Autism spectrum disorder (ASD) affects people in different ways. Some may need substantial support in daily life, while others can live more independently. Understanding the levels of autism can help people get the assistance they need.
In this comprehensive guide, we’ll cover:
- What autism spectrum disorder is
- The DSM-5 levels of autism
- The symptoms and support needs for each level
- Resources for getting help and services
We’ll also share tips for supporting autistic children and adults. Our goal is to empower you with knowledge so you can improve life for those with autism.
What is Autism Spectrum Disorder?
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by:
- Differences in social communication and interaction
- Restricted, repetitive behaviors and interests
- Sensory processing differences
The word “spectrum” indicates that autism affects each person differently. There’s a wide range of support needs, challenges, and abilities.
Autism often comes with strengths as well like:
- Attention to detail
- Deep focus and interests
- Visual thinking
- Honesty and loyalty
The diagnosis focuses on the support someone needs, not their abilities. With the right assistance and accommodations, autistic people can thrive in school, work, and life.
The DSM-5 Levels of Autism
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) categorizes autism into 3 levels of support needs:
Level 1: Requiring support
Level 2: Requiring substantial support
Level 3: Requiring very substantial support
These levels give a general idea of how much help someone needs in areas like:
- Communication
- Social skills
- Organization
- Transitions
- Self-care
- Restrictive/repetitive behaviors
But support needs can vary day-to-day or by environment. Just because someone qualifies for one level doesn’t mean they’ll always need that degree of help.
Next, we’ll explore the specific symptoms and needs for each level.
Level 1 Autism: Requiring Support
People with level 1 autism don’t typically show obvious symptoms. They can communicate through speech and have conversations. But social nuances and nonverbal communication may remain challenging.
Communication Differences
Those with level 1 autism have mild difficulties with social communication. For example, they may:
- Struggle to start conversations or interact socially
- Respond atypically to social initiations from others
- Have limited interest in relationships
- Dislike back-and-forth conversation
They can speak fluently but may have monotone or pedantic speech. Reading subtle cues in conversation is difficult. Figurative language like sarcasm, metaphors, and idioms often goes over their heads.
Restricted & Repetitive Behaviors
Level 1 autism also involves restricted, repetitive patterns of behavior. The person may:
- Insist on rigid routines and get upset if they change
- Have highly fixated interests and struggle to talk about other topics
- Have difficulty with transitions, organization, and time management
- Display repetitive motor movements like flapping, rocking, or spinning
These behaviors aren’t necessarily obvious to casual observers. But they do cause impairment for the individual.
Other Common Traits
Those with level 1 autism may also:
- Be overly sensitive to noises, textures, and other sensory input
- Experience high anxiety and depression
- Have sleep disturbances or gastrointestinal issues
- Display intense focus and attention to detail
They usually have average or above-average intelligence. But they still need accommodations and support to reach their full potential.
Level 2 Autism: Requiring Substantial Support
Level 2 autism is characterized by more obvious impairments in communication and social interaction. The person generally has limited speech and struggles more with changes.
Communication Challenges
People with level 2 autism show greater deficits in verbal and nonverbal communication. For example:
- They have limited speech or often repeat set phrases and quotes
- Conversations are difficult even with support
- Responses to social approaches are absent or odd
- They don’t initiate social interaction or make eye contact
Language and speech issues are more pronounced. But they can communicate basic needs through short phrases or augmentative devices.
Increased Restricted & Repetitive Behaviors
Level 2 autism also involves more restrictive, repetitive behaviors that interfere with functioning. The person is likely to:
- Have extreme distress over small changes in routine
- Display obvious repetitive motor behaviors constantly
- Develop rituals that disrupt daily life
- Have intense, fixated interests in certain topics
- Struggle severely with transitions and time management
Additional Support Needs
Those with a level 2 diagnosis typically have:
- Uneven skill development, with delays in daily living skills
- Challenging behavior when upset or overstimulated
- High anxiety and difficulty regulating emotions
- Sensory sensitivity that disrupts functioning
A level 2 autistic person can often learn self-care skills like dressing, bathing, and feeding themselves with special education support. But they require help with communication, social skills, and coping.
Level 3 Autism: Requiring Very Substantial Support
Autistic people at level 3 have severe communication challenges and repetitive behaviors that require maximum support. Most can’t live independently without full-time assistance.
Profound Communication Impairment
Those with level 3 autism show little to no functional communication or speech abilities. They:
- Rarely speak, or only say set words/phrases
- Don’t communicate through writing, sign language, pictures, etc.
- Don’t initiate or respond to social interaction
- May not understand basic language
It’s difficult for them to make even basic needs known. Augmentative communication devices provide limited benefit due to comprehension issues.
Extreme Restricted & Repetitive Behaviors
People with level 3 autism also display repetitive behaviors that severely inhibit functioning:
- Highly restricted interests that can’t be interrupted
- Repetitive, self-injurious behaviors like hand flapping or head banging
- Extreme distress and tantrums when routines are changed
- Rituals and rigid behaviors that disrupt daily activities
These repetitive actions are constant and difficult to redirect. The person relies heavily on structure and sameness.
Substantial Support Needs
In addition, those with level 3 autism have extreme difficulty with:
- Academic learning and cognitive skills
- Adaptive living skills like dressing, bathing, or feeding themselves
- Safety awareness and impulse control
- Regulating emotions, sensory input, and behavior
They require 24/7 supervision for safety and support. Most don’t achieve independence in adulthood but can learn basic life skills with intensive, full-time therapy.
Getting the Right Support for Autism
Every autistic individual has unique needs. But understanding the general levels can help you find appropriate services and assistance. Here are some tips for accessing help:
- Get evaluated by an experienced professional. They can diagnose ASD and indicate a level.
- Talk to your school. Ask about special education services like social skills training, speech therapy, and occupational therapy.
- Contact your regional center if you’re in the U.S. They coordinate services for those with developmental disabilities.
- Look into Medicaid waivers like the Home and Community-Based Services Waiver that pays for therapies and support.
- Find an ABA therapist to work on communication, behavior, and life skills.
- Consider assisted living if your loved one needs full-time care. There are facilities specifically designed for adults with autism.
- Connect with community autism resources. They offer everything from respite care to job coaching.
- Join an autism support group. Connecting with other families helps you find programs and share advice.
- Advocate for accommodations at school and work like sensory breaks, headphones, and extended time on tasks.
The right interventions make all the difference. With support, those with autism can gain skills, confidence, and independence.
Resources for Autism Information and Support
Here are some top autism organizations to turn to:
- Autistic Self Advocacy Network: Run by and for autistic people. Provides resources, advocacy, and support.
- Autism Society: Offers information, tools, and referrals on lifespan autism services.
- Autism Speaks: Funds autism research and advocacy efforts. Has a help line and local resources.
- National Autism Association: Provides education and safety resources for families.
- Autism Research Institute: Funds biomedical research and alternative therapies.
- The Arc: Advocates for rights of those with intellectual disabilities. Offers advice and referrals.
There are also excellent online communities where you can connect with others, ask questions, and find tips. Some to check out include Wrong Planet, Autism Forums, and Autism Parenting Magazine.
You’re not alone on this journey. There are many organizations working to improve understanding of autism and help families thrive.
Get Started with ABA therapy in Maryland from Jade ABA
Applied behavior analysis (ABA) is a proven therapeutic approach that builds skills for those with autism. It focuses on:
- Communication and social abilities
- Learning and cognition
- Adaptive living skills
- Behavior and emotional regulation
- Functional independence
Numerous studies show ABA improves outcomes for autistic children and adults. Early intensive ABA therapy has even been shown to boost IQ and reduce symptoms.
That’s why we recommend Jade ABA’s services. Their passionate therapists provide personalized in-home ABA for kids and adults with autism throughout Maryland.
Jade ABA’s proven curriculum is based on the latest behavioral science. Their positive, play-based programs help clients gain confidence and become their best selves.
You can get started with their world-class ABA therapy services by calling (410) 616-0901 today.
Their dedicated team is ready to collaborate with you to achieve progress. They’re confident they can help you and your loved one thrive.
Don’t wait to get the assistance you need. Call Jade ABA now to schedule an evaluation and consultation. This is the first step to unlocking your child’s potential and creating a brighter future.
References:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
Autism Society. (n.d.). Facts and statistics. https://www.autism-society.org/facts-and-statistics/
Autism Speaks. (2022). How is autism treated? https://www.autismspeaks.org/how-autism-treated
Centers for Disease Control and Prevention. (2022). Treatment for Autism Spectrum Disorder. https://www.cdc.gov/ncbddd/autism/treatment.html
Lord, C., Elsabbagh, M., Baird, G., & Veenstra-Vanderweele, J. (2018). Autism spectrum disorder. The Lancet, 392(10146), 508-520. https://doi.org/10.1016/S0140-6736(18)31129-2
Maglione, M. A., Gans, D., Das, L., Timbie, J., Kasari, C., & Technical Expert Panel. (2012). Nonmedical interventions for children with ASD: Recommended guidelines and further research needs. Pediatrics, 130 Suppl 2(Suppl 2), S169–S178. https://doi.org/10.1542/peds.2012-0900O
National Institute of Mental Health. (2018). Autism spectrum disorder. https://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd