significant difficulties with communication and social interactions. However, it's still important to include them as much as possible in decisions about their care, adapting the approach to accommodate their unique needs.

Here are some strategies that might be employed:

Enhanced Communication Supports: Individuals with Level 3 ASD might benefit from more robust communication aids, such as advanced assistive communication devices or tailored communication methods developed in collaboration with speech-language pathologists.

Involvement of a Multidisciplinary Team: A team that includes caregivers, therapists (like occupational, speech, and behavioral therapists), and medical professionals can help interpret the individual’s behaviors and preferences as part of the decision-making process.

Routine and Familiarity: Keeping the environment and personnel consistent can help reduce anxiety and improve communication. Individuals with severe ASD often respond better in familiar settings with people they recognize.

Legal Guardianship and Advocacy: Many individuals with Level 3 ASD may have a legal guardian who makes formal health care decisions on their behalf. Even so, efforts should be made to ascertain the individual's likes, dislikes, and comfort levels to guide these decisions empathetically and ethically.

Simplified Decision-Making Processes: Breaking down decisions into simpler, more concrete choices can help in eliciting preferences from someone with significant communication barriers.

The focus is on respecting the dignity and rights of the individual, providing them with the support needed to have as much influence as possible over decisions affecting their health and well-being. This approach emphasizes a person-centered care model, which is tailored to the individual’s specific needs and circumstances.

Note: There is no one size fits all with ASD. I use the levels here as a placeholder for the ability to consent.