Levels of Autism

Autism is a spectrum disorder that affects how a person perceives the world and interacts with others and their surroundings. The disorder can make it difficult to participate in daily life. Doctors use three levels to describe autism.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), doctors categorize autism by assigning level 1, 2, or 3 to two areas of functioning: social communication and restricted, repetitive behaviours.

The level that the doctor assigns will reflect how much outside assistance a person is likely to need in their daily life.

Assessing this correctly can help doctors and other specialists work with the individual to provide the right support. In this article, learn more about the levels of autism.

Level 1: Requiring support

A person who meets the criteria for level 1 may face social challenges that require some support. They may find it difficult to:

• initiate conversations with others

• respond as others would expect

• maintain interest in the conversation

As a result, it can be hard to make friends, especially without the right support. The person may also:

• feel a need to follow rigid behavioral patterns

• feel uncomfortable with changing situations, such as a new environment

• need help with organization and planning

Level

2: Requiring substantial support

People who meet the level 2 criteria need more support than those with level 1 autism. Social challenges can make holding a conversation very difficult.

Even with support, the person may find it hard to communicate coherently, and they are more likely to respond in ways that neurotypical people consider surprising or inappropriate.

The person may:

• speak in short sentences

• only discuss very specific topics

• have difficulty understanding or using nonverbal communication, including facial expression

For example, they may face away from the person with whom they are communicating.

People with level 2 autism may also find daily functioning difficult due to the challenges of coping with change. Facing change might cause them to experience significant distress.

Level 3: Requiring very substantial support

Among autistic people, those with level 3 autism will need the most support. They will find it very difficult to use or understand verbal and nonverbal communication.

The person may:

• avoid or limit interaction with others

• find it difficult to join in imaginative play with peers

• show limited interest in friends

• have difficulty forming friendships

They may:

• face extreme difficulty in changing their daily activities or routine

• follow repetitive behavioral patterns, such as flipping objects, to the point that it affects their ability to function

• experience a high level of distress if a situation requires them to alter their focus or task